Best States for Autism Families: Which Is Easiest in 2026?

If you're raising an autistic child or a child with a developmental disability, you may have heard another parent say "it's so much easier in another state." Sometimes they're right. A few big programs work the same everywhere. Many of the things that make daily life easier, like Medicaid for your child when you earn too much, help at home, or money for school and therapy, depend on where you live.

This guide covers what every family can use, what changes from state to state, and an open scoring of which states make it easiest right now.

Rules and amounts change, often every year. This is general information, not legal or financial advice. Before you apply for anything or make a big decision, check with your state agency. We checked the figures on October 7, 2026 and linked our sources.

The Short Answer

Of the states we scored, Idaho and New Hampshire came out on top. In KFF's 2026 survey, neither reported anyone with an intellectual or developmental disability waiting for Medicaid home care. Both have a Medicaid route for children with disabilities that doesn't count parents' income. And both offer school funding with extra money or priority for students with disabilities.

Next, tied and listed alphabetically: Arizona, Arkansas, California, Delaware, Massachusetts, Minnesota, Mississippi, Nebraska, Oklahoma, Rhode Island, Vermont and Washington, DC.

The longest waiting lists were in Texas, then South Carolina, Florida, North Carolina and Illinois.

Help Every Family Can Use

Early intervention, birth to 3

Every state has a publicly funded early intervention program. The CDC says these programs "provide services for free or at reduced cost for any child who is eligible," and "a doctor's referral is not necessary" (CDC). You don't need an autism diagnosis. Eligibility is based on an evaluation of how your child is developing. Find your state's program at cdc.gov/FindEI.

School services, from age 3

At 3, support moves to the school system. The CDC suggests you "call any local public elementary school (even if your child does not go to school there)" and ask for an evaluation for preschool special education (CDC). A child who qualifies gets an IEP (Individualized Education Program), a written plan of goals and services, at no cost to you.

A Section 504 plan is the other route. Section 504 is a civil rights law that requires public schools to provide a "free appropriate public education" to each qualified student with a disability (US Department of Education).

Medicaid and EPSDT

If your child has Medicaid, a federal rule called EPSDT covers children under 21. States must provide the "medically necessary services needed to correct and ameliorate health conditions" (Medicaid.gov). In plain words, if a covered service is medically necessary for your child, Medicaid is generally required to cover it.

SSI for children

Supplemental Security Income is a monthly payment for children with a disability in families with limited income and savings. The 2026 federal maximum is $994 a month (SSA). Many families get less.

For a child at home, Social Security counts part of the parents' income and savings. This is called "deeming." Parents' countable resources above the individual limit (one parent) or couple limit (two parents), $2,000 and $3,000, count toward the child's own $2,000 limit (SSA).

ABLE accounts

An ABLE account is a savings account for a person with a disability. Since January 1, 2026, you can open one if the disability began before age 46. The 2026 contribution limit is $20,000 from all sources combined. A 2025 federal law changed how it is adjusted, so it is now $1,000 above the gift tax exclusion (ABLE National Resource Center). Up to $100,000 in the account isn't counted against SSI's resource limit (The Arc).

Federal tax help

• Child Tax Credit: up to $2,200 per qualifying child under 17 for the 2025 tax year (IRS).
• Child and Dependent Care Credit: can apply to a dependent "of any age who is incapable of self-care" (IRS).
• Medical expense deduction: if you itemize, medical costs above 7.5% of adjusted gross income (IRS).

What Changes From State to State

Waiting lists for home care programs

States run Medicaid "home and community-based services" programs, often called waivers. They pay for things like in-home support and respite. States can cap how many people get in, so many have waiting lists.

In KFF's 2026 survey, 576,672 people with intellectual or developmental disabilities were waiting nationwide (KFF). In 2024, those who got services had waited 50 months on average (KFF). KFF calls lists "an incomplete measure of unmet need": some states don't check eligibility before adding names, and a state with no list may offer fewer services.

Katie Beckett and TEFRA: Medicaid when you earn too much

Normally a child's Medicaid depends on family income. A Katie Beckett program (also called TEFRA) looks only at the child's own income and savings, for a child with a significant disability who could otherwise need institutional care but can be cared for at home. Some states reach the same result through a waiver. Each state sets its own "level of care" bar, and many autistic children won't meet it.

Autism insurance laws

All 50 states now require some autism coverage in state-regulated health plans (Autism Speaks). Details vary, including age or dollar caps. Many large employers are "self-funded," and those plans "are not subject to state autism insurance laws" (Autism Speaks). Ask HR which kind you have.

These laws often cover applied behavior analysis (ABA), and many also cover speech and occupational therapy. ABA is one option insurance may pay for. Families and autistic adults hold very different views about it. If you consider it, ask providers how they work and how they respect your child's comfort and ways of communicating.

Early intervention fees

Some states charge sliding-scale fees for some early intervention services. Federal rules keep evaluation, service coordination and the family plan free, and say a family's "inability... to pay for services will not result in a delay or denial of services" (34 CFR 303.521).

