When Texas turned over the care of sick and disabled people to giant health care companies, they made billions of dollars as they systematically denied life-sustaining drugs and treatments – often with dire consequences for patients. The Dallas Morning News exposed systemic problems with the way Texas provides health care for its most vulnerable citizens through Medicaid managed care. The series showed how years of inept state regulation allowed corporations to profit even as they skimped on treatment for thousands of sick kids and disabled adults, with life-threatening results. And how Texas health officials hid the full extent of the problems from the public.
We led with the story of D’ashon Morris, a foster baby, who suffered a catastrophic brain injury because his managed care companies refused to provide the overnight nursing he needed. It’s a narrative built through public records requests, confidential sources, emails, leaked confidential memos and dozens of interviews. D’ashon’s nurses, doctors and foster mother had all warned the insurance company that he needed 24/7 nursing care because he constantly pulled out his trach tube, records show. The company refused to pay for medical supervision, saving hundreds of dollars a day and costing D’ashon everything.
His story was just one example of how the system allowed companies to place profits over their patients. Other significant findings: Using social-science techniques to analyze data collected by health-commission nurses, we found that at least 8,000 disabled and elderly Texans in just one of the state’s many managed-care programs weren’t getting the care they needed.
The News obtained confidential records and data that enabled reporters to find victims like Heather Powell, a quadriplegic woman who was denied the medical bed she needed to avoid life-threatening bed sores, among other cruel denials of care. Some companies inflated the number of doctors and specialists that were in their networks and available to million of vulnerable Texans. When companies refuse to provide treatments or services, patients are supposed to be able to fight back through a so-called “fair hearing.” But that system is stacked against patients. Our analysis showed how personal bias and secret policies enabled companies to win more than two-thirds of the time. The state knew thousands were suffering, but it covered up problems and ignored its own data while companies avoided hundreds of millions of dollars in fines. Key lawmakers knew about these failures, yet they gave these companies billions of dollars more anyway.