Thousands of Americans with disabilities like spinal cord injuries (SCI) depend on Medicaid for essential care. Medicaid pays for home and community-based services (HCBS), like skilled nursing and personal care attendants, so individuals with a high level of need don’t have to live in institutions like nursing homes. In most states, family members can be paid by Medicaid to take care of Americans with disabilities like SCI in the comfort of their own homes.
These are rights that are guaranteed to people with SCI by the 1999 Supreme Court ruling Olmstead v. L.C.—which requires people with disabilities to receive care in the most integrated setting appropriate.
But recently, the U.S. Department of Justice released an Office of Legal Counsel opinion that reinterprets Olmstead. It argues that the “integration mandate” derived from the Americans with Disabilities Act (ADA) is not a legal mandate. By questioning the legal foundation of the mandate, the federal shift could encourage states to reduce HCBS.
While the DOJ’s shift signals a major change in federal enforcement priorities, the federal government cannot overturn Supreme Court precedent with a memo. The Olmstead decision is still the law of the land, and the courts will ultimately have to resolve this clash between federal interpretation and decades of established civil rights law.
This prompted a massive 17 states to back Texas v. Kennedy, a lawsuit challenging the U.S. Department of Health and Human Services (HHS) regarding the integration mandate. Advocacy efforts have convinced several states to withdraw, and as of this writing, the remaining plaintiff states are Alaska, Florida, Louisiana, Montana and Texas.
If these states win, federal requirements to fund Medicaid HCBS waivers would essentially dissolve. States would legally be allowed to treat community-based care as entirely optional, making it much easier for them to slash state budgets and defund home caregiving programs.
If your state is one of the current plaintiffs and you want them to oppose this lawsuit and protect the right of Americans with disabilities to receive care in their own homes, you can write or call your Governor and Attorney General to ask them to withdraw from the litigation.
You can also join grassroots or advocacy efforts, such as the campaign organized by The Arc, which provides state-specific contact directories and toolkits.
Receiving care in our own homes is a right that disability advocates have fought for and apparently we need to continue fighting. Living with disability shouldn’t mean living in an understaffed institution.
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