Unraveling Challenges in Texas’ Health Insurance & Care

TL/DR –

Three ongoing situations might endanger Texans’ access to healthcare and health insurance coverage. First, Baylor Scott and White Health and Blue Cross Blue Shield of Texas are in dispute over terms that could risk in-network coverage at Baylor Scott and White Health facilities for BCBS plan holders. Second, the Texas Health and Human Services Commission’s refusal to grant a Medicaid contract to the Fort-Worth-based nonprofit insurer Cook Children’s Health Plan could force millions of Texans to change plans next year. Third, Dallas-based Steward Health Care, which filed for bankruptcy in May, plans to sell over 30 hospitals it operates across the country, potentially leaving many rural Texans without access to local healthcare facilities.

Recent developments are threatening Texans’ access to healthcare and health insurance coverage.

Three unfolding situations are influencing this shift. Baylor Scott and White Health and Blue Cross Blue Shield of Texas are in a dispute over terms that may affect BCBS plan holders’ coverage at Baylor Scott and White Health facilities. Then, the Texas Health and Human Services Commission’s refusal to award a Medicaid contract to Fort Worth-based nonprofit health insurer Cook Children’s Health Plan may require millions of Texans to change plans next year. Lastly, Dallas-based hospital operator Steward Health Care’s plans to sell over 30 hospitals may leave many rural Texans without local healthcare facilities.

Baylor Scott and White Health’s negotiations with Blue Cross Blue Shield

Baylor Scott and White Health hospitals could soon be out of network for those with Blue Cross Blue Shield of Texas insurance unless agreements are made by July 1. This issue stems from a discrepancy between the increased reimbursement rates Baylor Scott and White are requesting and the amount that Blue Cross Blue Shield of Texas agrees to.

Texas denies Cook Children’s Health Plan Medicaid contract

The Texas Health and Human Services Commission has decided not to award a Medicaid contract to Cook Children’s Health Plan, a provider of Medicaid health insurance to children and pregnant people in Tarrant County. As a result, nearly 2 million Texans will have to change plans next year unless the decision is reversed.

Steward Health Care plans to sell its hospitals after filing for bankruptcy

Steward Health Care filed for bankruptcy in May and plans to sell its hospitals, raising concerns about potential hospital closures, especially in rural areas. Prior to bankruptcy, Steward was hit with multiple lawsuits alleging unpaid services. The company’s operations in Texas, Massachusetts, and other regions are under particular scrutiny.

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