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The Texas Health and Human Services Commission has proposed eliminating state funding for the Children’s Autism Program in its 2028-29 budget request. The program subsidizes applied behavior analysis therapy for children, including families who may struggle to find services through insurance or Medicaid. The Texas 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 budget request for the 2028-29 biennium, a move that could end subsidized therapy for families who depend on the program. The proposal is not final: the Texas Legislature must decide whether to adopt the cut.
CAP contracts with 16 providers across Texas to offer focused applied behavior analysis, or ABA, therapy to autistic children at a reduced cost based on family income and insurance coverage. Eligible children can receive up to 720 hours over their lifetime. The program began in 2008 and is funded by the state.
The state spent $13.7 million over the past two years on CAP, according to the report. In fiscal year 2026, it funded treatment for 583 children. Contractors said at least 1,000 additional children are on waiting lists statewide. This year, the state expanded eligibility to people up to age 21 and removed a cap on annual hours, the report said.
HHSC’s budget request acknowledges that demand for autism services exceeds the supply of qualified providers, particularly in rural areas. Asked about the proposal, agency officials referred to a budget reduction summary describing a focus on cuts with the lowest direct effect on clients and limited impact on federal funding. The summary does not explain specifically why CAP was selected for elimination.
Families Could Lose Subsidized Therapy
If lawmakers approve the proposal, families who use CAP could lose an option for therapy that is reduced-cost or free, depending on income and coverage. The impact may be especially acute for households unable to find a provider through other coverage. The report describes parents who turned to CAP-supported programs after struggling to locate ABA services, including one mother whose child had Medicaid.
Medicaid coverage does not necessarily mean a family can access treatment, according to advocates cited in the report. They said some families are outside the relevant coverage rules, while low reimbursement rates can make it difficult to find providers who accept Medicaid. The program’s waitlists already exceed 1,000 children, contractors report, so ending it could narrow an already limited route to services.
Advocates also argue that delaying services could carry costs for the state later. That is their assessment, not a forecast quantified in the budget request. What is established is that HHSC recognized a shortage of providers and that the proposal would remove the program’s state funding if adopted.
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How Texas Reached the Proposal
In July, Gov. Greg Abbott, Lt. Gov. Dan Patrick and House Speaker Dustin Burrows directed state agencies, appellate courts and universities to reduce spending by 3% in the next biennium. HHSC’s proposal comes within that broader budget-cutting effort. The agency’s request identifies the provider shortage even as it proposes eliminating CAP funding.
Medicaid benefits began covering ABA therapy for people age 20 and younger in 2022, a change that may have made the state program appear duplicative, according to Jeff Miller of Disability Rights Texas. But CAP’s supporters say insurance and Medicaid do not reach every family or guarantee that a willing provider is available. The report also notes that private and public insurance coverage can coexist with local provider shortages.
CAP funded treatment for hundreds of children in fiscal year 2026, while the program’s contractors reported a much larger waiting list. The proposed cut follows an expansion this year, but the budget request alone does not change current eligibility or immediately shut down services.
“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, a parent whose children receive services through CAP-funded programs
Legislators Have Not Decided
The proposal is part of HHSC’s budget request, not an enacted cut. It remains unclear whether lawmakers will approve it, revise it or maintain some funding for CAP. The report does not provide a final budget allocation or identify a legislative decision date.
HHSC has not provided a detailed, program-specific explanation for selecting CAP for elimination in the material cited by the report. The agency’s general budget summary refers to limiting client and federal funding impacts, while the request itself recognizes the shortage of autism providers. The size of any effect on individual families would depend on the final budget and the availability of alternatives in their areas.
HHSC said children would continue receiving services through the end of August 2027 if lawmakers agree to eliminate the program. The report does not specify what transition arrangements, if any, would be offered after that date.
Budget Decision Sets the Timeline
The Texas Legislature will consider HHSC’s request as it develops the 2028-29 biennial budget. Until lawmakers act, the proposed elimination remains a recommendation rather than a change to CAP services. Families and providers will be watching for budget amendments or other decisions that could preserve, reduce or remove the program’s funding.
If the cut is approved, HHSC’s stated timeline means services would continue through August 2027. The next key developments are lawmakers’ budget decisions and any further agency guidance on how current participants would be affected. The available reporting does not identify a specific date for a final decision.
Key Questions
Has Texas already eliminated the Children’s Autism Program?
No. HHSC has proposed the elimination in its 2028-29 budget request. The Texas Legislature has not yet made a final decision.
What services does the program provide?
CAP contracts with providers to offer reduced-cost applied behavior analysis therapy for eligible autistic children. The report says children may receive up to 720 hours over their lifetime, with costs based on family income and insurance coverage.
How many children could be affected?
The report says CAP funded treatment for 583 children in fiscal year 2026, while contractors reported at least 1,000 more children on waiting lists statewide. The number who would lose access if the proposal is approved is not specified.
Will Medicaid provide an alternative?
Not necessarily. Advocates cited in the report say coverage does not guarantee access to a provider, and some families may not qualify for the relevant coverage. The availability of alternatives may vary by family and location.
When could services end if lawmakers approve the cut?
HHSC said children would continue receiving services through the end of August 2027 if the Legislature agrees to eliminate CAP. The report does not describe plans for services after that point.
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