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At the Border Health Conference, from left to right: Dr. Victor Gonzalez of McAllen, Dr. Gilbert Handal of Lubbock, Eddie Olivarez of Edinburg, Dr. Carlos Cardenas of Edinburg, R.J. Dutton of Austin, Dr. Hector Gonzalez of Laredo, and Waldo A. Lopez of Laredo.

EDINBURG, RGV – Texas is waiting for final approval to renew a provision that secures federal Medicaid funding, according to a U.S. Representative last week at a healthcare conference in Edinburg.

The Border Health Caucus, which is sponsored by the Texas Medical Association, held its 12th Annual Border Health Conference at the Edinburg Conference Center at Renaissance last Friday to discuss healthcare and medicine along the US-Mexico border.

The keynote speaker of the conference, U.S. Representative Michael Burgess, R-Texas, is a medical doctor that practiced medicine for over 30 years before he ran for public office in 2003.

Rep. Burgess serves as Chairman of the U.S. House Energy and Commerce Subcommittee on Health, and understands the biggest concern for Texas is awaiting approval to renew the 1115 Medicaid waiver, which is set to expire in December.

“Perhaps the biggest thing that’s out there and what my counterparts in the State House talk to me about a lot is the 1115 waiver,” Rep. Burgess said. “And we’ve actually heard it mentioned a few times this morning, so I’m getting the message that it is important.”

Section 1115 of the Social Security Act allows the U.S. Secretary of Health and Human Services (HHS) to waive provisions in social welfare programs under the Act, to allow states to use federal Medicaid funds to make changes in Medicaid eligibility, benefits and cost sharing, and provider payments for low-income adults.

In September 2015, Texas submitted a waiver extension request to the Centers for Medicaid and Medicare Services (CMS) to renew the five-year waiver and to continue receiving federal Medicaid funds until September of 2019.

Rep. Burgess noted the sense of urgency among the State Legislature to secure the 1115 waiver renewal as the expiration date is approaching.

“Remember the 1115 waiver that was given over five years ago was given a 15-month extension in September of 2015, so times up in December,” Rep. Burgess said. “Obviously you don’t want to wait until the 11th hour before that is extended and my understanding is that folks at the state level have asked for an extension on the 1115 waiver.”

The congressman said Florida’s 1115 waiver received final approval last week, a good sign to other states that are still waiting for approval, including Texas.

“So yesterday Florida received notice that their low-income pool was finally approved, it had taken them some time to get through that, that is very similar to the 1115 waiver here in Texas,” Rep. Burgess said. “My hope is but as of 10 o’clock this morning I haven’t heard, but my hope is that Texas extension of the 1115 waiver will be one the things that happens fairly quickly.”

The congressman said people from the Governor’s Office and the State Legislature were surprised and concerned at how long it has taken the Trump Administration to renew the 1115 waiver’s for states, but expects the Texas 1115 Medicaid Transformation Waiver to be extended soon.

“A little bit of concern, and I know I’ve heard from the Governor’s office, heard from people in the State Senate and State House, about the length of time it has taken to get the 1115 waiver approved,” the congressman said. “Yes, there’s a new administration, there was going to be a new administration no matter what before the November election, so a little surprised that things weren’t further along at the agency level, but I think we’ve worked through most of the problems and my expectation that the 1115 waiver will in fact be approved and obviously we’re waiting to see the result in that.”

Repeal and Replace

Rep. Burgess said efforts to repeal and replace the Affordable Care Act (ACA) seemed to have died in the U.S. Senate after Senate Republicans failed to secure 50 votes on a ‘skinny repeal’ of the ACA the previous week.

The congressman, who has voted over 50 times to repeal the ACA, said the Senate ‘simply gave up’ on repeal and replace efforts.

“The crystal ball got a little murky about a week ago and that the Senate left town yesterday after they said they were going to extend deep into the month of August, they simply gave up yesterday and went home,” Rep. Burgess said. “So is it possible that the so-called repeal and replace effort is now done.”

House leadership has already moved on to tax reform, but Rep. Burgess said the repeal and replace debate might spring back when Congress returns from their break and meeting with constituents.

“If you look at House leadership they’re all talking about taxes and tax reform that will give you that impression,” the congressman said. “It is always entirely possible that senators who go home and spend these next three weeks with their constituents, next four weeks with their constituents, may come back to Washington D.C. in December and want a redo of the votes that they walked away from the other night.”

“This is not a political talk, but just from a political observation this could be a ‘read my lips’ moment that some people will encounter when they go back home to their states and meet with their constituents, but maybe not and that’s the difficulty,” Rep. Burgess said.

The congressman concluded from his experience in the various committees he’s in, that the healthcare debate will continue and will not disappear.

“There is no way in the world that we are through with healthcare related issues in this Congress,” the congressman said. “We’ve got a couple of big things that are right on the horizon.”