Some $350 million in cuts to a Texas Medicaid program providing therapy for disabled children have taken effect.
The reductions sparked outcry after being approved by the GOP-controlled Legislature last year.
They reduce revenue for some Texas therapy providers. Opponents say they'll force providers to close, and could cost roughly 60,000 children access to speech and occupational therapists.
Health and Human Services Commission spokeswoman Carrie Williams said the cuts were implemented Thursday to "achieve savings," as directed by state lawmakers.
She added: "We will monitor the reduction of rates to ensure access to care is not impacted."
Advocates sued to stop the cuts, but Texas' Supreme Court refused to hear the case.
Texas House Speaker Joe Straus says the Legislature may readdress the cuts, though, after it convenes Jan. 10.