School funding for students with disabilities

Several states give public money for private school, tutoring or therapy. Examples are in the ranking below. These programs usually mean leaving public school, and with it some IEP rights. Ask before you switch.

Family support payments and respite

A few states pay families directly. According to Saginaw County's mental health agency, Michigan's Family Support Subsidy is a monthly payment for families of children with a school eligibility of autism, severe cognitive impairment or severe multiple impairment, under an income limit (Saginaw County CMH). According to the Louisiana Developmental Disabilities Council's 2023 fact sheet, Louisiana's Flexible Family Fund gives a monthly stipend to families of eligible children with severe disabilities until age 18 (Louisiana DD Council). For respite near you, try the ARCH National Respite Locator (ARCH).

The Ranking

How we scored

Three things that differ by state and can be checked in public sources. Up to 4 points.

1. Waiting list (up to 2). People with intellectual or developmental disabilities waiting for Medicaid home care, KFF 2026 survey. None: 2. Fewer than 3,000: 1. More: 0.
2. Medicaid without parents' income (1). A route open to children with developmental disabilities. We accepted a state agency, a county agency, a university, a legal-aid group or a parent organization as the source, and name it in the text. A route with capped slots or its own waiting or priority list is marked "limited slots" and earns no point.
3. School funding (1). A statewide program with extra money or priority for students with disabilities.

Ties are listed alphabetically. Insurance laws aren't scored, because every state has one.

Which states we scored. Only a state with fewer than 3,000 people with I/DD waiting can reach 3 points, so we checked every one of them in the KFF table. The table shows each state that reached 3 or more, plus a few large states for comparison. Every other state on that short-list scored 2 or less in our check: Alabama, Alaska, Colorado, Connecticut, Maine, Michigan, Missouri, Montana, Nevada, Oregon, South Dakota, Tennessee, Washington, West Virginia and Wyoming. We couldn't confirm a Medicaid route for autistic children in Hawaii, New Mexico, New York or North Dakota, and New Jersey's figure was unclear, so those five aren't scored.

The comparison table

Table sources: waiting counts from the I/DD column of KFF's 2026 table. Ohio: EdChoice. Wisconsin: DHS and DPI. Pennsylvania: DHS. Other states are sourced in the text below.

"Not found" means we found no statewide program, not that nothing exists. "Not confirmed" means we couldn't confirm a route from any source we accept.

The states that came out on top

Idaho. According to Idaho's health department, the Katie Beckett program covers children "even if their family income is above Medicaid federal poverty guidelines." There's a premium based on income, but "if you are unable to pay the premium, your child's eligibility won't be impacted" (Idaho Health and Welfare). Under a 2025 law upheld by the Idaho Supreme Court, a refundable education tax credit gives up to $7,500 for a student with a qualifying disability, according to Ballotpedia (Ballotpedia).

New Hampshire. According to the parent group NH Family Voices, for Home Care for Children with Severe Disabilities "only the income and resources of the child are counted" (NH Family Voices). Education Freedom Accounts opened to all students in 2025, and children with disabilities are exempt from the enrollment cap, according to Reaching Higher NH (Reaching Higher NH).

Arizona. Any K-12 student can apply for an Empowerment Scholarship Account, and students with special needs "receive significantly more depending on their specific disabilities," according to EdChoice (EdChoice).

Arkansas. According to the Arkansas Down Syndrome Association, under TEFRA "only the income and resources of the child are counted," with a sliding-scale premium for some families (Arkansas Down Syndrome Association). Education Freedom Accounts are open to all students from 2025-26, and according to Outschool's guide, students with disabilities come second in line if demand exceeds funding (Outschool).

California. According to Undivided, a California parent guide, through the regional center waiver "Medi-Cal will only look at your child's income and resources, without regard to parental income," if the child meets the waiver's support-needs rules (Undivided).

Delaware. According to the University of Delaware, the Children's Community Alternative Disability Program covers children who don't qualify "because of their parents' income and/or resources" (University of Delaware).

Massachusetts. According to the Massachusetts Law Reform Institute, CommonHealth charges a monthly premium at higher incomes "but has no upper income level" (MLRI, 2025).

Minnesota. According to Minnesota's human services department, TEFRA "only considers the child's income" (Minnesota DHS), and parent fees for it ended in July 2023 (Minnesota DHS).

Mississippi. Mississippi Medicaid says children who don't qualify "because the income or assets of their parents are too high may be eligible" through Katie Beckett (Mississippi Medicaid). Its education savings account is for students with an IEP, but it's small: EdChoice counts 454 students, and eligible applicants may be waitlisted (EdChoice).

Nebraska. Since July 2024, Katie Beckett covers children who need an intermediate care facility level of care and "only considers the child's income and resources," according to KOLN 10/11 (KOLN).

Oklahoma. The state health care authority says that under TEFRA "only the child's income, not the family's, is counted" (Oklahoma Health Care Authority). The Lindsey Nicole Henry Scholarship is open to students "of any income level" who have, or qualify for, an IEP, according to EdChoice (EdChoice).

