Late last week, the agency revoked a 10-year Texas 1115 Medicaid waiver approved in the final days of the Trump Administration that would have provided federal funding for the state’s uncompensated care funding pool, which reimburses hospitals for caring for the uninsured. Though Medicaid advocates had criticized the waiver as a poor substitute for Medicaid expansion, CMS based its rescission on procedural grounds. In its decision letter, CMS states that Texas did not provide an adequate public notice and comment process or a sufficient basis for an exemption to the public notice and comment process. The Trump Administration also approved related waivers in Florida and Tennessee, two other non-expansion states. The Texas decision indicates that waiver reversals in other states may be coming.