Don’t let Texas move Fort Worth-area kids off health plans their families prefer | Opinion

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 dates back 107 years; it is far-reaching and deeply rooted. We operate two medical centers, neighborhood health centers, urgent cares, home health services and more, And our Cook Children’s Health Plan has provided health care coverage for families and children with limited resources for more than 20 years.

However, last year, the Texas Health and Human Services Commission denied Cook Children’s Health Plan a renewed contract to serve its membership. The commission’s decision would upend the coverage choices of thousands of Dallas-Fort Worth area families. We are doing everything we can to protect those families.

Two bills proposed in Austin offer a ray of hope. House Bill 3538, introduced by Rep. Charlie Geren, R-Fort Worth, and Senate Bill 2331, filed by Sen. 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.

Cook Children’s Health Plan provides care through two state programs: STAR (which is part of Medicaid) and CHIP. The state health commission oversees the contracts — and therefore, the funding — for those programs. In March 2024, the commission 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, the commission chose to give those contracts to for-profit health care companies, all of which keep their central operations out-of-state. 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 children with serious conditions, 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 had coverage through Cook Children’s Health Plan for six years. Through the plan, she has access to specialists, therapists and unique programs under the same roof, rather than having to navigate multiple practices for each medical need.

She also was paired with a service coordinator, who helps manage 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 for families 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 the health commission’s contract-renewal process is unsound and has led to the flawed decision to decline contracts to high-performing health plans, such as Cook Children’s Health Plan. The current process is subjective and ignores how such health plans, have been providing quality care for Texans for more than two decades.

That is why the proposed bills would change the law on how the commission 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 the commission’s decision-making process was not consistent with the law. Agency officials were legally required to consider past performance and quality when awarding these contracts. But the commission ignored telling track records, such as 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 promises on a website to 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. The proposed bills 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.