The Texas Department of Health and Human Services recently made a concerning decision. The company announced its intention to award contracts in the region to four state-run commercial insurance companies through a dubious bidding process. Shockingly, despite 20 years of outstanding service to the community, the Cook Children's Health Plan was not renewed. This disrupts critical systems without any explanation or justification.
For more than a century, Cook Children's has been a pillar of our community. We've grown with generations of families, weaving the promise of excellent health care into the very fabric of our city. The promise is clear. All children, especially the most vulnerable, deserve the best care, with both excellence and compassion.
Our strength lies in our integrated pediatric health care system, a model of efficiency that provides a seamless experience for children and families. From preventive care to emergency care, specialty care, and home health care, our system provides everything children need. A critical component of our system, Cook Children's Health Plan serves families enrolled in Medicaid and the Children's Health Insurance Program (CHIP). Praised by healthcare leaders across the country, this integrated design ensures smooth coordination between all services, ultimately delivering the best possible outcomes for young patients.
There are other reasons to be concerned about the Texas Department of Health and Human Services' decision. The Texas Tribune reported that the renewal process was deeply flawed and that Aetna likely received advance copies of proposals from 17 competitors, including the company. This has given Aetna an unfair advantage, and we are demanding prompt action from the government.
Beyond the procedural issues, the decision itself is devastating. They are robbing our communities of hundreds of millions of dollars and putting the checks in the pockets of out-of-state corporate shareholders. This isn't just about paperwork. This puts the health of 125,000 children and mothers at risk, including more than 170 ventilator-dependent patients who depend on our seamless care. The impact extends far beyond Tarrant County, affecting 1.8 million children and expectant parents across the state, according to the Texas Tribune.
For more than 20 years, Cook Children's Health Plan has been a trusted and proven model for managing care. We urge the state to ensure that Cook Children's Health Plan, like other eligible plans, seamlessly serves our communities and continues to care for our most vulnerable children and families. We urge you to reverse your recent decisions.
Without a health plan, the ability to provide excellent care throughout the system is compromised. Children dependent on Medicaid are disproportionately affected, leaving them vulnerable and at greater risk.
I would like to share some facts and scenarios that will help explain this situation more clearly.
- In our service area alone, more than 75% of children and mothers receiving Medicaid will be forced to change their plans, causing unnecessary changes in care. This comes on the heels of the easing of the pandemic and the disruption these families are already experiencing. Have experience re-enrolling in health insurance.
- Imagine the disruption this change would cause for families of children with complex medical needs who are on ventilators or in wheelchairs. You'll have to find a new doctor, new home therapy and nursing care, and an entirely new system. If you've ever felt frustrated getting a simple pre-approval for a routine surgery, imagine that frustration multiplied tenfold.
- We are passionate about our community and uniquely equipped to serve it. Cook Children's provides more than $200 million in community benefits and free care to families in need each year.
- We are not a for-profit shareholder and reinvest funds into countless programs, including neighborhood health centers in underserved communities. When the Las Vegas Trail region's ninth center opens next year, it will be a new ray of hope for families struggling to access quality care.
This fight is for our children, for systems that work, for stability, and for the health of our communities and the promise we make to all children. We have the facts on our side and will not give up on the families who need us most. This is about protecting a legacy built on decades of trust and data-driven results.
Dear Texas Department of Health and Human Services, it's never too late to do the right thing. Let Cook Children's Health Plan continue to coordinate and manage the care of the children and families who depend on us.
Children's health and well-being depend on proven, reliable systems, not gambles on the unknown.
Rick W. Merrill serves as President and CEO of Cook Children's Health Care System.
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