Contact: Jess Davidson, jdavidson@aapd.com; 202-465-5528

WASHINGTON, D.C. – This afternoon, the U.S. House of Representatives held its final vote on the budget reconciliation bill. After being approved by the Senate by a vote of 51 – 50, with Vice President JD Vance casting the tie-breaking vote, the budget reconciliation bill passed in the House. 

After holding the procedural vote open for hours on Wednesday night and after many hours of debate, the final vote occurred on Thursday afternoon. The bill passed by a vote of 218 – 214. The final bill cuts nearly $1 trillion from Medicaid and will endanger 17 million Americans’ health insurance coverage.

“This is a devastating day for disabled Americans,” said AAPD President and CEO Maria Town. “The catastrophic effects of this bill will reverberate for generations to come. As a result of this bill, 51,000 Americans will die every single year from  needless, preventable deaths.”

The budget reconciliation bill will trigger a massive crisis in our healthcare system, which already struggled to support people with disabilities adequately and has been under even more significant strain since the COVID-19 pandemic began in 2020. At least 300 rural hospitals are at risk of immediate closure because of this bill, and 700 more (or one-third of all rural hospitals in the U.S.) are at risk of closure due to financial strain. Nearly 14 million Medicaid enrollees reside in rural areas, including over 3 million disabled individuals. Without Medicaid funding, rural hospitals might face closure or be forced to cut services. This means Americans living in rural areas may soon reside a dangerous distance from the nearest hospital. Wait times will increase in all healthcare facilities, even those in suburban and urban areas, and even for patients not on Medicaid. 

“To every disabled American who feels terrified and defeated right now: You are not alone,” said AAPD President and CEO Maria Town. “I am crushed for every single disabled person who will no longer be able to work because they will lose coverage for the personal care attendant who ensures they can get ready for the office. I am terrified for every disabled American who will be weeded out by strict, difficult-to-keep-up-with administrative requirements. I am heartbroken for every disabled family who loses SNAP and will now have to choose between paying for medications and putting food on the table. No one should ever have to make these decisions.”

“While the outcome of today’s vote is an enormous blow, disabled people will keep fighting and working to build systems that allow us to lead full, dignified lives in the communities and with the people we love. Already, disabled people must adapt, share resources, and crowdfund to make up for gaps in programs and services that are meant to support us. Our community will continue to show up for one another, as we always have, to survive what comes next and insist upon a future where we can thrive,” Town concluded.

President Trump is expected to sign the bill as soon as possible, but the cuts will not take effect immediately. Cuts begin to go in effect at the end of 2026 and roll out over the course of 10 years from the legislation’s signature date. In the coming weeks and months, AAPD will provide resources and information to help members of the community navigate changes in care, health coverage, and benefits.

The post American Association of People with Disabilities Responds to Passage of Budget Reconciliation Bill: “This Is A Devastating Day for Disabled Americans” appeared first on AAPD.

• Healthcare for disabled people inside their home. This is called “Home and Community-Based Services.”

• Support for people who have jobs

• Medical treatments that allow people to live full lives

This bill puts these programs in danger because there would be less money to pay for them. Without these services, many disabled people will not be able to live independently anymore. Many disabled people will die because they can’t get the care they need.

This bill also cuts money from SNAP and changes how it works. SNAP stands for “the Supplemental Nutrition Assistance Program”. SNAP helps people who don’t always have enough money to afford food. The bill does this by making it harder to get SNAP. You already have to be able to show you’re looking for a job to get SNAP. This bill makes it so you have to  show more proof. This bill also shifts the cost for SNAP from the entire country to each state. This means that states with less money won’t be able to provide as much support for people who may need it.

This bill has not become law yet. The next step is that it goes to the House of Representatives. The House of Representatives is the other part of Congress. Some members of the House of Representatives have already said they do not support this bill. They do not like this bill because it is harmful to people with and without disabilities. We want everyone to call or write their member of the House of Representatives and tell them to vote NO. AAPD thinks any bill that harms people with disabilities is bad. The government needs to protect Medicaid.

The post [Plain Language] AAPD Condemns Senate Budget Reconciliation Bill and Deeper Medicaid Cuts appeared first on AAPD.

For Immediate Release: July 1, 2025

Contact: Michael Lewis at mlewis@aapd.com; 540-447-9438

WASHINGTON, D.C. — The American Association of People with Disabilities (AAPD) strongly condemns the budget reconciliation bill passed by the Senate, which includes an alarming $930 billion in cuts to Medicaid. These proposed cuts are even more severe than those passed by the House of Representatives and represent a direct threat to the health, independence, and lives of millions of Americans with disabilities.

Medicaid is a lifeline for people with disabilities. It provides essential services such as home and community-based services, employment supports, and critical medical treatments that enable individuals to live independently, participate in their communities, and maintain their well-being. The deep cuts proposed in this Senate bill would dismantle these vital supports, forcing many people with disabilities into institutions, limiting access to necessary medical care, and ultimately jeopardizing their ability to live full and meaningful lives.

