1.8 million low-income Texans may see health coverage changes after Medicaid proposes redistribution

Texas health officials are poised to drop the state's three largest nonprofit children's health plans from multibillion-dollar Medicaid and children's health insurance contracts - threatening the future of plans run by legacy children's hospitals in Fort Worth and South Texas, and shaking up health care coverage for low-income families throughout the state.Some 1.

The decision, which has not been finalized, comes from a new procurement process by Texas Health and Human Services that was put in place in 2021 after a long fight between the state and managed care organizations over how Texas chooses its Medicaid MCOs. It would also trigger a massive effort by the state to inform all those families of the change, which would take effect late next year if the plan holds.

Meanwhile, a handful of national for-profit chains would significantly expand their foothold in those markets - in one case growing from serving just one region of Texas to seven - while the others are either diminished or forced out. If the procurement is vacated, it would be the agency's third unsuccessful attempt to procure new contracts for STAR and CHIP managed care organizations.

"We're going to do everything we can to continue to serve those kids," Love said. "But it would be a financial challenge, no doubt about it. Cook Children's Health Care System is very strong financially. We've been here for more than 100 years. We'll probably be here for another 100 years. We are the provider of choice for families in North Texas and we'll continue to do that. But the MCO would be challenged to continue operations.

The April 3 letters demand that the decision be delayed and reconsidered - especially due to its impact on the Driscoll Health Plan and the roughly 180,000 STAR and CHIP members the plan serves in those lawmakers' districts. "It is important that the decision-making process acknowledges the significant contributions and expertise of DHP in addressing the healthcare needs of our region," the letter reads. "HHSC did not take into consideration our communities' needs and preferences, nor did it seek input from legislators, providers, or other stakeholders impacted by the decision."

"It's definitely a threat to the health plan," she said. "One of my greatest fears, if this procurement stands, is that all that work we've done over the last 18 years is down the tubes, and I don't see any other health plans coming in to do the type of work we've done," she said.

Health Health Latest News, Health Health Headlines

Similar News:You can also read news stories similar to this one that we have collected from other news sources.

Proposed Medicaid changes could shake up coverage for 1.8 million TexansThe move, which has not been finalized, would drop three large health plans run for two decades by nonprofit children’s hospitals.
Source: TexasTribune - 🏆 441. / 53 Read more »

CDC issues bird flu health alert to clinicians, state health departments, public after Texas farmer infectedThe Centers for Disease Control and Prevention issued a health alert to inform clinicians, state health departments and the public of a case of bird flu in a person in Texas.
Source: FoxNews - 🏆 9. / 87 Read more »

Montefiore Health System's community health workers focus on social needs as part of health careMontefiore in the Bronx screened 200,000 people for social detriments of health, and found at least 20% have at least one social need.
Source: CBSNewYork - 🏆 268. / 63 Read more »