TL;DR
The Texas Health and Human Services Commission has proposed eliminating state funding for the Children’s Autism Program in its 2028-29 budget request. If lawmakers approve the proposal, the program would continue through August 2027, but families who rely on its subsidized therapy could lose an option as providers report long waitlists.
The Texas Health and Human Services Commission has proposed eliminating state funding for its Children’s Autism Program in the 2028-29 budget cycle, a move that could end subsidized applied behavior analysis therapy for children whose families have few affordable alternatives. The proposal is not final: If lawmakers approve it, the program would continue providing services through August 2027.
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The state program contracts with 16 providers across Texas to offer focused applied behavior analysis, or ABA, therapy at reduced cost based on families’ income and insurance coverage. Eligible children can receive up to 720 hours over their lifetime. Some families pay nothing for services through participating programs, according to the report.
Texas spent $13.7 million over the last two years on the program. In fiscal year 2026, it funded treatment for 583 children, while contractors reported at least 1,000 more children on statewide waitlists. The state expanded eligibility this year to include people up to age 21 and removed a cap on annual hours, the report said.
HHSC’s budget request recognizes that demand for autism therapy exceeds provider availability, particularly in rural areas. Asked about the proposed elimination, agency officials pointed to a summary of its required budget reductions, which said HHSC focused on cuts with the lowest direct impact on clients and sought to limit effects on federal funding. The summary does not explain specifically why the autism program was selected.
Families Could Lose a Therapy Option
The proposal could affect families who cannot find an ABA provider through insurance or Medicaid, or who need help paying for treatment. The state program offers a reduced-cost route to services, including for some families who pay nothing. If funding ends, the families affected would have fewer options in a state where contractors already report at least 1,000 children waiting.
Medicaid coverage does not automatically mean a family can find a provider. Advocates quoted in the report said low reimbursement rates can make providers reluctant to accept Medicaid clients. Private coverage also has limits: the report notes that self-funded insurance plans are not required to cover ABA therapy. The proposal’s practical effect would therefore depend on whether families can find other providers and how those providers are funded.
Advocates argue that delaying services could carry costs for families and the state, but that is their assessment, not a documented outcome of this budget proposal. The immediate concern is access: CAP is a state-funded program that has served children who may not be able to use other coverage effectively.
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Budget Cuts Meet Existing Waitlists
CAP began in 2008 and is funded solely by the state, according to the report. Jeff Miller, a senior policy specialist at Disability Rights Texas, suggested that its funding structure may have made it appear to be a relatively straightforward target compared with programs that use federal matching dollars. That is his analysis, not an explanation confirmed by HHSC.
In July, Gov. Greg Abbott, Lt. Gov. Dan Patrick and House Speaker Dustin Burrows directed state agencies, appellate courts and universities to cut spending by 3% in the next biennium. The proposed autism-program elimination comes amid that broader budget-cutting effort, even as HHSC’s request describes an unmet need for therapy and shortages of qualified providers.
Medicaid began covering ABA therapy for people 20 and younger in 2022, a change that may have made the state program seem duplicative. But advocates say insurance coverage on paper does not resolve provider shortages or gaps affecting people without applicable coverage. The report also describes families who struggled to locate a provider despite having Medicaid.
“If the doors just completely close to access that at all, you just feel like it’s all caving in on you, like ‘how am I going to get some help?'”
— Elizabeth Solis, parent of children receiving services through a CAP-funded program
Legislative Decision Still Pending
The proposal is a budget request, not an enacted decision. The report does not say whether lawmakers will accept, revise or reject the recommendation, or whether the program could receive funding through a different budget arrangement. HHSC has not provided a program-specific explanation for selecting CAP beyond pointing to its general budget-reduction approach.
It is also unclear how many families would lose access if funding ends, what alternative providers could take them, and whether any replacement services would be available in areas with shortages. The waitlist figure is reported by contractors, and the source does not provide a full breakdown by location, waiting time or eligibility status.
Legislature Weighs the Budget Request
The Texas Legislature will decide whether to approve HHSC’s proposed elimination as it considers the 2028-29 biennium budget. Until lawmakers act, the proposed cut remains uncertain. HHSC said services would continue through the end of August 2027 if the Legislature agrees to eliminate the program.
Families, providers and disability advocates are likely to press lawmakers on the program’s role in serving children who cannot readily access therapy through other coverage. The next key developments are the Legislature’s budget deliberations and any revisions that determine whether CAP receives state funding in the next biennium.
Key Questions
Has Texas decided to end the Children’s Autism Program?
No. HHSC has proposed eliminating funding in its 2028-29 budget request, but the Legislature has not made a final decision.
When would services end if lawmakers approve the proposal?
HHSC said children would continue receiving services through the end of August 2027 if lawmakers agree to eliminate the program.
Who does the program serve?
CAP contracts with 16 providers to offer reduced-cost ABA therapy to eligible children. The program was expanded this year to include people up to age 21, according to the report.
Why might Medicaid not replace the program?
Advocates say some families are outside Medicaid coverage or have insurance that does not require ABA coverage, while low reimbursement rates can make it difficult to find providers who accept Medicaid. Provider shortages may also limit access.
How many children are waiting for services?
Contractors reported at least 1,000 children on waitlists statewide. The report does not provide a detailed breakdown of the waitlists by region or how long families have been waiting.
Source: rss
