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The Texas Health and Human Services Commission has proposed eliminating the state-funded Children’s Autism Program in its 2028-29 budget request. The program subsidizes applied behavior analysis for children, including families who may have difficulty finding or affording services through insurance; the Legislature has not yet decided whether to approve the proposal.
The Texas Health and Human Services Commission has proposed eliminating state funding for the Children’s Autism Program in its 2028-29 budget request, a move that could end subsidized therapy for eligible children if the Legislature approves it. The proposal comes as providers report lengthy waitlists and families say insurance coverage has not guaranteed access to care.
The program, known as CAP, contracts with 16 providers across Texas to offer focused applied behavior analysis therapy at a reduced cost based on family income and insurance coverage. Eligible children can receive up to 720 hours over their lifetime. The state spent $13.7 million on the program over the past two years, according to the report.
In fiscal year 2026, CAP funded services for 583 children, while contractors reported at least 1,000 more on statewide waitlists. Texas expanded the program this year, extending eligibility to people up to age 21 and removing a limit on yearly hours. The budget request nevertheless proposes eliminating the funding line.
HHSC said that, if lawmakers approve the proposal, children would continue receiving services through the end of August 2027. The agency’s budget materials acknowledge that demand exceeds the supply of qualified providers, particularly in rural areas, and that providers are not available everywhere even when insurance covers treatment.
Families Could Lose a Route to Therapy
CAP is designed to help families who cannot readily obtain or pay for therapy through other channels. Its income-based fees can leave some families paying nothing, as reported by the mother of a child receiving services through a CAP-funded program. Ending the program could remove that option for children whose coverage does not apply or whose families cannot find a participating provider.
Medicaid began covering ABA therapy for people age 20 and younger in 2022, but advocates say coverage on paper does not always translate into available care. Some self-funded insurance plans are not required to cover ABA, and low Medicaid reimbursement rates can make it difficult to find providers who accept Medicaid clients. The proposal therefore has implications beyond the program’s current caseload: families may have to seek alternatives in a system already reporting long waits.
Advocates also argue that delayed services could carry future costs for the state, though that is their assessment, not a quantified finding in the budget proposal. The immediate confirmed issue is access: whether eligible children can continue receiving subsidized therapy after the proposed funding period depends on the Legislature’s budget decision.
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A State Program Amid Coverage Gaps
CAP began in 2008 and is funded entirely by Texas, rather than through federal matching dollars, according to the report. Disability Rights Texas policy specialist Jeff Miller suggested that its state-only funding may make it appear to be a simpler target for reductions than programs tied to federal funds. That is an explanation offered by an advocate, not a stated rationale from 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. Asked about the CAP proposal, HHSC referred to its budget reduction summary, which said the agency focused cuts on areas with the lowest direct impact on clients while minimizing effects on federal funding.
The proposal follows the expansion of Medicaid coverage for ABA therapy in 2022, which could make the state program appear duplicative. Advocates counter that Medicaid and private insurance do not reach every family and that provider availability remains a barrier. The report also cites research by Johns Hopkins University researchers finding that the number of children diagnosed with autism spectrum disorder rose 300% over 20 years; the report provides no further details about the measure or comparison period.
“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, whose son receives CAP-supported services
Legislators Have Not Made the Decision
The proposal is part of HHSC’s budget request; the available report does not say that lawmakers have approved the elimination. The final budget outcome, the program’s funding after August 2027 and any alternative state support remain undecided.
HHSC has not, in the information reported, explained specifically why it selected CAP for elimination beyond pointing to its general approach to budget reductions and federal funding. It is also unclear how many current or waitlisted families would qualify for other services, how quickly they could obtain them, or whether providers would expand Medicaid participation.
Budget Deliberations Will Set the Course
The next key step is the Texas Legislature’s consideration of the agency budget for the 2028-29 biennium. Lawmakers can approve the requested elimination, change the proposal, or provide funding for CAP, but the source report does not identify a final vote date or predict the outcome.
Until a decision is made, the agency says enrolled children would remain eligible for services through the end of August 2027 if the cut is approved. Families, providers and advocates are likely to watch for the budget’s treatment of the program and for any plan addressing children who rely on CAP or remain on provider waitlists.
Key Questions
What is Texas proposing?
The Texas Health and Human Services Commission proposed eliminating funding for the Children’s Autism Program in its budget request for the 2028-29 biennium. The Legislature has not yet made the final budget decision.
What services does the Children’s Autism Program provide?
CAP contracts with 16 providers to offer focused applied behavior analysis therapy at reduced cost based on family income and insurance coverage. Eligible children can receive up to 720 lifetime hours.
When could services end if the proposal is approved?
HHSC said children would continue receiving services through the end of August 2027 if lawmakers approve the elimination. The proposed budget period is 2028-29.
Does Medicaid coverage mean families can readily get ABA therapy?
Not necessarily, according to disability advocates cited in the report. They say some families are outside the relevant coverage rules and that low reimbursement rates can make it hard to find Medicaid-participating providers.
How many children are waiting for CAP services?
Contractors reported at least 1,000 children on statewide waitlists. The report does not provide a precise count of all eligible children who would be affected by the proposed cut.
Source: rss
