(Fort Worth, Texas – May 9, 2025)—Cook Children's expresses profound concern Today over a looming crisis that threatens health care access for Texas' most vulnerable children. A staggering 1.8 million children and expectant mothers statewide, including 125,000 within Cook Children’s Health Plan’s Tarrant County service area, face potential disruptions in their health coverage due to the current situation. 

This precarious situation will have devastating consequences for 10,000 children with complex medical conditions, including 170 relying on ventilators and 1,700 who use wheelchairs. Beyond the direct impact on these children and their families, the repercussions extend to our community's economic stability, potentially costing 400 jobs in Tarrant County and up to 2,000 jobs across the state within Texas-based children’s health plans if this issue is not resolved. 

Despite hopeful signs earlier this session, with bill language from Representative Charlie Geren and Senator Juan “Chuy” Hinojosa making its way to the Senate Committee on Health and Human Services, recent legislative inaction suggests a willingness not to address this critical matter during the current legislative session as intended by the courts. This is an urgent situation demanding immediate attention. June 2, 2025, is the critical deadline.

 At the heart of this crisis is a flawed procurement process by the Health and Human Services Commission (HHSC) that inexplicably favored large, for-profit, out-of-state national plans over established local children’s health plans like Cook Children's, Driscoll Children's Hospital, and Texas Children's Hospital in Houston. These Texas-based organizations possess a proven track record of delivering high-quality care while achieving positive patient outcomes and maintaining high member and physician, and provider satisfaction. HHSC’s process failed to adequately consider past performance, quality of care, and health plan member satisfaction, leading to this deeply concerning outcome. 

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.

 The question remains: why has decisive action not been taken? 

For more than 107 years, Cook Children's mission has been unwavering: to do everything for the health and well-being of the children we serve. This commitment compels us to continue fighting tirelessly for these children and their families. The stakes are simply too high to do otherwise. Our state's leaders have a critical 24-day window to rectify this flawed procurement process. We urge them to prioritize Texas children by investing in their health care and ensuring local, proven children’s health care providers can continue serving our communities. Allowing the current HHSC contract awards to stand will drain millions of dollars from our state, benefiting out-of-state shareholders instead of Texas children and businesses. Cook Children’s alone reinvests $200 million annually in our community, demonstrating our commitment. We implore our leaders to choose Texas children and Texas-based, non-profit children’s health plans over out-of-state, for-profit interests. 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. 

The time for action is now! Before it’s too late.

Vivienne Molen, a 15-year-old with type 1 diabetes, is one of thousands of children who rely on the Cook Children’s Health Plan (CCHP) for life-saving treatment. Now, she is at risk of losing insurance coverage for the care she needs.

On March 7, 2024, CCHP was denied a new contract for STAR & CHIP Managed Care Services by the Texas Health and Human Services Commission (HHSC). Though CCHP’s initial protest to the state’s decision was rejected, the team has filed another appeal and continues to fight for a contract renewal.  

If not reversed, this ruling will result in a serious disruption in care for nearly 125,000 low-income families, pregnant women, and medically complex children like Vivienne. 

Vivienne's Story 

In December 2019, when Vivienne was 10 years old, she became critically ill with both the flu and strep throat. When she wasn’t responding to typical treatments, her mother, Tricia Moon, brought her to the emergency room. From there, Vivienne was rushed to the ICU, where she was diagnosed with type 1 diabetes. “It was confusing, scary and overwhelming,” Tricia said. “Vivienne’s care became quite complex.”

When Tricia went through a divorce, she and Vivienne lost their health insurance coverage. Since then, they have been members of the CCHP STAR Medicaid plan. 

“Insulin is so expensive and we are so grateful that it’s covered under the STAR plan,” Tricia said. “We’ve always felt supported. I think it would just be terrible [if the new contract is denied].”

For Vivienne, getting diagnosed with type 1 diabetes was life-altering. Her chronic health issues have robbed her of the opportunity to be a normal teenager, but she has found a safe space in Cook Children’s. 

“I always love coming to Cook Children’s and I look forward to coming to my appointments,” Vivienne said. “It is the one place where I feel like I can try to gain control of my diabetes.”

Vivienne’s robust care plan involves seeing numerous specialists and getting labs and scans on a regular basis. She also frequently visits the emergency room. 

“I couldn’t imagine the stress it would put on my family, my mom, to have to pay for everything,” Vivienne said. 

As Tricia reflects on Vivienne’s journey, she becomes overwhelmed with emotion. 

“Vivienne is so resilient,” Tricia said. “She should never ever have to worry about how the adults in her life are going to care for her. That responsibility is not hers to bear.” 

What's at Stake  

Vivienne and other STAR and CHIP members could not only lose their health coverage, but also the vital support of their case managers. 

The CCHP case management team helps members in countless ways, from connecting them to food and transportation resources, to coordinating appointments and follow-ups, to ensuring they receive the medications they need.  

“Our health plan staff is very knowledgeable about the programs and resources in this community. They know how to access those services and get things for families that they need,” said Vivienne’s case manager, Jami Jensen, RN, CCM. 

If the STAR and CHIP contract is ultimately denied, more than one hundred thousand members and children could be forced to switch health plans, find new in-network doctors, and undergo lengthy authorization processes for life-saving treatments. 

“There could be issues with getting the care they need in a timely manner,” Jami said. “It’s just added stress on them, trying to navigate something from the start when there were services already in place that they were happy with.”

Without the STAR and CHIP programs in place, CCHP would likely become unsustainable—and Jami, along with hundreds of other CCHP employees, could lose their jobs. 

