Following my recent discussions with legislative staff, it has become clear that while progress is being made on certain issues, critical gaps remain in Texas' healthcare system for disabled children and their families. Senator Creighton's legislative aid confirmed that:

Medicaid and SSI thresholds are set at the federal level and would require Congressional action to transition from income-based to needs-based eligibility.
Attendant care wages are increasing to $12/hour in SB 1, but this applies primarily to senior care and does not address the 16+ year wait times and restrictive income-based requirements for families needing similar support for disabled children.
Dental anesthesia coverage under Medicaid exists, but private insurance does not provide this coverage for medically necessary cases, leaving families with no assistance if they do not qualify for Medicaid.

What is SB1?

Senate Bill 1 (SB 1) is Texas's proposed state budget for the 2026-2027 biennium, encompassing a wide range of funding allocations across various sectors, including healthcare, education, public safety, and infrastructure. While SB 1 does allocate funds for senior care, it is not exclusively focused on services for seniors.

Key Allocations in SB 1: According to The Texas Lieutenant Governor's Office

Healthcare Services: The budget designates $46.5 billion from All State Funds for Health and Human Services, representing a 1.9% increase from the previous biennium. This includes $756 million aimed at increasing base wages for community attendants.

 
Public Education: SB 1 allocates $71.3 billion in All Funds to fully fund the Foundation School Program, accounting for enrollment growth. An additional $5.3 billion is earmarked for public education enhancements, including teacher pay raises and school safety initiatives.

 
Property Tax Relief: The bill provides $32.2 billion to extend previous tax cuts, offer additional compression under House Bill 3 (86th Legislature, 2019), and increase the homestead exemption to $140,000 for regular homeowners and $150,000 for seniors.

Border Security and Public Safety: SB 1 allocates $6.5 billion to maintain Texas's border security operations and $402 million for the recruitment of new Department of Public Safety troopers and related enforcement personnel.

Infrastructure Investments: The budget includes $5 billion for the Texas Energy Fund to strengthen the electric grid, $2.5 billion for water and flood infrastructure projects, and $40.4 billion for the Texas Department of Transportation.

In summary, SB 1 addresses a broad spectrum of state needs, with funding allocated to various sectors beyond senior care, aiming to benefit multiple demographics across Texas, but does not directly address the issue at hand.

 

Key Issues That Remain Unaddressed

Texas lacks a program that allows parents of medically complex children to receive financial support as caregivers. Unlike senior care programs, there is no needs-based alternative for non-Medicaid families to access home health care or attendant services.

Medicaid Waiver Programs remain income-based with excessive wait times (16+ years) . Disabled children whose families exceed the income threshold are left without essential support.

Private insurance does not cover critical medical procedures like dental anesthesia. Parents are forced into costly hospital settings or must pay out of pocket, leading to medical neglect for children who require sedation for safe dental care.

 

What Can Be Done Next?

While legislative offices have acknowledged these challenges, we need a stronger public push to demand action. Here’s how we can support the cause and create momentum for change:

• Federal-Level Advocacy
  Call and write to Texas’ Congressional Representatives (Senators and House members) urging them to support federal Medicaid reforms that introduce needs-based eligibility instead of income-based restrictions. Advocate for federal funding increases for home-based care and a new waiver program for disabled children, not just seniors.
• State-Level Legislative Action
  Engage with Texas lawmakers to introduce a state-specific solution that mirrors waiver programs but removes income restrictions.
  Push for state-mandated private insurance reform to require coverage of medically necessary in-home procedures like dental anesthesia for special needs children.

The response from the legislative office shows that while some progress is being made, the core issues remain unresolved. The current system continues to fail disabled children who do not qualify under outdated income-based Medicaid models. If Texas can reform these policies, we can provide thousands of families with essential caregiving and medical services that should be a right, not a privilege.

The next step is public action—we need to pressure legislators, advocate for policy changes, and mobilize community support to ensure that children with disabilities receive the care they need, regardless of their family’s income.

Let’s work together to push for real change. Our voices matter.