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WASHINGTON — The Biden administration is pressuring states to expand Medicaid — and it’s setting up a tussle with the hospital industry, too.

The Biden team is running out of options to ensure coverage for low-income people in states that have chosen not to expand coverage under the Affordable Care Act. An early overture in Texas reveals one of its strategies: There, the administration is forcing state officials to renegotiate an agreement that gives hospitals money for uninsured patients, and hospitals are nervous that their funding could be cut in the process.


While hospitals across the country are outspoken supporters of Medicaid expansion, they will also work to defend the entrenched systems that guarantee they’ll get nearly $4 billion in funding per year.

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