AUSTIN (Nexstar) — A bipartisan group of state senators stood with faith leaders at the Texas Capitol Wednesday to push back on looming changes to Medicaid that could strip almost $9 billion out of the system and leave hundreds of thousands more Texans uninsured.

The concern followed a February memo from the federal Center for Medicare and Medicaid Services (CMS) that sought to end certain payment agreements between Texas and its hospitals. Texas taxes hospitals to cover the state’s portion of Medicaid costs, and in return the state receives federal funds and the hospitals recover their taxes with state Medicaid funding. Texas hospitals also share their Medicaid funds to help hospitals that care for a higher proportion of low-income patients. The federal memo targets this arrangement as illegal.

“For forty years, we’ve had a good system where the state and the federal government cooperate with health care providers to provide care. This has been settled law for a long time. And Texas has built its system around this settled law. But now, because of changes proposed by unelected bureaucrats, this whole system is in jeopardy,” State Sen. Bryan Hughes, R-Mineola, said.

Faith leaders stressed the human toll this esoteric policy shift could bring.

“This move proposed by CMS is not only unconstitutional and unlawful, but it’s also not moral, it’s immoral. We’re talking about hospitals closing,” Bishop James Dixon said. “This is a total crisis for all of us… please do not play politics with people’s lives.”

Texas is already the least insured state in the nation, with almost one in five Texans in need of healthcare coverage. Looming expirations of pandemic-era funding increases also threaten to throw nearly a million more Texans off of Medicaid.

States began disenrolling people from Medicaid in April after three years of a COVID policy that allowed for continuous enrollment. The Kaiser Family Foundation estimates this move will remove 833,600 from Medicaid, including 506,500 children.

Attorney General Ken Paxton, before he was impeached and suspended pending trial, filed a lawsuit against CMS to challenge the funding policy shift.

“CMS’ actions imperil not only local governments’ ability to support Medicaid providers in their area, but the entire State of Texas’ ability to adequately fund its Medicaid program,” Paxton said in April. “This unlawful policy change will endanger vulnerable Texans’ access to health care and handicap local providers’ ability to serve our citizens in every community across the state.”

Democrats, while criticizing the CMS ruling alongside Republicans, argued that expanding Medicaid could be a long-term solution. State Democrats have long argued Texas is keep residents uninsured and leaving billions of dollars on the table by not accepting expanded Medicaid provisions from the federal government. Republicans have long turned that measure down.

Yet Democrats characterized this year’s CMS ruling as coercion.

I think it’s a gross abdication of responsibility that the state has not expanded Medicaid, but put it in context,” State Sen. Nathan Johnson, D-Dallas, said. “If we did expand Medicaid, we’d pick up about a million people. We have more than 5 million uninsured people in Texas. So the idea that you’re going to punish Texas for not expanding Medicaid takes hostage those other 4 million uninsured people, not to mention the many more millions of low income people who cannot afford health care in this state… this tactic is devastating.”