State Budget & Appropriations

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State Budget icon. A 2-dimensional representation of the state Capitol building with a dollar sign on the dome.Our Position

Texans need prosperous, safe, and healthy communities that promote growth and opportunity. Excellent public schools, quality health care, safe roads, environmental protection, and other crucial services require strong public investments, yet state spending does not keep up with growth in population and inflation, let alone prepared our state for the challenges of the future (not to mention the present).

The coronavirus pandemic has brought some of the most devastating effects of chronic systems underfunding into sharp focus. At the same time, this crisis, including unemployment and economic impacts, has prompted speculation of severe budget cuts in 2021. CTD firmly believes that budget cuts will amplify, not relieve, the worst effects of the coronavirus in Texas. Given Texas’ massive rainy day fund, the extra billions the federal government has sent and will send, and multiple opportunities to close revenue loopholes, state leadership cannot claim helplessness in state finances.

The Latest

February 3. 2021: Rep. Lyle Larson's op-ed to the Austin American Statesman: Refusing to Expand Medicaid is the Wrong Call

December 1, 2020: Cause for optimism...? The Texas Tribune reports that Despite staggering pandemic losses, Texas budget forecast better than expected, state comptroller says


Across our priorities, CTD favors policies that support long-term sustainability and prosperity while benefitting Texans with disabilities. As individuals, basic principles of money management tell us that it’s smarter to plan up-front investments and prevent expensive, avoidable crisis situations. The same is true for the state. Here are a few of CTD’s policy positions that build on this foundation:

Community attendant wages

People who need help with activities of daily living to stay in their own home benefit from reliable community attendants, but the wage set by the Legislature is very low and not competitive. A raise in the wage will result in better health for Medicaid beneficiaries, fewer acute care costs, fewer ER visits and hospitalizations, and less unnecessary institutionalization. All of these costs are paid for by the public and far more expensive than a fair wage for community attendants. More about Community Attendants

Medicaid waiver interest lists

With 165,000+ unduplicated individuals as of August 2020, Texas has the nation’s largest and longest waitlist to receive services under a Medicaid waiver program. In their budget request, the Health and Human Services Commission (HHSC) set aside funds to reduce the list by 1,756 slots per year. On average, a Texan joining the list at #165,000 would be looking at a wait of 93 years before reaching the top of the list. Even a 10% reduction of the list each year would be an improvement.

Access to oral and dental care

About 90% of adults in Texas Medicaid have little or no preventive dental services. Severe dental pain is among the most common reason Medicaid adults go to the ER. Poor oral health impacts nutrition and is linked to heart disease, diabetes, and other chronic conditions. A modest preventive dental benefit would keep Medicaid consumers healthier and cost less overall. More about Access to Oral Healthcare

Increase the number of insured Texans

To borrow the words of Rep. John Bucy, "Medicaid expansion is the biggest tool we have to save lives and help people access needed healthcare." If Texas accepted Medicaid expansion, currently uninsured Texans would have access to health care, the federal government would provide several billion dollars to the state coffers, and an estimated 300,000+ jobs would be created.

Special education

It’s simply accepted that public education leads to citizens better able to be good learners, workers, entrepreneurs, neighbors, and taxpayers. The same is true for kids with disabilities. A strong Early Childhood Education program for kids 0 - 3 is pennies on the dollar with a huge return on investment. More about Special Education

Access to medical cannabis

Props to the Legislature for permitting then expanding access to medical cannabis. Consequently, hemp (derived from the same plant) has been legalized and is largely unregulated. The result has been that numerous consumers left regulated medical cannabis for cheaper, unregulated hemp products. Legislators should recognize this change in environment and reform the medical cannabis laws with a goal to drive consumers to safer, more regulated, and more effective products in the Texas Compassionate Use Program (TCUP). This should be a source of state revenues and new jobs as demonstrated in multiple states. More about Medical Cannabis

In every area of our work, it is clear that lawmakers' budgetary decisions can empower and help all Texans, including Texans with disabilities—or hurt them. That's why CTD always priorities the State Budget and Appropriations in our advocacy work. While securing funding is often an uphill battle, CTD has built a track record of success: over the past decade, we have calculated that CTD has led or significantly contributed to legislative efforts that have added over $3 billion in state budget appropriations to programs and services that support Texans with disabilities and seniors.

Further Reading