Texas Gets 1115 Waiver Extension

waiver

Hidalgo County health officials breathed a sigh of relief after the federal government last week extended the state’s 1115 Waiver program that provides hundreds of millions of dollars for health care services throughout the county.

1115 Waiver extension helps county keep over 72 health care programs

Naxiely Lopez | Staff Writer  | Posted 13 hours ago

EDINBURG — Hidalgo County health officials breathed a sigh of relief after the federal government last week extended the state’s 1115 Waiver program that provides hundreds of millions of dollars for health care services throughout the county.

The 1115 Waiver program was approved by the federal government after several states, including Texas, refused to expand Medicaid as part of the Affordable Care Act — also known as Obamacare — five years ago.

The 1115 Waiver program allocated $829 million worth of matched funding over a five-year period to this region, which includes the counties of Hidalgo, Starr, Cameron and Willacy, Hidalgo County Health Director Eddie Olivarez said. Basically, matched funding meant the county had to send the federal government taxpayer money in order to get 100 percent of it back, plus some additional funds.

“We did not qualify for that funding because we didn’t have the tax base for it,” Olivarez said. “So what happened is, there was over $400 million that was left on the table that was not utilized to get federal funding to assist with healthcare in our community.”

As a response, Sen. Juan “Chuy” Hinojosa authored House Bill 1623, which created a care funding district for Hidalgo, Cameron and Webb counties. The Hidalgo Care Funding District is not a taxing entity, Olivarez said. Instead, it allowed hospitals within Hidalgo County to develop a Local Provider Participation Fund (LPPF).

Hospitals in Hidalgo County essentially assessed a fee on themselves based on each outpatient served, and that fee was used to help leverage federal funding through the LPPF. Hospitals gave the county the fee they assessed on themselves and the county sent it to the federal government, which in turn sent it back in full plus more based on a multiplier.

“So by the LPPF doing that, we actually were able to recoup nearly 90 percent,” Olivarez said of the total allocated funds. “We did lose some of that funding, but we were able to get up to $729 million of the over $800 million that was allocated over a 5-year period.”

The five-year waiver, however, was set to expire Aug. 31. Last year, Texas asked the federal government to extend it, and last week the federal government finally agreed to extend it for 15 more months.

“We have 72 programs (funded) through the 1115 Waiver (program), adding up to more than $680 million worth of service to our county over the last five years. And this 15-month extension is a very important part,” Olivarez told county commissioners. “If we hadn’t gotten this extension, on Aug. 31 of this year it would have gone belly up.”

NLopez@themonitor.com