Don’t Let Texas Move Fort Worth-Area Kids Off Health Plans Their Families Prefer

A health plan that serves 125,000 vulnerable children and families in the Tarrant County area is in danger of being destroyed.

Cook Children’s dedication to the North Texas community is far reaching and deeply rooted. In addition to operating two medical centers, neighborhood health centers, urgent cares, home health and more, we operate a health plan that currently serves 125,000 Tarrant County area residents, most of whom are children.

Cook Children’s Health Plan has provided health care coverage for families and children with limited resources for more than 20 years, and Cook Children’s itself has been serving this community for more than 107 years.

However, last year, the Texas Health and Human Services Commission (HHSC) denied Cook Children’s Health Plan a renewed contract to serve its membership. This threatens the health care choices of thousands of vulnerable North Texas children.

HHSC’s decision would upend that choice of coverage for North Texas families in need. We are doing everything we can to protect those families from this harmful decision.  

Two proposed bills offer a ray of hope. House Bill 3538, introduced by Rep. Charlie Geren, R-Fort Worth, and Senate Bill 2331, filed by State Senator Tan Parker, R-Flower Mound, would give families the right to choose whether they want to remain on Cook Children’s Health Plan, and other care plans, or not.

Cook Children’s Health Plan provides care through two state programs: STAR (Medicaid) and CHIP. HHSC oversees the contracts – and therefore, the funding — for those programs. In March 2024, HHSC announced it would not renew contracts for major community-based, not-for-profit health plans, including Cook Children’s Health Plan and two other health plans in South Texas and the Houston area.

Instead, HHSC chose to give those contracts to for-profit health care companies, all of which keep their central operations out-of-state and their proceeds benefit out-of-state shareholders. The decision would force 1.8 million children and pregnant women who qualify for the Medicaid STAR and CHIP programs to switch from the health plans they rely upon to unfamiliar, corporate insurers.

This move would needlessly yank away the familiar integrated care that families rely on and hand it to strangers. This could delay or disrupt care for vulnerable children, including patients on ventilators, who are enrolled in the Cook Children’s Health Plan.

Liz Piñon’s family is among those who rely on Cook Children’s Health Plan, which she described as a “godsend.” Piñon’s 12-year-old triplets and 19-year-old son have various complex medical needs and have relied on Cook Children’s Health Plan for six years. Through the plan, she has access to specialists, therapists and unique programs under the same roof, as opposed to having to navigate multiple practices for each medical need.

She also was paired with a service coordinator, who helps coordinate all the specialized care the family needs. In Piñon’s case, the coordinator not only connected the family with specialists and set up appointments, but she also ensured the triplets could attend daycare. 

“It was such a nightmare doing private insurance for our kids,” Piñon said. “We were living check-to-check. Even though my husband had a white-collar job, we were in the food lines the last week of the month to get vegetables to puree.”

Cook Children’s Health Plan is able to provide personalized care like the Piñons’ because its staff live and work alongside the families they serve. Staff work one-on-one with families and go the extra mile; they help with transportation to appointments, provide healthy groceries when resources are limited and offer emotional support.

But private, out-of-state insurance companies are not embedded in the communities they serve. And the profits those companies earn from covering Texas families flows to corporate offices and shareholders’ pockets out of the state.

We believe HHSC’s current contract-renewal process is unsound and has led to HHSC’s flawed decision to decline contracts to high performing health plans, like Cook Children’s Health Plan. The current process is subjective and ignores how health plans, like Cook Children’s, have been providing quality care for Texans for more than two decades.

That is why the proposed bills would change the law on how HHSC awards contracts. The bills would replace the current error-prone, subjective bidding process with a more modern and straightforward system. Most importantly, the bills would allow families enrolled in STAR, CHIP and other Medicaid programs to choose whether they want to remain on their current health plans or switch to the private insurers.

We believe HHSC’s decision-making process was not consistent with the law. HHSC was legally required to consider past performance and quality when awarding these contracts. However, HHSC’s decision did not take past performance of the plans into consideration. HHSC ignored telling track records, like Cook Children’s Health Plan’s high member ratings and demonstrated quality of care, and instead chose untested promises made by for-profit insurance companies.

This goes against even common-sense decision-making.

Imagine choosing between two doctors. One has a website where they promise they’ll take care of you. The other has decades of experience and thousands of patient reviews about incredible care. Which will you choose? The state chose the first. But we believe families should make their own choices.

We urge the Legislature to give families the power to choose. Proposed legislation would give families this right. Let’s protect our children and ensure they receive the quality health care they deserve.

To learn more and support our efforts, please visit SaveCookChildrensHealthPlan.com.