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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 therapy for children, including families who may have difficulty finding providers through insurance or Medicaid. The Legislature has not decided whether to approve the proposed cut.
The Texas Health and Human Services Commission has proposed eliminating funding for the Children’s Autism Program in its 2028-29 budget request, a move that could end a state-subsidized source of autism therapy for families who struggle to find or afford other services. The proposal is not final: the Texas Legislature must decide whether to accept it, and HHSC says children would continue receiving services through the end of August 2027 if lawmakers approve the elimination.
CAP contracts with 16 providers across Texas to offer focused applied behavior analysis, or ABA, therapy at a reduced cost based on family income and insurance coverage. Children can receive up to 720 hours over their lifetime. In fiscal year 2026, the program funded treatment for 583 children; contractors report that at least 1,000 more were on statewide waitlists. The state spent $13.7 million on CAP over the previous two years.
The proposal comes after the program was expanded this year. Eligibility was extended to people up to age 21, and a cap on yearly therapy hours was removed. HHSC’s own budget request acknowledges that demand exceeds the availability of qualified providers, particularly in rural areas, and that providers are not available everywhere even where public or private insurance covers treatment.
Families described CAP as a route to therapy when other options were difficult to access. Seven-year-old Israel Solis, who is nonverbal, learned to communicate wants using a picture system through services his family receives at no cost. His mother, Elizabeth Solis, also has another son in a CAP-funded program. Emily Pena said she struggled to find a provider for her daughter Lila, who has Medicaid, before finding a program supported by CAP at the University of Houston-Clear Lake.
Families Could Lose a Therapy Access Route
Ending CAP could affect families who cannot pay privately and cannot find a provider accepting their insurance or Medicaid. Medicaid began covering ABA therapy for eligible people 20 and younger in 2022, but advocates say coverage does not guarantee that a family can obtain care. Self-funded insurance plans are not required to cover ABA, and low Medicaid reimbursement rates can make providers reluctant to accept Medicaid patients.
The scale of unmet demand adds to the stakes. Contractors report at least 1,000 children waiting for CAP-partnered services, while the program funded treatment for 583 children in fiscal year 2026. These figures describe different groups and do not establish how many children would lose access if the proposal is approved. They indicate, however, that existing services are already difficult to obtain for many families.
Disability Rights Texas policy specialist Jeff Miller suggested that CAP may have been viewed as a comparatively straightforward place to cut because it is funded solely by the state, unlike many public programs supported by federal matching dollars. That is his explanation, not a stated finding about HHSC’s decision. The agency cited its general approach to budget reductions, while also recognizing in its request that autism therapy demand exceeds provider availability.
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Budget Cuts and Existing Coverage Gaps
CAP began in 2008 and provides focused ABA therapy through contracted providers. ABA uses positive reinforcement to encourage particular behaviors. The source report describes therapy supporting communication and helping a child manage transitions; individual experiences vary, and the account does not establish that every child will have the same outcomes.
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. HHSC referred questions about its proposed CAP elimination to a summary of the agency’s reductions, which says officials focused on areas with the lowest direct impact on clients and sought to minimize effects on federal funding. The separate CAP budget request says qualified providers are scarce in some areas.
Medicaid’s coverage of ABA, which began in 2022 for people 20 and younger, may have made the state program appear duplicative, according to advocates cited in the report. They argue that coverage rules and provider availability leave gaps that CAP helps fill. The proposed cut would therefore remove a state-funded option while access through other payers remains uneven.
“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 CAP-funded services
communication picture exchange system
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Legislative Decision and Service Effects
The budget request is a proposal, and the Legislature has not yet decided whether to eliminate CAP. The available information does not specify how lawmakers will weigh the proposed cut against the program’s waitlists, provider shortages and recent expansion, or whether they will consider restoring or changing its funding.
It is also unclear how many current or waiting families would lose services if CAP ends, whether other programs could absorb them, and how access would differ across regions. Medicaid and private insurance may cover some treatment, but advocates say coverage does not always translate into an available provider. HHSC says services would continue through August 2027 if the Legislature approves the proposal; the source does not detail what transition arrangements would follow that date.
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Lawmakers Set the Program’s Future
The next decision rests with the Texas Legislature as it considers the state’s 2028-29 biennium budget. Until lawmakers act, the proposed elimination should not be treated as a completed cut. Families, service providers and disability advocates are likely to focus on whether the final budget retains CAP funding, revises the program or adopts HHSC’s proposal to remove it.
If lawmakers approve the elimination, HHSC says current services would continue through the end of August 2027. The budget process will determine whether CAP has funding after that point and what, if anything, replaces its role for families who cannot secure therapy through insurance or other providers.
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Key Questions
Has Texas already eliminated the Children’s Autism Program?
No. HHSC has proposed eliminating its funding in the 2028-29 budget request, but the Texas Legislature has not made a final decision.
What does the Children’s Autism Program provide?
CAP contracts with 16 providers to offer reduced-cost ABA therapy based on a family’s income and insurance coverage. Eligible children can receive up to 720 hours over their lifetime.
How many children currently receive services or are waiting?
CAP funded treatment for 583 children in fiscal year 2026. Contractors report at least 1,000 additional children on waitlists statewide. The figures cover different groups and do not show how many would lose services under the proposal.
Would Medicaid coverage replace the program?
Not necessarily. Medicaid covers ABA therapy for eligible people 20 and younger, but advocates say provider shortages and low reimbursement rates can make it difficult to find care. Self-funded insurance plans also are not required to cover ABA therapy.
When would services end if lawmakers approve the cut?
HHSC says children would continue receiving services through the end of August 2027 if the Legislature approves eliminating the program. Details about what would happen after that date have not been provided in the source report.
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