“I want to make sure these families get the things they need for their health, and I have a lot of experience and skills doing that,” Jami said. “Not being able to continue to help would be hard.”

What's Next? 

The current CCHP STAR and CHIP contracts will remain active through Aug. 31, 2025. At that time, families currently enrolled in CCHP will be forced to choose a new plan from four national, for-profit insurance companies— Aetna, Blue Cross Blue Shield of Texas, Molina, and UnitedHealthcare—three of which have no experience in our local market. Until then, CCHP will continue to appeal the state’s flawed decision.

“We’re putting our money back into the community, and we feel like that is what makes us different from the national companies,” said CCHP president, Karen Love.

Love is ready and willing to compete with other plans in the area, as long as families continue to have meaningful options. 

“This is not about money for the system. This is because Cook Children’s Promise is to care for every child who needs us,” Love said. “This is a fight for the children in our community, to make sure they still have access to the high-quality care that we provide.” 

For more information, including key facts, videos, photos and recent media coverage, please visit SaveCookChildrensHealthPlan.com.  

The state of Texas is trying to end a program that allows thousands of children to thrive.

That’s the message Liz Piñon wants to send to state leaders trying to end the Cook Children’s Health Plan. Liz’s children are among the 8,000 medically fragile kids on the health plan; her 12-year-old triplets and 19-year-old son have various medical needs and have relied on CCHP for six years.

In March, the Texas Health and Human Services Commission announced plans to deny Cook Children’s a new contract for the Medicaid STAR and CHIP managed care programs. In June, Cook Children’s took legal action against the state for its decision to cut funding for the program, which has provided care for more than 20 years.

“If they don't have a child like we do, I feel like all families have to know that they can be in this position from one minute to the next,” she said. “And if they do, you know, having a system like the Cook Children’s Health Plan is such a godsend.”

For Liz’s family, paying for medical needs was like paying for another mortgage.

Liz’s triplets, born at 25 weeks, each have their own medical complexities requiring four or five specialty medications. Liz initially had to stay home with the kids because no daycare would take them due to their medical needs. The financial cost of medication, medical care and other specialty needs quickly added up.

“It was such a nightmare doing private insurance for our kids,” Liz 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.”

Six years ago, everything changed when the family applied for care with Cook Children’s Health Plan. When Liz called to apply, the nurse she talked to knew the kids’ doctors, the equipment they might need and the therapists they might need now and in the future. This was different from talking to a private insurance agent who likely had no connection to Liz’s family, the doctors they saw or the community care available to them.

With Cook Children's Health Plan, the family has access to specialists, therapists and various programs under the same roof as opposed to having to navigate multiple practices for each medical need.

For almost eight years, the family saw the same pediatrician at Cook Children’s. While the doctor is no longer at the hospital, it made all the difference to have a physician who developed a relationship with the kids and the family as a whole.

“It's not easy being a Latina with special needs kids in Texas, right? I feel like I was always scrutinized a whole lot more,” Liz said. “So it was just nice to know that this doctor knew my family, knew everything I did for my kids, right? And was a voice for our family.”

Cook Children’s Health Plan also connects families with a service coordinator, who helps coordinate all the specialized care the family needs. In Liz’s case, the coordinator not only connected the family with specialists and set up appointments, but she also ensured the triplets could attend daycare. This alone changed Liz’s life; Liz has been able to serve as an expert on the Department of Education Committee because she does not have to stay home 24/7.

As young tweens, the Piñon triplets are thriving. One of her daughters participated in a wheelchair dance performance in Los Angeles this summer. Her other daughter, who has severe anxiety, was able to perform on a stage in Disney with her choir.

“Anyone that sees my kids says, ‘Oh, they look fine,’” she said. “They don't know all the thousands of appointments, thousands of hours of therapy, thousands of phone calls that have been made for them to be thriving and doing as well as they are.”

The Cook Children’s Health Plan has allowed Liz and her family to thrive. That may not have been the case under a different insurance plan, like the ones the state plans to fund instead. Without Cook Children’s Health Plan, thousands of kids may lose that same opportunity to truly thrive.

In 2011, she shadowed a social worker in the Emergency Department, and after that day she knew Cook Children’s was the place for her.

“When I was at the medical center I felt so many positive vibes and I just can’t wait to be a part of that and to learn as much as I possibly can,” said Rustin.

Rustin, a licensed baccalaureate social worker, will be part of a brand new team called STAR Kids, the new Cook Children’s Health Plan. STAR Kids is a state level medical program that helps children across Texas. Cook Children’s recently built brand new facilities for their team and is in the process of hiring over 100 new employees.

Before working at Cook Children’s, Rustin worked with a mental health organization in Fort Worth. She hopes to go back to school in the next few years to receive her Master’s Degree in social work. And with Cook Children’s generous tuition reimbursement plan, she sees it as a very attainable goal. After getting her Master's, she hopes to return to Cook Children’s and build her career within the medical center.

- Written by John Davidson

To help you through the process, here are five helpful questions to consider as you shop for health insurance:

1. Does my plan cover services including my pediatrician, specialty care, urgent care and home health?
2. Will I be charged for copayments for my doctor visits?
3. Will be charged a deductible or coinsurance for inpatient hospital services, home health or skilled nursing facility services?
4. Will eye exams and dental exams be covered?
5. Will specific chronic conditions, such as asthma, diabetes and heart conditions, be covered?

And that’s just scratching the surface of questions you should be asking. Learn much more in the “things to know when shopping for insurance” section of www.cookchildrens.org/insurance.