Texas health agency proposes eliminating children’s autism program
[October 13, 2026]
By SASHA DRAEGER-MAZER/The Texas Tribune
For years, 7-year-old Israel Solis couldn’t communicate with the world
around him. Born with autism and nonverbal, he would bite and scratch
himself in frustration when someone couldn’t understand his needs.
Therapy through a state-subsidized program gave him a voice: using a
picture system he’s learned from his providers in Houston, he’s now able
to convey his desires.
But Texas wants to eliminate the state program, which allows some
families to pay nothing for services, because of state budget cuts. In
its budget request to the Legislature for the 2028-2029 biennium, the
Texas Health and Human Services Commission (HHSC) proposed eliminating
funding for the Children’s Autism Program (CAP) entirely, stunning
advocates, providers and parents.
“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?’”
said Israel’s mother Elizabeth Solis, who has another son who obtains
services through a CAP-funded program at the University of Houston-Clear
Lake’s Center for Autism and Developmental Disabilities; she pays
nothing for their services.
CAP, which started in 2008, contracts with 16 providers across Texas to
provide focused applied behavior analysis (ABA) therapy to autistic
children at a reduced cost based on their families’ incomes and
insurance coverage. Children are eligible for up to 720 hours of ABA
therapy, which advocates consider the gold standard for autism
treatment, over their lifetime.
Over the last two years, the state spent $13.7 million on the program,
and this year even expanded the program, extending eligibility to those
up to 21 years old and removing a cap on yearly hours. In fiscal year
2026, the state autism program funded treatment for 583 children, but
contractors report there are at least 1,000 more children on waitlists
statewide.
“We were really shocked to see nothing, and it’s just blank where the
line item should be,” said Jacquie Benestante, executive director of the
Autism Society of Texas. “We’re used to having to fight for funding, but
to actually have a program just slashed and canceled is pretty
shocking.”
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. In response to questions about
why HHSC chose to eliminate the program, officials pointed to HHSC’s 3%
budget reduction summary, which says the agency “focused reductions on
the lowest direct service impact to clients and minimizing impacts to
federal funding.”
But, in HHSC’s budget request proposing to axe the program, officials
explicitly acknowledged the acute need for autism therapy. “The demand
for services exceeds the availability of qualified providers especially
in rural parts of the state,” per the request. “While private and public
insurance now provide coverage for treatment services there are often
not providers available in all parts of the state.”
If the Legislature agrees to eliminate the program, children would still
receive services through the end of August 2027, HHSC said.
Many of Texas’ public programs are funded with federally matched
dollars. Jeff Miller, a senior policy specialist at Disability Rights
Texas, said CAP, as a solely state-funded program, may have seemed like
an easy way to cut costs without endangering federal funding.
Complexities around Medicaid coverage for ABA therapy may also be partly
to blame. In 2022, Medicaid benefits started covering ABA therapy for
people 20 years old and younger, making the state’s autism program
appear redundant. But relying solely on Medicaid could still leave many
without access to ABA therapy, said Jolene Pohl, advocacy director for
the Coalition of Texans with Disabilities.
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 First, those Medicaid benefits don’t
apply to families without insurance or who are on self-funded
insurance plans, which aren’t required to cover ABA therapy. Second,
Medicaid, despite the new benefits, is far from a guarantee for
accessing ABA therapy: due to low reimbursement rates, it’s
difficult to find providers willing to take Medicaid clients. CAP is
an avenue for families that fall through these gaps to still access
ABA therapy, Pohl explained.
“It would make more sense to increase the funding
and get those kids off the waitlist and give them the services that
they need,” Pohl said, “because eventually it’s going to cost the
state more if we don’t provide the services to these eligible
families in a timely manner.”
Single mother Emily Pena said that even though her daughter Lila
Rodriguez, 5, is on Medicaid, finding a provider still proved
difficult. She eventually discovered a CAP-funded program at the
University of Houston-Clear Lake’s autism center.
Lila was nonverbal when she was first diagnosed and struggled in
pre-K. ABA therapy works by using positive reinforcement to
encourage desired behaviors. For instance, to help address Lila’s
meltdowns when tablet time ended, therapists used something fun,
like slime, to redirect her so that she associated the transition
with a positive outcome. Pena said the center’s program, which Lila
attended two or three times a week until she graduated in June,
allowed her to enjoy “somewhat of a normal childhood.”
Over the past 20 years, the number of children diagnosed with autism
spectrum disorder has risen 300%, according to researchers at Johns
Hopkins University. With autism diagnoses on the rise, ABA therapy
is in high demand. In Texas, wait times for CAP-partnered programs
are measured in years, not weeks.
The University of Houston-Clear Lake’s autism center has worked with
the state to offer ABA therapy since CAP launched. Last year, the
center’s CAP-affiliated programs provided therapy for 41 families,
the center’s director, Dorothea Lerman, said, and there’s another
200 families on the waitlist. She called the proposal to eliminate
CAP “devastating.”
“There is no other option for the majority of them, and so they
would basically have no services,” Lerman said. “It would greatly
impact the quality of the whole family’s life – the ability to take
your child to the grocery store or out to a restaurant, to function
better and learn better in public school.”
Her center doesn’t have the infrastructure to take Medicaid or
insurance, Lerman said. If the proposed CAP elimination goes into
effect, the center would have until August 2027 to find an alternate
source of funding before its CAP-affiliated programs shut down.
The proposal has also left Hailey Johnson baffled and frustrated.
Her son Micah Ortiz was diagnosed with autism at 18 months; now 3
years old, he attended one of the university’s CAP-funded programs
for several months and is on the waitlist to return to the program.
Johnson said that ABA therapy improved his communication skills and
mitigated his meltdowns and aggressive behavior.
“It’s already hard enough on families with kids with autism … We
don’t have that many resources as it is,” Johnson said. “This was a
really great one, and they’re going to take that away.”
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