In March 2024, the Texas Health & Human Services Commission (HHSC) announced plans to deny contract renewals to several Medicaid providers, including three non-profit, Texas-based children’s hospital plans: Cook Children’s Health Plan (CCHP), Texas Children’s Health Plan, and Driscoll Children’s Health Plan. Despite their combined 60+ years of proven, high-quality care, HHSC intends to award the multi-billion-dollar Medicaid STAR/CHIP contracts primarily to publicly-traded insurers beholden to out-of-state shareholders.

On June 2, 2025, the clock will run out on the Texas Legislature to prevent the largest Medicaid upheaval in state history, costing Texans nearly 2,000 jobs and millions in tax dollars. Without immediate legislative action, at-risk families may lose access to pediatric specialists, leading to the loss of hundreds of local jobs. Furthermore, taxpayers might bear the burden of increased ER overcrowding and higher uncompensated care costs resulting from coverage gaps due to this disruption.

What’s at stake

•  1.8 million children and pregnant women across Texas would be forced to change health insurance plans if HHSC’s current award stands.
• 125,000 North Texas children, including as many as 10,000 medically complex kids who count on Cook Children’s Health Plan (CCHP) today. 
  •  Includes 170 children on ventilators who cannot afford a lapse in care and more than 1,700 children dependent on wheelchairs.
•  Texas stands to lose billions in taxpayers’ dollars if Medicaid and CHIP funding are redirected to out-of-state, for-profit corporations. This change will shift profits to shareholders across America, and away from reinvestments in local non-profit children's health plans based health care programs and access points throughout Texas. Don’t let these dollars leave Texas!
•  Three children’s hospital plans at risk: Cook Children’s, Texas Children’s, and Driscoll Children’s non-profit Health Plans swapped in favor of for-profit insurance companies, most of whom are out of state.

Economic Impact

Why non-profit children's health plans outperform for-profit insurance companies

• Texas-based, non-profit children's health plans pour their resources and earnings back into the communities they serve. These reinvestments build and strengthen communities across Texas.
• 107-year local legacy: Cook Children’s reinvests more than $200 million back into the community every year through community benefits and uncompensated care, not Wall Street dividends. 
• Nine neighborhood health centers (two opening this year) are placed in high-need ZIP codes at no additional cost to taxpayers. This keeps families out of emergency rooms for primary care needs. Cook Children’s funds $1 million annually for each center (total $9 million). Checkup Newsroom
•  Top-tier member satisfaction and quality metrics HHSC failed to consider in scoring the 2024 bids, prompting bipartisan criticism of a “subjective and unsound” procurement. AP News

The Solution:

Several bills have been filed in Austin, and officials are actively shepherding this cause.  We are hopeful there will be legislation finalized prior to June 2.

What’s the benefit of Texas-based, non-profit children's health plans?

• Local control of taxpayer dollars. Funds stay in Texas communities, not out-of-state shareholders.
• Free-market competition. Offers more consumer choice instead of narrowing it.
• Fiscal stewardship and ensures quality care. Maintains a proven, nonprofit plan with an integrated health system and a proven quality track record vs. paying corporate margins.
• Family values & self-reliance. Protects parents’ ability to choose trusted doctors and keeps medically fragile kids out of crisis care that drives up costs.

Additional Fast Fact:

• Cook Children’s Healthy Homes Asthma Program significantly improves the quality of life for families by remediating homes to eliminate asthma triggers and providing essential resources like cleaning supplies. To date, we have improved the home environments of 760 children living with asthma, including 314 health plan members.

SaveCookChildrensHealthPlan.com is a valuable resource packed with facts, articles, timelines, photos, member/patient stories, and more. Visit the website here.

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