"It is like our lifeline. It is something to hold onto." – Breanna Hernandez, Cook Children's Health Plan Member

Breanna Hernandez getting a hug from her son MJ

"When other systems have failed, Cook Children’s Health Plan has leaned in. That matters when you’re a parent who is constantly fighting for your child’s needs." – Dr. Liz Pinon, Cook Children’s Health Plan Member

Children in Jeopardy: The Piñon Family's Story

Dr. Liz Piñon with her triplets standing under twinkling lights

"The Cook Children’s Health Plan means quality care that is designed specifically for the needs of my kids." – Rebekah Jones, RN, Cook Children's Health Plan Member

Children in Jeopardy: Rebekah's Story

Rebekah Jones, RN standing in a hallway with her three sons in matching black and white checkered shirts

Save Cook Children's Health Plan

What's happening now

Statement (June 6, 2025)

"Cook Children's is deeply disappointed that Texas lawmakers failed to pass crucial legislation that would have prevented the most significant disruption to the families receiving Medicaid benefits in 25 years of managed care. This essential reform aimed to address how the Texas Health and Human Services Commission (HHSC) awards contracts for its STAR and CHIP programs. Despite the legislative session ending, our commitment to the 125,000 Tarrant County area families and children who depend on Cook Children's Health Plan (CCHP) and our Promise remain unwavering. We will now continue our fight for them in court."

Barry Corbin issues urgent call to Austin policymakers

As a Texan and grandfather of a Cook Children's patient, award-winning actor Barry Corbin is issuing an urgent call to action to our elected officials in Austin, "Save Cook Children's Health Plan"

The Texas legislature is weeks away from allowing the largest Medicaid upheaval in state history, which will cost Texans nearly 2,000 jobs and millions in tax dollars. Unless legislators act now, 1.8 million children and pregnant women will be forced off their current health plans and into unfamiliar, for‑profit insurers headquartered outside Texas.

In 2024, the Texas Health & Human Services Commission (HHSC) denied contract renewals to several Medicaid providers, including three non‑profit, Texas‑based children's hospital plans: Cook Children's Health Plan, Texas Children's Health Plan and Driscoll Children's Health Plan. Despite their combined 60-plus years of proven, high‑quality care, HHSC awarded the multi‑billion‑dollar Medicaid STAR/CHIP contracts to several publicly traded insurers beholden to out‑of‑state shareholders.

If legislation isn't adopted immediately, vulnerable families could lose their lifeline to pediatric specialists, hundreds of local jobs will be eliminated, and taxpayers could possibly pay the price through ER overcrowding and higher uncompensated-care costs when families have a gap or lapse in coverage as a result of this disruption.

What Texans stand to lose

1.8 million children & expectant mothers will have their health care disrupted.
Nearly 2,000 Texas jobs (physicians, nurses, clinical care coordinators, member advocates, quality review managers, IT, accountants and more) eliminated across Fort Worth, Houston & Corpus Christi.
$5 in statewide economic activity for every $1 in Medicaid payments—a multiplier that vanishes when dollars leave the state, according to the HHSC.

Tarrant County service area impact

125,000 North Texas families face disrupted and even delayed health care, including:
- Up to 10,000 medically-fragile children
- More than 1,700 children dependent on wheelchairs
- 170 children dependent on ventilators
Millions of dollars in local community investments to fund programs such:
- Cook Children's nine neighborhood health centers serving low‑access ZIP codes in Tarrant County alone ($9 million spent per year)
- Drowning prevention, safe sleep and gun safety efforts
- Asthma prevention and maternal health programs

The solution

Texas legislators need to adopt a law this session that:

Extends existing contracts through 2027, preventing immediate upheaval.
Allows families to remain with their current plan or switch, restoring free‑market principles.
Prioritizes past performance and quality metrics in future procurements, ensuring fiscal stewardship.

We're asking Cook Children's Health Plan supporters to share video messages on social media. Tell us what keeping Cook Children's Health Plan means to you in a 15 to 30-second video (filmed horizontally). To be part of our campaign, videos should be posted on social media using the following hashtags:

#savecookchildrenshealthplan
#protecttexaskids
#txlege
#protectcommunityhealthplans

Health Plan stories of hope and healing

For more than 20 years, Cook Children's Health Plan (CCHP) has provided outstanding service for hundreds of thousands of families as part of the STAR and CHIP Managed Care Services. However, on March 7, 2024, CCHP was denied a new contract starting Sept. 1, 2025, by the Texas Health and Human Services Commission (HHSC) due to a flawed methodology. This decision jeopardizes access to vital health care for nearly 125,000 CCHP Members from low-income families and children with complex medical needs. CCHP is appealing the decision, arguing that the state's scoring methodology lacked transparency, and disadvantaged regional, provider-sponsored plans like theirs. If not reversed, the result will be a serious disruption in care and potential harm to the vulnerable children and families who depend on CCHP.

HHSC unilaterally made the decision, without any direction from the legislature, to depart from a community-based care model to provide Medicaid services across the state of Texas to a for-profit national model. Their decision was flawed in many ways, including failing to follow statutory mandates requiring preference for health plans committed to providing charity care. HHSC was also required to give weight to health plans that provide care to special populations, such as children. They did not. Additionally, HHSC failed to consider how continuity of care would be impacted, as well as the costs to the state.

HHSC did not go through the proper rulemaking process for making critical changes to the Request for Proposal (RFP) and their scoring was riddled with mistakes. As a result, 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. This disruption is a 56% turnover if this decision stands. (In Tarrant County, it is a 75.6% turnover.)

