With Texas lawmakers adamantly opposed to a Medicaid expansion, the waiver expiration creates a potential showdown between state and federal health care officials that, if not resolved, threatens to unravel the state's health care safety net. Coverage rather than uncompensated care pools is the best way to secure affordable access to health care for low-income individuals," CMS acting director Vikki Wachino wrote, "and uncompensated care pool funding should not pay for costs that would be covered in a Medicaid expansion. Florida Gov.