Children’s Medicaid Therapies

Children's icon, a cluster of simplified figures, one smaller than the other two.

Our Position

We strongly urge the Legislature to restore reimbursement rate cuts made during the previous session by Rider 50. Whether in the supplemental budget or during the regular session, funding should be restored to eliminate the budget cuts which have already limited the access to therapies for many families whose children rely on Medicaid services and have pushed some therapy providers into closure.

The Latest

New HHSC policies could not only cancel out funds partially restored by the Texas legislature—they could actually deepen the cuts (Sept. 1, 2017).

Although therapies cuts weren't on Gov. Abbott's priority list for the special session, the House unanimously passed a bill to partially restore them (Aug. 4, 2017).

We signed on to a "Do No Harm Standard" letter to leaders in Congress, urging them to protect children as the American Health Care Act (AHCA) or any changes to national healthcare policy develops. (Mar. 22, 2017).

Pres. Trump signed an executive order Friday (Jan. 20) to weaken the Affordable Care ActThere is a lot of uncertainty about, among other things, what will happen to Medicaid. We're watching this closely (Jan. 23, 2017).


In 2015, as a budget containment measure, lawmakers directed the Health and Human Services Commission (HHSC) to cut $150 million from the Texas Medicaid budget (which causes a loss of an additional $200 million in federal funding). These cuts came in the form of about a 20% reduction to reimbursement rates for home health providers of certain speech, occupational, and physical therapies for children with developmental disabilities. The State continues to defend the measure, even though health care experts profess that childhood therapies improve lifelong functioning and reduce the need for long term services and supports in individuals with disabilities.

Many providers are unable to maintain their current level of service- or stay in business at all- resulting in the loss of these therapies for about 60,000 Texas children.

Push back against the Rider 50 cuts garnered tremendous support, led by a group of families who filed a lawsuit against the State. In addition, both Republican and Democratic lawmakers spoke out against the cuts, including seeking federal intervention.

A study that lawmakers cited in proposing the Rider 50 cuts has come under fire as well. Its researchers have disavowed the study, criticizing lawmakers for their use of the data and asserting that their work was never intended to predict loss of access to care. It bears noting that the full study- funded by tax payers and prepared by the state- has yet to be released to the public.

Despite efforts to delay and cancel the Rider 50 cuts, they went into effect December 15, 2016. However, House Speaker Joe Straus said in November that the cuts were a mistake and he intends to work to correct them this session.

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