The bill also includes stricter work requirements for the Supplemental Nutrition Assistance Program (SNAP), which helps millions of people with disabilities, older adults, and their families buy food each month. Furthermore, it goes beyond proposing SNAP cuts and also shifts the cost onto states, which would significantly impact their budgets and hit rural communities the hardest. 

“The Senate’s budget reconciliation bill is a cruel assault on disabled people and other marginalized communities,” said Maria Town, President and CEO of AAPD. “These unprecedented cuts to Medicaid and SNAP will not only strip away essential services but will also inflict immeasurable harm on individuals with disabilities, their families, and their communities, all under the deceitful guise of preventing waste, fraud, and abuse, which rarely occurs. Disabled people have fought cuts before, and we will not only continue to fight against cuts that slash our services and threaten our rights, we will fight for more investment in services so that disabled people have what we need to thrive,” Town continued.  

“AAPD also extends its sincere gratitude to the Senators who, during the exhaustive 20-hour ‘vote-a-rama,’ offered crucial amendments to remove the bill’s cruelest provisions. This resulted in the removal of the harmful moratorium on state laws regulating the use of artificial intelligence and included proposed amendments to strip the bill of some of the worst of the Medicaid cuts, remove onerous work requirements, prevent bans on Medicaid coverage for gender-affirming and reproductive healthcare, and preserve vital food assistance. Their tireless work to mitigate the harm of this bill and make our government responsive to the daily needs of the American people is deeply appreciated,” Town concluded.

This fight is not over. The bill now returns to the House of Representatives for a vote on the Senate’s version. We are encouraged that some House members have already indicated their opposition to this harmful legislation. We urge all concerned citizens to contact their Representatives immediately and demand they vote NO on this destructive bill. The AAPD is firmly against any legislation that undermines the rights and well-being of people with disabilities. We call on Congress to protect Medicaid and ensure that people with disabilities have continued access to the services they need to thrive.

The post AAPD Condemns Senate Budget Reconciliation Bill and Deeper Medicaid Cuts appeared first on AAPD.

Note: This resource is based on a rapidly evolving situation and will be updated as we receive more information.

UPDATE from July 3, 2025:

Last night, the House started a vote on the rule to open debate around 9:30 pm ET. Initially, the rule did not have enough votes to pass, but vote was held open for five hours in order to get some Members of Congress to change their vote. The rule passed 219-213, and the bill could move forward for a full floor vote. The only Republican member of Congress to vote no was Representative Brian Fitzpatrick from Pennsylvania, the Chair of the Bi-Partisan Disabilities Caucus.

The House floor is currently debating the Senate-passed version with no changes. Majority Leader Hakeem Jeffries has been speaking for more than four hours reading stories about the importance of Medicaid from all 50 states. There is still time to contact your Representatives to ask them to oppose this bill and to protect Medicaid and SNAP.

UPDATE from July 2, 2025 at 7:53PM:

Current State of Play: Speaker Johnson brought the House to the floor today to vote on the rule to debate and the budget reconciliation text from the Senate, but the Republican  leadership is short of the votes needed to pass the rule for debate. The House floor has been frozen since the vote began around 2:00 pm ET as the leadership tries to have conversations to sway Members of Congress who have not decided how they will vote yet. This means that the bill is stalled. 

The content of the bill is still the same as what was in the Senate bill. It is critical that you contact your Representatives to ask them to oppose this bill and to protect Medicaid and SNAP.

UPDATE from July 2, 2025:

Current State of Play: Early Wednesday morning, the House Rules Committee advanced the budget reconciliation bill after 12 hours of debate. The House Rules Committee plays an important role in determining how a bill will be considered on the floor. The committee can set time limits for debate, restrict or allow amendments, and even determine how certain amendments will be handled. 

There were no changes to the Senate’s version of the budget reconciliation bill in the House Rules Committee. The content of the bill remains the same as described in the update from July 1st update. The House is set to convene Wednesday morning and start voting on the rules to advance the legislation.

UPDATE from July 1, 2025:

Current State of Play: The Senate passed its version of the budget reconciliation bill on July 1st, with Vice President Vance casting a tie-breaking vote. This bill must still pass the House in order to be final.  Contact your Representatives to ask them to oppose this bill and to protect Medicaid and SNAP. 

The Senate budget reconciliation bill makes the largest cuts to Medicaid in history, almost $1 trillion in Medicaid cuts. This is about 20% of the federal Medicaid budget and would cause 17 million people to lose access to healthcare. The bill also contains nearly $200 billion in cuts to the Supplemental Nutrition Assistance Program (SNAP). Four out of five households that receive SNAP benefits include a person with a disability. If passed by the House, these cuts will mean that disabled people and our families will go hungry. 

