The lives of our most vulnerable population are at stake


Children’s hospitals in Texas are facing a dire future—their collective Medicaid losses, across the eight nonprofit institutions statewide in less than ten years—are a breathtaking three-quarters of a billion dollars. The population served by these hospitals include Texas’ poorest and most at-risk children.

Children’s hospitals are crucial safety nets, purposefully created many years ago to provide the best healthcare to children with the most severe conditions: cancer, organ failures, premature birth issues and other chronic, life-threatening illnesses. Often, the only place a child can get this life-saving care is at a children’s hospital.

For many years, the hospitals have been supported with Medicaid funding, which has been cut back virtually every legislative session over the past decade. We have, quite simply, almost reached the point of no return.

 This is why the Children’s Hospital Association of Texas is asking for $100 million—$50 million per year—to be included in the biennial budget that will be considered by the 86th Legislature, which just convened in Austin.

But why do we care? Can’t other hospitals pick up the slack?

In a word, no. The children’s hospitals in Texas are strategically located around our huge state—Dallas, San Antonio, Fort Worth, Lubbock, Austin, Corpus Christi, Houston and El Paso—and this geographic reach gives them the ability to take care of sick children from virtually every county. They are the first line of critical care for the kids they treat.

About 3.4 million—one-half of all children living in Texas—are enrolled in Medicaid or the Children’s Health Insurance Program. Children under 18 make up 75 percent of all Medicaid cases in Texas. Children’s hospitals depend on Medicaid funding, as between 50% and 80% of the days spent by children at a children’s hospital in Texas are paid for by Medicaid.

And no, other hospitals are not well positioned to handle this population if the children’s hospitals can no longer perform their vital role. Many of the services that children’s hospitals provide can be found only at a children’s hospital.  Our most vulnerable children and their families see a centralized treatment team of pediatric specialists dedicated to caring for that child in one location. Children’s hospitals serve as the safety net for both urban and rural hospitals, as kids who are too sick to be treated at these other hospitals are often transferred to one of our children’s hospitals for care. 

Investing in the health of our children, especially those who are sickest, is an investment in the future of our state. Employers indicate that quality healthcare—including excellent children’s hospitals—is key to decisions about where to locate headquarters. 

 Additionally, treating children as early as possible gives them a much better chance of living productive lives. The future of Texas depends on having a thriving and well-educated population as the years unfold, and a fundamental building block of that prosperity is keeping the population healthy.

Most important, these hospitals save lives. For many Texas families, a children’s hospital is the only hope their child has for survival. 

 You may be wondering why we’re “only” asking for $100 million for the biennium when the shortfall is so much greater than that.

Children’s hospitals in Texas have become skilled at keeping their doors open on the thinnest of operating margins. The current situation is something they cannot sustain, so the $100 million allows them to continue operating until a longer-term solution can be found.

 Texas Gov. Greg Abbott has announced a sweeping commitment to public education in our state, which we applaud. We must keep our children healthy enough to benefit from that education, or we will make a mistake that will haunt Texans for generations.

Please let your elected representatives know that this issue is important to you, and ask them to vote YES to funding children’s hospitals in Texas.


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