Senator John Cornyn (R-Texas) is holding up Senate confirmation of President Biden’s nominee to head up the Centers on Medicare and Medicaid (CMS), Chiquita Brooks-LaSure. Senator Cornyn’s action comes in response to the Administration’s withdrawal of a Texas Medicaid waiver that had been approved shortly before the expiration of the Trump Administration. Under the 50-50 Senate, nominees can still make it out of committee (Finance Committee) on a split vote, but Cornyn is using another Senate tradition of allowing a senator to “hold’ up a name or bill. It is not a filibuster unless leadership pushes the issue and forces a member actually to filibuster.


A week before the Cornyn hold, the Senate Finance Committee held a hearing on Brooks-LaSure, with little controversy. A day later, the Administration revoked an extension of the Texas Medicaid waiver. The Trump waiver allowed a 10-year extension of a Medicaid program providing billions of dollars in funding for uncompensated health care. Texas is one of approximately 12 remaining states that still have not opted into a Medicaid expansion under the ACA. The March COVID-19 relief package adds additional benefits to these states even though the ACA already provides a 90 federal percent match in Medicaid funds if the state expands Medicaid to people and families at 150 percent of the federal poverty level. The Biden Administration said they pulled back on the waiver because it did not follow the required public comment period.


The Biden Administration has dropped some Medicaid waivers, especially those that had work requirements as a condition of Medicaid health care coverage. Figures from last year indicate that the state of Texas leads the nation in the number of uncovered children at 995,000, with 12.7 percent without coverage. The Texas numbers represent approximately 25 percent of all uninsured children in the country.