Since the 2011 creation of Texas’ Medicaid 1115 Waiver, the hospital Uncompensated Care (UC) payment program has made more than $38 billion in payments potentially available to Texas’ public and private hospitals to offset some of their unreimbursed charity care costs. Texas hospitals reported $7 billion in unreimbursed charity care costs in 2021 alone. As the number of uninsured Texans remains persistently high – currently 21.4 percent of the population, or 5.2 million – UC payments to offset some of the costs of their care are essential.