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2019 Knight Award for Public Service finalist

Pain and Profit

About the Project

When Texas turned over the care of sick and disabled people to giant health insurance companies, the companies made billions of dollars while systematically denying life-sustaining drugs and treatments – often with dire consequences for patients.

Using public records and leaked data, we found thousands of sick and disabled Texans weren’t getting life-sustaining care that taxpayers were paying for. The companies profited by stalling or denying nursing services, medical equipment and therapy. They vastly overstated how many doctors were available to patients. The state didn’t track failures and rarely penalized the companies. For patients, challenging the system was almost impossible under the state’s stacked rules. McSwane found a whistleblower who told us taxpayers were being duped while hundreds of thousands of sick and disabled Texans suffered.

To connect this suffering to financial decisions made in far-flung corporate offices, the reporters stitched together thousands of spreadsheets, logged hundreds of phone calls, knocked on doors from Lubbock to Houston, filed more than 170 public records requests, and pored over 70,000 pages of records. They created their own data, talked with skittish sources in parking garages and accepted leaked files through encrypted communications.

The end result is a unique mixture of narrative storytelling, shoeleather reporting, data analysis, use of social science tools and political reporting – all of which have forced policy makers to improve care for the 1 in 7 Texans who rely on the government insurance program.