Texas Medicaid adds future coverage for autism

June 28, 2019

Update as of July 15, 2021: Due to COVID-19, the implementation of coverage for autism services was delayed. The benefit implementation date has been confirmed for February 1, 2022.

 

On June 15, Governor Greg Abbott signed a budget bill which included a requirement for Texas Medicaid to cover medically necessary care, including applied behavior analysis (ABA), for all Texas Medicaid-enrolled children. 

An estimated 80,000 children with autism in Texas rely on Medicaid for their healthcare and have been unable to access the most basic, evidence-based treatments for diagnosis. The added coverage will ensure access to appropriate services, resources and interventions, including ABA, following an autism spectrum disorder diagnosis. This timely access to care may influence individuals’ life outcomes, including reducing needs for special education services, improving quality of life or opening the door for further education, employment and independent living. 

In the coming months, children under the age of 21 will have access to medically necessary care, including ABA, through Texas Medicaid. The addition of this coverage brings Texas in line with a 2014 bulletin from the Centers of Medicare and Medicaid Services (CMS) which requires states to add coverage of medically necessary autism treatments for children to their state plans. Texas now joins more than 40 other states in including this coverage.

Autism Speaks will continue to work on the implementation of this coverage in order to ensure access to reliable services and information for people with autism and their families.