Rhode Island, Vermont and Washington, DC. Each has a Katie Beckett pathway that counts only the child's income and resources, according to the Rhode Island Parent Information Network, the Vermont Department of Health and DC's Medicaid agency (RIPIN, Vermont Department of Health, DC DHCF).

Michigan just misses. According to a Lapeer County mental health agency policy, the Children's Waiver Program treats a child "as a family of one (the parent's income is waived)," but places go by an invitation to "the family with the highest updated score," so we mark it limited slots (Lapeer County CMH). Michigan also has its Family Support Subsidy.

Where it's hardest right now

Texas has by far the longest lists: 343,197 people with intellectual or developmental disabilities waiting in KFF's 2026 survey (KFF). Texas doesn't check eligibility before adding names, so not everyone listed would qualify. The director of The Arc of Texas said people "can wait 17 to 18 years" for two main programs (TPR). Texas's Medically Dependent Children Program counts only the child's income (Texas HHS), but it has its own interest list (Texas HHS), so we mark it limited slots. From 2026-27, Education Freedom Accounts may give up to $30,000 a year to a child with a disability who has an IEP on file with the Texas Education Agency and attends a participating private school, pre-K or kindergarten (Texas Comptroller).

South Carolina (36,824 people with I/DD waiting), Florida (22,621), North Carolina (19,000) and Illinois (17,700) also had long lists (KFF). According to the Florida Health Justice Project, Florida's main Katie Beckett-style route is a waiver with 20 slots (Florida Health Justice Project). Its school scholarship for students with disabilities funded 147,728 students in 2025-26, starting at age 3 (Step Up For Students).

If you live in one of these states, help is still there. Early intervention, school services, Medicaid's EPSDT benefit and your insurance don't depend on these lists.

What this ranking doesn't measure

It can't tell you how long you'll wait for a diagnosis, whether a speech therapist near you is taking new clients, or what housing costs. It doesn't score the quality of public special education. And school funding programs usually mean giving up some IEP rights. Treat the score as a starting point for your own questions.

Should You Move?

Some families do. Ask the agencies in the new state whether there's a waiting list for what your child needs, how long it is, and whether your child is likely to qualify. A place on one state's list doesn't carry over. You generally need to be a resident of the state when you apply. Check with each state agency before deciding.

What to Do This Week

None of these steps needs a diagnosis.

• Under 3? Call your state's early intervention program and ask for an evaluation (cdc.gov/FindEI).
• 3 or older? Ask your local public elementary school, in writing, for a special education evaluation.
• Ask about Medicaid for your child, even if you think you earn too much. Use the words "Katie Beckett" or "TEFRA."
• Ask your state's developmental disabilities agency about waiting or interest lists. Lists usually move by date, so it's worth asking early.
• Call your insurer or HR. Is your plan fully insured or self-funded? Which autism and speech services does it cover?
• If income and savings are limited, check whether your child may qualify for SSI.
• Start one folder for every evaluation, report, plan and letter.
• Find your Parent Center. These federally funded centers help families with school and services (Parent Center Hub).

While You Wait, Practice at Home

Paperwork moves slowly. Your child's day doesn't. Small habits help: naming things during play, reading the same picture book again and again, offering two choices. And every way your child communicates counts, including gestures, signs, pictures and talking devices (often called AAC). Our guides on what to do while you wait for speech therapy and speech therapy exercises at home have simple ideas.

If an app fits your routine, Word Tube was made by a dad for his daughter, for short daily practice with real photos and words, between therapy sessions or while you wait for them. It's for practice alongside your child's team, not instead of it.

Common Questions

What is the best state to live in for a child with autism?

There's no single best state. Of the states we scored in 2026, Idaho and New Hampshire came out on top: no one with intellectual or developmental disabilities waiting for Medicaid home care in KFF's survey, a Medicaid route that doesn't count parents' income, and school funding with extra for students with disabilities. Arizona, Arkansas, California, Delaware, Massachusetts, Minnesota, Mississippi, Nebraska, Oklahoma, Rhode Island, Vermont and Washington, DC came next.

Can my autistic child get Medicaid if we earn too much?

Possibly. Many states have a Katie Beckett or TEFRA program, or a waiver, that looks only at the child's own income, for a child whose needs meet the state's level of care rules. Ask your state Medicaid agency.

Does my child need an autism diagnosis to get early intervention?

No. Eligibility is based on an evaluation of your child's development, and the CDC says a doctor's referral is not necessary.

How much is SSI for a child with autism in 2026?

The federal maximum is $994 a month in 2026. Many children get less, because part of the parents' income and savings counts. A child must also meet Social Security's disability rules.

Do all states require insurance to cover autism services?

All 50 states require some autism coverage in state-regulated plans. Self-funded employer plans follow federal law and aren't bound by state autism laws.

Which states have the longest Medicaid waiver waiting lists?

In KFF's 2026 survey, Texas had the most people with intellectual or developmental disabilities waiting, 343,197, followed by South Carolina, Florida, North Carolina and Illinois.