Cook Children’s issues ‘dire’ warning if TX fails to address health coverage

Nearly 2 million Texas children and expecting mothers could face disruptions in their health coverage if the state Legislature fails to act on a pair of bills in the coming weeks, according to Cook Children’s Health Plan.

The health plan run by the Fort Worth-based children’s hospital warned of a “looming crisis,” saying in a press release Friday that “recent legislative inaction” threatens the health coverage of 1.8 million children and expecting mothers, 125,000 of which are within the plan’s Tarrant County service area.

Bills brought by state Rep. Charlie Geren, a Fort Worth Republican, and state Sen. Juan “Chuy” Hinojosa, a Democrat from Corpus Christi, aim to change how the Texas Health and Human Services Commission awards contracts for the management of Medicaid programs that provide coverage to low-income families.

Medicaid’s STAR program covers children in low-income families and the CHIP program provides coverage to families whose income is too high to qualify for STAR but who cannot afford private health insurance.

The bills address what Cook Children’s called a “flawed procurement process” by the health commission that “inexplicably favored large, for-profit, out-of-state national plans over established local children’s health plans.”

Last year, the health commission declined to award the Medicaid contracts to Cook Children’s and two other nonprofit plans run by Driscoll Children’s Hospital in Corpus Christi and Texas Children’s Hospital in Houston, choosing instead for-profit insurers like Aetna, Blue Cross Blue Shield, UnitedHealthcare and others.

The Texas-based organizations have a better track record of serving these vulnerable populations, delivering high-quality care and maintaining high levels of patient, physician and provider satisfaction, the hospital said. If the awards that the state announced last year go into effect, the new contracts will require 1.8 million children and pregnant women across Texas to have to choose new health plans, most of which are run by out-of-state companies.

“The potential consequences of inaction are dire, inevitably leading to further costly litigation and, more importantly, threatening to disrupt the vital health care services that countless Texas children and their families depend upon,” Cook Children’s said.

A Cook Children’s spokesperson did not respond to an email seeking elaboration on the nature of the inaction in the Legislature.

The Star-Telegram reached out to Geren’s and Hinojosa’s offices, but did not receive immediate responses.

Who will the Legislature’s inaction on child health coverage affect?

Cook Children’s warned of a “precarious situation” with potentially “devastating consequences” if the legislature does not act on the bills by June 2, the day the session closes.

Those consequences will be felt by “10,000 children with complex medical conditions, including 170 relying on ventilators and 1,700 who use wheelchairs,” the hospital said.

The bills’ failure would also have economic repercussions, putting 400 jobs in Tarrant County and as many as 2,000 jobs statewide at risk, the press release states.

Cook Children’s highlighted the $200 million it reinvests in annually in the local community and warned that leaving the health commission contract awards unchanged “will drain millions of dollars from our state, benefiting out-of-state shareholders instead of Texas children and businesses.”

What remains of the 2025 legislative session is a “24-day critical window” for lawmakers to take action “to rectify this flawed procurement process,” the hospital said.

“We implore our leaders to choose Texas children and Texas-based, non-profit children’s health plans over out-of-state, for-profit interests,” Cook Children’s said. “The exclusion of dedicated children’s health plans from this process demands explanation, as the health and stability of our health care system are at stake.”

Texas court gave Legislature time to address Medicaid contracts issue

Cook Children’s Health Plan sued the health commission in June 2024 over the Medicaid contract awards after the commission denied an appeal earlier that month.

The contracts were set to take effect in September of this year, but a district court judge issued a temporary restraining order in October, ruling the awards “will impose significant harm and confusion on millions of Texas’ STAR & CHIP members.”

The judge set a hearing for after the legislative session in order to give lawmakers the chance to address the contracting issue, a Cook Children’s spokesperson said, but was unable to provide the date of the hearing. Court records were not immediately available online.

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