The independent source for health policy research, polling, and news.<\/p>\n
Amanda DeSimone-Shabrack relies on a home healthcare aide to help her high-needs autistic 12-year-old son. Virginia\u2019s Medicaid program covers the assistance, enabling her to work as both an education technology specialist and a professor, run errands, and keep Mason in the home.<\/p>\n
This story also ran on CBS News. It can be republished for free.<\/p>\n
That could change. In June, the Department of Justice issued a legal opinion saying federal disability rights laws don\u2019t require states to provide services that allow people with disabilities to remain in their homes rather than institutions.<\/p>\n
It\u2019s a sharp reversal from 1999, when a landmark Supreme Court ruling held that unjustified institutionalization constituted discrimination under the Americans with Disabilities Act. Previous administrations have relied on that ruling to enforce civil rights for disabled people, but the Trump administration says that long-held interpretation is wrong.<\/p>\n
Advocacy groups say legal protections for about 40 million adults and 5 million children who have disabilities could be undermined, and they worry that the new interpretation may herald a return to forced institutionalization.<\/p>\n
The stage is also now set for a legal fight between advocates, states, and the federal government. Some states with ongoing lawsuits challenging disability rights requirements are already citing the DOJ opinion in hopes it will help them prevail.<\/p>\n
In a case in Texas, for example, some Republican-led states are arguing that a rule instituting a 1973 civil rights law that led to community and home integration of people with disabilities is costly and infringes on states\u2019 rights.<\/p>\n
People like DeSimone-Shabrack are especially worried because, they say, the opinion follows a spate of White House and Republican-led initiatives that have already begun eroding hard-won protections for people with disabilities.<\/p>\n
\u201cI\u2019m worried. Am I going to have to put him in an institution, and what\u2019s that going to be like for him?\u201d said DeSimone-Shabrack, whose personal home care help was recently reduced from 30 to 18 hours a week by the state. \u201cAs he gets older, am I going to be able to care for him without this support?\u201d<\/p>\n
The Department of Health and Human Services remains steadfast in enforcing federal civil rights laws, agency spokesperson Emily Hilliard said in an email.<\/p>\n
\u201cOur commitment to ensuring that individuals with disabilities are treated with dignity, afforded equal opportunity, and are able to meaningfully access community services remains unchanged,\u201d she said.<\/p>\n
But advocacy groups say the DOJ opinion could have sweeping repercussions. The opinion doesn\u2019t change existing law, but advocates worry that HHS and the DOJ could begin rescinding guidance and regulations that mandate integration for people with disabilities.<\/p>\n
They\u2019re concerned that agencies will stop enforcing disability laws that ensure people aren\u2019t unnecessarily institutionalized. HHS, for example, has historically investigated disability discrimination claims at hospitals and in states that get federal funding, enforcing compliance with home and community integration through voluntary agreements. Disability rights experts say those agreements could now be imperiled.<\/p>\n
And some states facing financial pressures may roll back Medicaid services that enable people with disabilities to stay in their homes and communities \u2014 a trend that\u2019s already happening following last year\u2019s passage of the One Big Beautiful Bill Act, which cuts a projected $900 billion-plus from the safety net program over a decade.<\/p>\n