Impact: Nearly 125,000 CCHP members from low-income families could lose access to vital health care services and providers.

More than 8,000 medically complex and fragile children will also be impacted.
Loss of the contract threatens the sustainability of the Cook Children's Health Plan, potentially impacting 400 local employees and 1,455+ primary care providers and 2,550+ specialists.

Timeline of events

March 7, 2024 - CCHP was denied a new contract starting Sept. 1, 2025, by the Texas Health and Human Services Commission (HHSC) due to a flawed methodology.
March 21, 2024 - CCHP filed a protest with the State of Texas
June 6, 2024 - CCHP was notified that the protest was denied by HHSC. Cook Children's vowed to pursue every legal option available, including filing an immediate appeal.
June 26, 2024 - Cook Children's announced it was filing a Petition for Declaratory Judgment and Injunctive Relief against HHSC Commissioner Cecile Erwin Young. This is the lawsuit to overturn the decision. Cook Children's has also filed a Temporary Restraining Order request to stop HHSC from finalizing its procurement results. Both actions were filed in Travis County.
June 2024 - Cook Children's also filed a protest of the STAR Kids RFP to stop HHSC from making the same mistakes it made in the STAR & CHIP RFP and from taking away options from the kids who need help the most.
October 7, 2024 - District Judge Laurie Eiserloh of Travis County blocked HHSC from finalizing a set of contracts that would drop the Cook Children's Health Plan, alongside the Driscoll Health Plan and the Texas Children's Health Plan, from Medicaid STAR and CHIP plans starting in September 2025. The trial to determine whether Judge Eiserloh will issue a permanent restraining order is scheduled for Nov. 3, 2025. The ruling can be appealed before then or the Health and Human Services Commission could choose to change the state's proposal.

As a non-profit, community-based health plan, Cook Children's has a deep understanding of local needs.
The Health Care System provides more than $200 million every year in community benefit and uncompensated care to families in need.
We have a 20-year history of serving the community with our high health plan member, physician and provider satisfaction and top tier performance.
Cook Children's has impressive quality outcomes as we utilize health plan data to identify opportunities to reduce costs and improve the health of the communities we serve. As a community-based health plan, we integrate our systems to better coordinate care and drive efficiencies. We also have a proven willingness to invest in services that are not reimbursable by the Medicaid programs and benefit vulnerable and medically complex children. Examples:
- Cook Children's Healthy Homes Asthma Program, which involves funding the remediation and repair of homes. Results:
  - Emergency Department (ED) visits declined 80%
  - ED charges were reduced 78%
- Each of our seven Neighborhood Health Centers serve underserved communities and have a $1 million financial loss per center each year. (There are 125,000 visits per year across the centers.)
- Through close collaboration with Cook Children's physicians, we were able to reduce pharmacy expenses over two years by 17%, while non-Cook Children's PCP costs went up by 10%.
Cook Children's also can address social determinants of health beyond just medical care (food security, transportation, etc.).
The Health Plan has saved the state of Texas millions of dollars in the last 20 years through proactive, preventative health care outreach efforts for children from lower-income families and communities across the state. Examples of this include:
- Partnership with Tarrant Area Food Bank to provide free fresh fruits, vegetables and dairy items through the R.E.D. Market to underserved families in Denton, Wise and Cooke Counties. This effort reduces the risk of children experiencing problems in school and serious health conditions due to hunger.
- Providing COVID-19 vaccines to homebound children and their families to prevent unnecessary hospitalizations.
- Partnership with the United Way of Tarrant County to create a doula certification program to provide education, a birthing plan and recovery period for soon-to-be moms, combating Texas's high maternal mortality rate.

Stories from our families

Shaquerial's journey

Cook Children's Health Plan is committed to ensuring that all children in our community are safe and healthy, it's Our Promise and it begins at conception.

MJ's story

MJ is one of the more than 8,000 medically fragile children covered under Texas' STAR Kids program by Cook Children’s Health Plan.

The Pinon family

Liz’s triplets, born at 25 weeks, each have their own medical complexities requiring four or five specialty medications and unique care needs.

Vivienne’s story

14-year-old Vivenne is one of nearly 125,000 Cook Children’s Health Plan (CCHP) members who could lose health care coverage.

The impact

The denial of a new STAR & CHIP Medicaid contract would signal a devastating disruption in care for vulnerable Texas children.

Zechariah’s story

Every breath 2-year-old Zechariah takes is dependent on a well-equipped and working ventilator that he relies on every minute of every day.

Meet Rebekah Jones

Longtime Cook Children's nurse, Rebekah Jenson, fears loss of Cook Children's Health Plan for her adopted children.

Information for Members/Providers

Information for Members Information for Providers Provider Update Sept. 2024

Have a story or a question?

If you'd like to share your experience with Cook Children's Health Plan, or submit questions, please email us at social@cookchildrens.org.

Save Cook Children's Health Plan

What's happening now

Barry Corbin issues urgent call to Austin policymakers

What Texans stand to lose

Tarrant County service area impact

The solution

Health Plan stories of hope and healing

What happened (understanding the situation)

Timeline of events

Timeline of events

What makes us different

Stories from our families

Shaquerial's journey

MJ's story

The Pinon family

Vivienne’s story

The impact

Zechariah’s story

Meet Rebekah Jones

Information for Members/Providers

Have a story or a question?