Samuel and Kathy Grace Sudolcan don’t want to have to change doctors or other care providers for their son, Zechariah, age 2, who grapples with various medical issues.

The parents attended a Fort Worth press conference June 26 where they supported the care that Cook Children’s Health Care System provides their child and others—care that Cook’s officials say is in jeopardy for many families because of a decision made by the Texas Health and Human Services Commission.

What's happening

Cook Children’s Health Plan officials held the news conference to announce legal action designed to stop the Texas Health and Human Services Commission from taking away its longstanding contract for Medicaid STAR and CHIP programs. Cook’s officials said the commission's decision threatens to remove the choice of Cook Children’s Health Plan from more than 125,000 families in Tarrant County and surrounding areas.

In addition to Cook Children's, the decision for the Medicaid contract also affects Texas Children's, Driscoll Children's and Baylor Scott & White, said Kim Brown, director of public relations for Cook Children's Health Care System.

The Health and Human Services Commission announced its decision in March, which Cook Children's Health Plan officials protested to the state later in March. On June 6, state officials denied the protest. The contract expires in September 2025.

Officials from Cook Children's said they have filed a lawsuit to overturn the decision as well as legal motions for the Health and Human Services Commission to refrain from moving forward with its "flawed procurement results."

Jennifer Ruffcorn, press officer with the Health and Human Services' Office of Communications, said in an email the commission does not comment on pending litigation but did say a "change in managed care organizations (MCOs) holding contracts with HHSC does not affect whether a Medicaid recipient receives services, nor does it affect the services that a recipient is eligible to receive."

The details

Cook Children's officials said if the decision is not reversed, Medicaid-dependent families could face a lapse in critical health care needs while being forced to switch to a “national, for-profit” company. The Health and Human Services Commission's decision was "flawed," Cook Children’s officials said, explaining on their website the state's scoring methodology lacked transparency and disadvantaged regional, provider-sponsored plans like Cook’s.

As a result of the commission's decision, Cook Children’s officials said 1.8 million of the 3.2 million children, pregnant women and adults enrolled in the STAR and CHIP plans will be forced to find a new plan.

Zooming in

Karen Love, president of Cook Children’s Health Plan, said in the press briefing that because of the length of time before the next state legislative session meets, which is in January, there could be time for lawmakers to devote to figuring out a way to make a permanent fix for the programs.

“I think there’s an opportunity for the state to recognize that they missed following some of the required statutes and make a different decision between now and then,” she said, noting that commission officials think their hands are tied. “If that’s the case, then we do want to get to a point where the Legislature can give [the commission] some additional direction,” she said.

Editor's note: This story has been updated to provide additional information.