Texas stands by its decision not to award major Medicaid contract to Cook Children’s
The Texas Health and Human Services Commission is standing by its decision not to award a large Medicaid contract to Cook Children’s Health Plan, a major provider of Medicaid health insurance to kids and pregnant people in the Tarrant County area.
In March, the state’s Health and Human Services Commission announced that it would not award a Medicaid contract to Cook Children’s and multiple other local health plans. Instead, the state said it planned to award the contracts to United Healthcare, Molina, Blue Cross and Blue Shield and Aetna for Tarrant County and five neighboring counties. The contracts are to provide health insurance to low-income kids and pregnant women who qualify for the Medicaid STAR and CHIP programs in the Tarrant County region.
The health plan, which is a subsidiary of the Cook Children’s pediatric health system, filed an appeal. On Thursday, a deputy executive commissioner for the Health and Human Services Commission denied that appeal.
Cook Children’s still has another chance to convince the state to change its mind. The health plan will file a second appeal, this one to Executive Commissioner Cecile Young.
Young will make the final decision on the appeal before the state officially awards the Medicaid contracts, which are some of the largest contracts the state government awards.
In a statement, a spokesperson for Cook Children’s said the health plan would file another appeal.
“This procurement process has been flawed from the beginning and we will pursue every legal option available, including filing an immediate appeal,” the statement read. “We are confident in the strength of our case and believe we will prevail.”
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HHSC did not immediately respond to an email asking for comment.
Currently, Cook Children’s Health Plan has two state contracts. One is to provide Medicaid health insurance to all of the kids and pregnant people enrolled in the STAR and CHIP programs. The health plan also has a second contract to provide Medicaid health insurance to kids with disabilities in the STAR Kids program. Altogether, there about 125,000 people in the area who get their health insurance through Cook Children’s Health Plan.
But the state’s decision would affect more than just those who get insurance through Cook Children’s. The state also chose not to award a contract to Wellpoint, which currently provides health insurance to about 46% of kids and families in the STAR and CHIP programs. Altogether, more than three out of every four people on Medicaid would have to pick a new plan next year. These families would still be eligible for Medicaid and CHIP health insurance, but critics of the state’s decision said that the complex process of switching insurance providers could cause a delay in care.
Multiple local lawmakers have called on HHSC to reverse its decision. State Sens. Tan Parker and Charles Perry wrote to Young last week, asking her to “either cancel the current procurement process or delay any decisions until after the legislative session in January 2025.” A group of six state representatives from the Fort Worth area sent Young a similar letter Tuesday to request a delay in the final decision.
