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Cook Children’s Health Warns of Looming Medicaid Crisis

Cook Children’s Health Care System is sounding the alarm over what it calls a looming Medicaid crisis that could endanger the health care access of 1.8 million children and expectant mothers across Texas.

The Fort Worth-based health system is urging immediate legislative action before a critical June 2 deadline, warning that inaction could disrupt services for thousands of medically fragile children and lead to significant job losses.

In North Texas alone, 125,000 patients served by Cook Children’s Health Plan in Tarrant County could be affected, including 1,700 children in wheelchairs and 170 who rely on ventilators. Across Texas, approximately 10,000 children with complex medical needs face uncertain futures.

The crisis stems from a controversial procurement decision by the Texas Health and Human Services Commission (HHSC), which awarded Medicaid contracts to large, out-of-state, for-profit health plans. In doing so, it excluded trusted, Texas-based nonprofit providers such as Cook Children’s, Driscoll Children’s Hospital, and Texas Children’s Hospital in Houston.

"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," states a release sent out by Cook Children's

Cook Children’s says the HHSC’s process failed to properly account for provider performance, patient outcomes, and satisfaction scores, areas where these local providers excel.

The repercussions could extend beyond the patients.

The health care system warns that as many as 2,000 jobs statewide, including 400 in Tarrant County, could be lost if local children’s health plans are forced to shut down.

Despite legislative efforts earlier in the session, including bill language from state Rep. Charlie Geren (R) and state Senator Juan “Chuy” Hinojosa (D), there are growing concerns that lawmakers will fail to act in time.

Cook  is calling on state leaders to rectify what it sees as a deeply flawed procurement process and prioritize the well-being of Texas children over out-of-state corporate interests.

Daniel Molina

Daniel Molina is an award-winning senior reporter based in Miami. He holds a bachelor’s degree in English Literature from Florida International University.

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