Archive for Affordable Care Act


Feds Rescind Texas Medicaid Waiver

A federal Medicaid waiver approved for the state of Texas in the waning days of the Trump administration has been rescinded by the Biden administration.

The waiver called for spending as much as $100 billion for health care for low-income Texans over the next ten years.

Officially, the Centers for Medicare & Medicaid Services revoked the waiver on technical grounds, maintaining that the agency “… erred in exempting the state from the normal public notice process – a critical priority for soliciting stakeholder feedback and ensuring public awareness.”  The Washington Post, however, reports that according to two unnamed federal health officials, the decision was “… an effort to push state officials toward accepting the Affordable Care Act’s Medicaid expansion, which would cover more low-income residents….”

According to the Post, “Health advocates had described that waiver as an effort to work around the federal Medicaid expansion by setting up alternate funding to help cover the costs of uninsured patients.” The Post notes that the Biden administration has been urging Texas and the other 11 states that have not expanded their Medicaid programs under the Affordable Care to do so.

Learn more about the CMS decision to rescind the Texas …

Federal Health Policy Update for Wednesday, March 24

Beginning today, DeBrunner & Associates is expanding its regular updates to encompass a broader scope of federal health policy endeavors to include other matters of importance to providers.  Feel free to share this newsletter with others in your organization or to send us the email addresses of those you think might be interested and we will send it directly to them.

The following is the latest such information from the federal government as of 2:45 p.m. on Wednesday, March 24.


The temporary delay of implementation of the Medicare two percent sequester expires at the end of the month and amid considerable advocacy by the health care community, Congress is considering extending this delay.  Last week the House passed a bill that would extend the current moratorium through December 31, 2021 and would waive “PAYGO” rules that apply to the American Rescue Plan Act that would necessitate an additional two percent sequester on Medicare payments starting in January, which would be added to the existing sequester to result in a four percent sequester. The Senate will not take up the House bill but could take up S. 748, which would extend the current moratorium for the duration of the COVID-19 …

ACA Medicaid Expansion Cut Young Adult Uninsurance in Half

The number of uninsured young adults fell nearly 50 percent after the Affordable Care Act authorized states to expand their Medicaid programs, a new study has found.

According to the Urban Institute, the uninsured rate among people between the ages of 19 and 25 fell from 30.2 percent to 16 percent between 2011 and 2018, with most of the decline coming between 2013 and 2016, when the first round of states expanded their Medicaid programs.

The decline in the rate of uninsured young adults mirrored declines in the overall U.S. uninsured rate, which fell from 27.7 percent to 11.3 percent in states that expanded their Medicaid programs.

Learn more about how implementation of the Affordable Care Act affected the insurance status of young adults in the Urban Institute report “Impacts of the ACA’s Medicaid Expansion on Health Insurance Coverage and Health Care Access Among Young Adults.”…

Coronavirus Update for Friday, January 29

The following is the latest COVID-19 information from the federal government as of 2:30 p.m. on Friday, January 29.

The Biden Administration

The Biden administration has issued an “Executive Order on Strengthening Medicaid and the Affordable Care Act” to make it easier for the uninsured to get coverage during the COVID-19 pandemic.  The order:

  • reopens access to the federal Affordable Care Act health insurance marketplace for three months, from February 15 through May 15, and restores some of the Affordable Care Act exchange marketing funds that had been eliminated by the previous administration and
  • calls for the review of all existing regulations, orders, guidance documents, policies, and any other agency actions that may be inconsistent with the administration’s desire to enhance access to health insurance through the Affordable Care Act, including policies that undermine protections for people with pre-existing conditions and policies that make it harder for people to get insurance coverage or to enroll in Medicaid.

Resources for learning more about this executive order are:


Provider Relief Fund

HHS has

Azar: Budget Proposes Reducing Medicaid Matching $

The federal government would reduce its financial commitment to state Medicaid programs under the FY 2021 budget the Trump administration proposed earlier this month.

While testifying before the Senate Appropriations Committee’s Subcommittee on Labor, Health and Human Services and Education, Health and Human Services Secretary Alex Azar acknowledged that the administration’s proposed FY 2021 would eliminate the enhanced rate at which the federal government matches state funds used to serve individuals who enrolled in Medicaid through the Affordable Care Act’s Medicaid expansion provision.  That enhanced rate calls for the federal government to pay 100 percent of the costs associated with the Medicaid population during the first year of Medicaid expansion, eventually scaling down to 90 percent after 2020.  Nationally, the federal government’s matching rate for the pre-expansion population is 57 percent; that matching rate would not be affected by this proposal.

This aspect of the administration’s proposed FY 2021 budget has mostly flown under the radar since the budget’s release and has received little public attention.

In explaining the proposal, Azar said that enhanced funding for the Affordable Care Act’s Medicaid expansion population was biased against the disabled, women, and children.

Learn more about what Secretary Azar said about federal …