Here is the current 2026 status on Intellectual and Developmental Disabilities (IDD) in Texas and the U.S., detailing major legal outcomes, systemic service gaps, and financial eligibility expansions. 

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Texas IDD Status Report: 2026 Overview 

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1. Federal Legal Milestones 

• Successful Facility Reform: In December 2025, the U.S. Department of Justice concluded a 16-year civil rights case against Texas. The state’s 13 state-supported living centers (SSLCs) were found to have successfully implemented reforms to protect residents and provide necessary clinical care.

• Nursing Facility Violation Ruling: Conversely, a landmark June 2025 federal court ruling in Steward v. Young found Texas in violation of federal law for unnecessarily institutionalizing over 4,000 individuals with IDD in nursing facilities. The court mandated the state develop a plan to transition these individuals into community-based settings. 

 

2. Access to Care & Service Gaps 

• Medicaid Waiver Interest Lists: Texas continues to face an immense backlog for Home and Community-Based Services (HCBS). Current estimates show over 170,000 unduplicated individuals on "interest lists" (waitlists), with many waiting over a decade for services.

• Mental Health Prevalence: Individuals with IDD in Texas experience mental health conditions at significantly higher rates—approximately 36% compared to 20% in the general population—and are estimated to experience trauma at 2.5 to 10 times the rate of the general population. 

 

3. National Financial & Digital Trends 

• Expanded ABLE Eligibility: As of January 1, 2026, the ABLE Age Adjustment Act has taken effect. Eligibility for tax-advantaged savings accounts now includes individuals whose disability began before age 46 (previously 26), benefiting an estimated 1 million additional Texans.

• Digital Accessibility Deadline: Public entities nationwide are approaching an April 2026 deadline to ensure all web and mobile applications meet federal accessibility standards for individuals with disabilities.

• Economic Impact: National I/DD spending reached approximately $104.6 billion in the most recent fiscal cycles, with 83.1% of funding sourced from federal-state Medicaid. 

 

4. Summary of Key 2026 Changes