The Centers for Medicare and Medicaid Services revoked the Medicaid waivers of key states like Texas, which the Trump-Pence Administration had granted in order to allow state-based innovation and flexibility in the bloated federal program. The move was an attempt to strong-arm states like Texas into expanding Medicaid under the Affordable Care Act. Ultimately, the state of Texas won a preliminary injunction in August of 2021 barring the Biden administration from refusing to extend a waiver.