The Texas Health and Human Services Commission has proposed eliminating funding for the Children's Autism Program in its 2028-2029 budget request. If lawmakers approve the proposal, the program that has provided reduced-cost autism therapy since 2008 would wind down after August 2027. At least 1,000 children are already on waitlists for CAP-partnered services; the proposal puts the program’s future in doubt but does not mean those children newly entered the waitlist.
The commission’s request would zero out the program’s entire appropriation if approved by state lawmakers, according to the Texas Tribune. CAP contracts with 16 providers statewide and offers applied behavior analysis, or ABA, therapy at a reduced cost based on family income and insurance coverage — in some cases, at no cost. Eligible children can receive up to 720 hours of ABA therapy over their lifetimes, the Tribune reported.
For Houston mother Elizabeth Solis, the program has meant free, specialized care for both of her sons through the University of Houston-Clear Lake Autism Center. Her 7-year-old son, Israel, communicates using a picture system he learned through his Houston therapy providers. Solis said she fears families like hers would lose access to help entirely if the funding disappears, the Tribune reported.
A Program Already Stretched Thin
The Children's Autism Program funded treatment for 583 children in fiscal year 2026; that figure describes services funded during that year, not current enrollment. Demand has exceeded available services: at least 1,000 additional children are on waitlists statewide for CAP-partnered programs, with waits measured in years, according to the Tribune's reporting. Those waitlists existed before the proposed budget cut.
At the University of Houston-Clear Lake's autism center alone, the program provided therapy to 41 families last year, while another 200 families sat on its waitlist. Texas has reported spending $13.7 million on the Children's Autism Program over the past two years, though a separate budget analysis from The Texas Dispatch put the program's full two-year appropriation at $13,663,084 — the exact amount it says would be eliminated under the proposal.
Jacquie Benestante, executive director of the Autism Society of Texas, said the proposed cancellation came as a shock, the Tribune reported. Jolene Pohl, advocacy director for the Coalition of Texans with Disabilities, argued that increasing funding for the program — rather than cutting it — could actually move children off waitlists and prevent the state from facing higher costs down the road, per the same account.
Why Medicaid Isn't a Safety Net for Everyone
Medicaid benefits began covering ABA therapy for people 20 years old and younger starting in 2022, making CAP appear redundant. But that coverage does not extend to families who lack insurance or who carry self-funded insurance plans, and low Medicaid reimbursement rates have made many providers reluctant to accept Medicaid clients in the first place, according to the Tribune's reporting.
The budget squeeze traces back to direction from Texas leadership. Governor Greg Abbott, Lieutenant Governor Dan Patrick and House Speaker Dustin Burrows directed state agencies, courts and universities to cut spending by 3% in the upcoming biennium, a mandate issued in July. The health commission has said its reductions were designed to minimize impacts on client services and federal funding, though eliminating the autism program entirely would represent one of the more direct hits to a vulnerable population.
The commission has acknowledged, per its budget request, that demand for autism services already exceeds the availability of qualified providers, particularly in rural parts of Texas. If the Legislature does approve the elimination, the commission has said services would continue through the end of August 2027 before winding down. Texas lawmakers have not yet decided whether to approve the cut, leaving the program's fate unresolved for now.
Families Describe What's at Stake
ABA therapy uses positive reinforcement to encourage desired behaviors, and families who've used it describe transformative results. Hailey Johnson said the therapy improved her son Micah Ortiz's communication skills and reduced his meltdowns and aggressive behavior, according to the Tribune. Five-year-old Lila Rodriguez attended a CAP-funded autism program two or three times a week until she graduated from it in June.
Jeff Miller, senior policy specialist at Disability Rights Texas, and Dorothea Lerman, director of the University of Houston-Clear Lake Center for Autism and Developmental Disabilities, have also weighed in on the stakes for families relying on the program, per the Tribune's reporting. Lerman's center says it would need to find alternate funding by August 2027 to avoid shutting down its CAP-affiliated programs altogether.
The pressure on Texas arrives amid a broader national reckoning over the cost of autism therapy. Autism spectrum disorder diagnoses among children have risen 300% over the past two decades, according to Johns Hopkins University researchers cited by the Tribune, and national Medicaid spending on autism therapy jumped to $10 billion in 2025, up from roughly $2 billion four years earlier, per the Times Union.
What autism statistics can—and can't—show
Texas Education Agency data show that 160,218 Texas students received special education services due to autism in the 2025-2026 school year. The agency also describes autism strategies in individualized education programs, according to the Texas Education Agency.
Separately, Johns Hopkins Bloomberg School of Public Health reports that CDC surveillance found autism prevalence of 1 in 31 among 8-year-olds across its study sites in 2022. That national estimate is a point-in-time finding: it does not establish Texas CAP demand, explain the proposed budget cut or, on its own, show how prevalence changed over time, according to Johns Hopkins Bloomberg School of Public Health.
Other States Have Already Cut Deep
Texas isn't alone in confronting rising autism-therapy costs. North Carolina's Medicaid payments for the therapy climbed from $122 million in fiscal year 2022 to a projected $639 million in fiscal year 2026 — a 425% increase — according to Stateline. North Carolina attempted a 10% cut to ABA provider payments, while Nebraska slashed payments by nearly 50% for some providers, with reductions ranging from 28% to 79% depending on the service, according to NPR.
New York providers began receiving roughly half their previous Medicaid reimbursement for autism services when the rate cut took effect on October 1, 2026. Reimbursement for behavior technicians dropped from about $77 per hour to about $38 per hour, the Times Union reported. Indiana lowered its reimbursement rate to about $68 per hour starting in 2024, per Stateline, after a federal audit estimated at least $56 million in improper Indiana Medicaid payments to ABA providers in 2019 and 2020.
Texas has made some moves in the other direction. The state expanded its non-Medicaid autism services program in August to cover a wider range of ages and more hours of ABA therapy, according to Houston Public Media. Whether that expansion will matter much if the Children's Autism Program itself disappears remains an open question for the families still waiting on the program's long lists.
