Texas is the only state in the country that refuses to cover orthotic and prosthetic devices under Medicaid for disabled adults over age 20, leaving many of the state's more than 550,000 residents with limb loss or limb difference without a path to the artificial limbs and braces they need to work, walk, or simply stay out of the hospital. That gap took center stage this week as individuals with limb loss, healthcare providers, and advocates gathered at the Texas Capitol in Austin on Monday to press lawmakers on the issue ahead of the next legislative session.
The advocacy day was organized by Ottobock and Hanger, Inc., two orthotic and prosthetic companies both headquartered in Austin, according to PR Newswire. Texas records roughly 45,000 amputations a year and has the highest number of people living with limb loss or limb difference of any state in the nation, per the same release. Because Medicaid's adult O&P benefit is optional rather than federally mandated, the state has chosen not to fund it, even though federal Early and Periodic Screening, Diagnostic and Treatment rules require states to cover the same devices for beneficiaries under 21, according to the American Orthotic & Prosthetic Association.
A Bill That Died Once Already
This isn't the first attempt to close that gap. Senate Bill 1466, authored by State Senator Juan “Chuy” Hinojosa, and House Bill 5544, authored by State Representative Gary VanDeaver, were both filed during the 2025 legislative session specifically to mandate Medicaid coverage of adult prosthetics, according to Texas Legislature Online. Both bills died in committee without advancing to a floor vote, the same records show.
An Earlier Coverage Proposal
Texas's adult coverage debate predates the 2025 bills. A separate proposal, S.B. 1174, was filed in 2017 by Hinojosa and would have required Medicaid prosthetic-device coverage for certain recipients regardless of age, according to a Texas Senate Research Center analysis. The analysis documents the proposal, not its enactment, and does not describe beneficiaries’ or clinicians’ experiences obtaining—or being unable to obtain—medically necessary prostheses.
House Bill 426 has technically passed, but access is expected to be delayed until September 1, 2027.
The Financial Case Advocates Are Building
Their pitch to lawmakers leans heavily on numbers. Advanced microprocessor knees alone can run $70,000 to $100,000 every three to five years, figures Hoodline has previously reported in coverage of a Santee, California, crash victim who lost both legs.
Hanger Clinic argues that covering adult O&P care ultimately saves the state money by preventing expensive hospitalizations, emergency room visits, and nursing home placements tied to secondary mobility complications. Amputation can affect health and workplace independence, and advocates say related costs fall on taxpayers regardless of whether Medicaid pays for a prosthetic up front.
Voices From the Advocacy Day
Company representatives also made the case for coverage at the advocacy day. Scott Schneider, head of governmental and medical affairs for Ottobock North America, said timely orthotic and prosthetic care can help people with limb loss improve their quality of life and return to work and family and community roles. Maggie Baumer, who leads enterprise patient advocacy for Hanger and uses a prosthetic device herself, said access to high-quality care is essential to independence, health, and quality of life, according to the PR Newswire release.
Both companies said they remain committed to advancing policies that support people with limb loss, limb difference, and other physical challenges, per the same statement. Ottobock, founded in Germany in 1919, has operated as an official technical partner to the Paralympic Games since 1988 and now employs more than 9,300 people across 135 countries, with over 1,100 in North America, according to Architectural Record. Hanger, meanwhile, runs two business segments — patient care and products and services — and provides outcomes-based orthotic and prosthetic care through more than 925 Hanger Clinic locations nationwide, treating roughly 1 million patients annually.
A Bigger Company, a Bigger Push
Hanger's footprint is about to grow further. The company announced a merger with mobility supplier Numotion in September under private equity sponsor Patient Square Capital, forming what will be known as Hanger Numotion, according to S&P Global. The consolidation adds financial and operational scale to a company that is simultaneously lobbying state lawmakers on Medicaid coverage.
Texas's Medicaid coverage debate also sits inside a wider national shift. Fifteen states have already enacted “So Every BODY Can Move” laws requiring health plans to cover activity-specific prosthetics and orthotics, part of a national push to reach 28 states by the 2028 Los Angeles Paralympics, per the Amputee Coalition. Texas has not joined that list, and its Medicaid program is separately grappling with processing backlogs — more than 200,000 Texans faced application delays at the Texas Health and Human Services Commission this month, driven partly by new semi-annual renewal rules, as reported by The Texas Tribune.
Whether the fiscal argument lands with lawmakers when they reconvene in January 2027 remains to be seen. Advocates have roughly three and a half months to make their case again, this time armed with a failed 2025 attempt, a pediatric precedent in HB 426, and a stack of cost data aimed squarely at persuading a state legislature that has so far chosen to leave adult amputees out of its Medicaid program.
