If US-based activists had hopes for a summer reprieve from the Trump administration’s ongoing attacks on disability rights, they were met with a very rude awakening.
Rather than getting much-needed time to regroup after a year and a half of fundamental rights being persistently undermined and cuts to community-based services and programmes (including Medicaid – the primary federal social insurance programme) they faced another huge threat from the government.
There was a shocking rebuke to the principle of community inclusion and de-institutionalisation and of protections under the Americans with Disabilities Act (which marked its 36th anniversary in July) in June. The Department of Justice issued a “memo” that effectively declared that it was no longer a priority to support people within the community rather than placing them in institutions.
Right at risk of loss
While the law itself has not changed, the memo argues the “integration mandate” that has long underpinned community-based support no longer stands – in particular for people with “severe mental illness or disabilities”. The memo is a clear indication that the right not to be segregated from society is at risk of being overturned.
As well as being unnecessary and cruel, it is absurd. Community-based support costs less than institutional care. A 2023 report from the United States Accountability Office, entitled Medicaid: Characteristics and Expenditures for Adults with Intellectual or Developmental Disabilities, found that home and community-based services (HCBS) were not as costly as placing individuals in institutions or care facilities.
“Average HCBS program expenditures were generally lower than states’ estimated costs for serving beneficiaries with intellectual or developmental disabilities in institutional settings,” the report concluded.
Advocates are rightly concerned at what the memo signals going forward. With cash-strapped states already forced to cut services as a result of Medicaid budgets being slashed, if the federal government decides to take a back seat on enforcing precedents that ensure community-based living is the priority, it could see decades of progress rolled right back.
As Alison Barkoff, a health law and policy professor at George Washington University who led the Administration for Community Living during the Biden presidency, told National Public Radio: “It is now the position of the United States government that people with disabilities don’t have a right to be part of their communities. I can’t overstate how significant this change in position is.”
People with disabilities no longer have a right to be part of their communities. I can’t overstate how significant this change in position is
This is all bad enough. But the Trump administration didn’t stop at the June memo. One month later, the Department of Justice issued a notice that it would no longer be adhering to guidance used by federal officials to enforce the Americans with Disabilities Act’s “integration mandate”.
Retreat from the community
The outcome? Confusion and uncertainty at the state level for providers and the possibility that some states will see the notice as a cue to retreat from supporting community-based services.
Fears that the second Trump administration would target disability protections have proved right and advocates have fought back consistently and passionately.
It’s not an exaggeration to say that the assault on disability rights has been relentless. As with the roll-out of austerity cuts in the UK, the normalisation of marginalising disabled people is a key tenet of the US government’s approach.
Instead of preserving and promoting rights to inclusion and independence, the government is actively subverting them.
Mid-term elections are due in November and Democrats are likely to wrest back control of the House of Representatives (suggested by dire approval ratings for the president). This at offers some hope.
However, the administration appears to be fine with running roughshod over rights, whatever the law stipulates. The battle is far from over.
