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The Texas Health and Human Services Commission has proposed eliminating all state funding for the Children’s Autism Program in its 2028-29 budget request. The program subsidizes applied behavior analysis for children, including families who may struggle to find providers through insurance or Medicaid; lawmakers have 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 children whose families have limited alternatives. The proposal is not final: the Texas Legislature must decide whether to approve it, and the agency says enrolled children would continue receiving services through August 2027 if the cut goes ahead.
CAP contracts with 16 providers statewide to offer focused applied behavior analysis, or ABA, 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 previous two years, according to the report. In fiscal year 2026, it funded treatment for 583 children; contractors reported at least 1,000 more on waiting lists.
The proposal comes after Texas leaders directed agencies, courts and universities in July to cut spending by 3% in the next biennium. Asked why the autism program was selected, HHSC officials pointed to the agency’s budget-reduction summary, which said it focused on reductions with the lowest direct impact on clients and sought to minimize effects on federal funding. In its budget request, however, HHSC also acknowledged that demand for autism services exceeds the supply of qualified providers, particularly in rural areas.
The state expanded CAP this year, extending eligibility to people up to age 21 and removing a cap on annual hours. The proposal would reverse that direction if lawmakers adopt it. HHSC has not said in the material cited how it would address the demand it identified if the program’s state funding ends.
Families Could Lose a Therapy Route
The proposed cut could affect families who cannot find an available provider through other coverage or cannot afford private treatment. Although Medicaid began covering ABA for people 20 and younger in 2022, that does not guarantee access: advocates say provider participation can be limited by low reimbursement rates, and some families have insurance arrangements that do not require ABA coverage. CAP has served as a subsidized option for some of those families.
The potential consequences are especially relevant in a state where CAP contractors report waitlists of at least 1,000 children and where agency officials acknowledge provider shortages. Ending the program would not automatically mean every child loses all therapy, since coverage and other services vary. But advocates say families could face longer waits, fewer affordable options or difficulty finding any provider. Those outcomes remain concerns, not confirmed effects of a decision that has yet to be made.
Advocates also argue that delaying support may carry costs for families and the state. Coalition of Texans with Disabilities advocacy director Jolene Pohl said the state could spend more later if eligible families do not receive services in a timely way. That is an attributed concern, rather than a fiscal finding in the budget proposal.
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How the State Program Works
The Children’s Autism Program began in 2008 and is funded by Texas rather than federal matching dollars, according to Jeff Miller of Disability Rights Texas. Miller said that may have made it appear to budget planners to be a comparatively straightforward target for savings without affecting federal funding. He also pointed to the complexity of Medicaid coverage as a possible factor; the report does not establish the agency’s precise reasoning for selecting CAP.
Texas Medicaid benefits began covering ABA therapy for eligible people 20 and younger in 2022. That change may have made a separate state program appear duplicative, but advocates say the two routes do not reach every family. Medicaid coverage does not necessarily translate into an available appointment, and coverage rules differ across insurance plans. CAP’s income-adjusted subsidies have helped bridge some of those gaps.
Families interviewed for the report described receiving services through a CAP-funded program at the University of Houston-Clear Lake’s Center for Autism and Developmental Disabilities. Elizabeth Solis said her son learned to communicate using pictures with help from providers. Emily Pena said her daughter, who was enrolled in Medicaid, still had difficulty finding a provider before reaching the center’s program. Their accounts illustrate individual experiences; they do not establish what every family would experience if funding ends.
“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 therapy through a CAP-funded provider
Legislators Have Not Decided
The proposal is a budget request, not an enacted cut. It is not yet clear whether lawmakers will remove CAP funding, revise the proposal or provide money for the program through another budget decision. The report does not provide a final legislative timetable or identify a replacement program if the request is approved.
It is also unclear how many current participants would be affected, how providers would manage existing waitlists, or whether families could transfer to Medicaid-funded or private services. Coverage eligibility alone does not confirm that a qualified provider will be available. HHSC’s budget request acknowledges shortages but the cited material does not explain how the agency would respond to them under the proposed funding level.
Budget Debate Will Set the Course
The Texas Legislature will consider HHSC’s request as it develops the 2028-29 biennium budget. Until lawmakers act, the proposed elimination remains subject to change. Families, providers and advocacy groups are likely to press legislators over the program’s cost, waitlists and role in filling gaps in insurance and Medicaid access.
If lawmakers approve the elimination, HHSC says services would continue through the end of August 2027. The source material does not specify what transition arrangements, if any, would be offered after that date. The final budget decision will determine whether CAP continues, changes or loses state funding.
Key Questions
Has Texas already ended the Children’s Autism Program?
No. HHSC has proposed eliminating funding in its 2028-29 budget request. Lawmakers have not yet made the final decision.
What services does the program provide?
CAP contracts with providers for subsidized applied behavior analysis therapy. Eligible children can receive up to 720 lifetime hours, with costs adjusted based on family income and insurance coverage.
Would Medicaid replace the program?
Not necessarily. Medicaid covers ABA for eligible people 20 and younger, but advocates say some families lack applicable coverage or cannot find participating providers. The availability of an alternative would depend on each family’s coverage and local provider capacity.
When could services stop if the proposal is approved?
HHSC said children would continue receiving services through August 2027 if lawmakers agree to eliminate the program. The cited report does not describe what support would follow.
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