Throughout the Vote-A-Rama process, amendments were passed that changed what was in the original bill. Some parts of the bill were also taken out because they violated rules about what can be voted on by a simple majority through the reconciliation process. 

The following amendments were added to the Senate bill:

• The rural health fund was increased to $50 billion from $25 billion. It directs money to mental health and behavioral health clinics, but not other disability-specific providers.
• Minor funding for Home and Community-Based Services (HCBS)

Neither of the increases within these amendments will come close to fully addressing the closures of rural health providers or the reduction of HCBS that this bill will cause if passed by the House.  

Some dangerous provisions got removed:

• The Medicaid funding reduction for states that cover undocumented immigrants with their own funds. This means that states that provide Medicaid coverage for undocumented immigrants with state funding will still receive their full federal match for Medicaid. 
• The prohibition on Medicaid coverage of gender-affirming care. 
• A requirement for Medicaid applicants to verify citizenship 
• A 5-year moratorium on the regulation of artificial intelligence (AI) platforms by states as a condition of accessing funding for broadband infrastructure and bridging the digital divide faced by marginalized communities. This means that states can still 

But there are many harmful parts remaining. Here are a few examples of what’s still in the bill:

• Stricter work requirements for the Supplemental Nutrition Assistance Program (SNAP), and increased program costs for states with high overpayment rates
• A one-year prohibition on Medicaid payments to reproductive health 
• Medicaid cuts to states through provider tax caps, work requirements, more frequent eligibility determinations, and new copays for Medicaid recipients. All of these changes will make it harder for people to become eligible for and stay on Medicaid, resulting in people losing benefits. 
• A national school voucher program that will divert $30 billion from public schools to fund private school tuition, making it more difficult for students with disabilities to access special education services

What’s Next? We take the fight to the House. 

This fight is not over. Because the bill the Senate passed is different from the bill the House passed, the House has to pass this version of the bill for these changes to be final.

The House Rules Committee has already come together to prepare the Senate-passed bill for House floor consideration. The bill could be on the House floor as early as Wednesday morning, and debate and final votes on the Senate-passed bill begin. Please contact your Representatives to ask them to oppose this bill and to protect Medicaid and SNAP. 

We are encouraged that some House members have already indicated their opposition to this harmful legislation. We urge everyone to contact their Representatives immediately and demand they vote NO on this destructive bill.

 AAPD is firmly against any legislation that undermines the rights and well-being of people with disabilities. We call on Congress to protect Medicaid and ensure that people with disabilities have continued access to the services they need to thrive.

UPDATE from June 29, 2025:

Current state of play: Very late on Saturday night, the Senate passed the motion to proceed by a vote of 51-49. Passage of the motion to proceed allows the Senate to begin debate on the reconciliation bill.

Sen. Rand Paul (R-KY) and Sen. Thom Tillis (R-NC) joined with all Senate Democrats voting against the motion to proceed. Senator Paul has been outspoken in his opposition to the bill because of its substantial increase to the federal debt. Senator Tillis has been making headlines for his very recent, but very vocal, opposition to the bill’s Medicaid cuts.

After intense negotiations with Senate Republican leadership and Vice President Vance, several Republican holdouts withdrew their opposition. Sen. Ron Johnson (R-WI) reported that he and Sen. Rick Scott (R-FL) agreed to vote for the motion in exchange for an amendment to the final bill that would end the 90% Federal Medical Assistance Percentages (FMAP) for Medicaid expansion. Majority Leader John Thune (R-SD) did not confirm Senator Johnson’s statement. Sen. Lisa Murkowski (R-AK) was given several Alaska-specific provisions, including an increased FMAP for the state (although this was later ruled out by the parliamentarian after senator Murkowski voted for the motion to proceed). A previously included $25 billion rural hospital fund was enough to quell opposition from Sen. Susan Collins (R-ME) and Sen. Josh Hawley (R-MO).

Next steps: Last night’s vote was only the beginning of the Senate floor process. Senate Democrats are forcing a full reading of the 900+ page bill by the Senate clerks. The Senate has now entered 20 continuous hours of debate, called “vote-a-rama.” The hours are divided evenly between Democrats and Republicans. Democrats will likely use all of their 10 hours of debate to highlight the unpopular parts of the bill. Republicans will probably forfeit most of their time to speed up vote-a-rama. If all stays on track for Republicans, a vote on the final bill should occur sometime on Monday.

Negotiations with Senate Parliamentarian still not finished: While a Monday vote is ideal for Senate Republicans, Sunday morning rulings from the Senate parliamentarian are casting doubt on that goal. The parliamentarian is still working but here’s what we know as of now, according to Senate Democrats. As of writing, more than 209 amendments have been filed.

What’s been removed from the bill?:
Repealing parts of the Biden era eligibility and enrollment rule for Medicaid and the Children’s Health Insurance Program (CHIP)
Repealing parts of the eligibility and enrollment rule for the Medicare Shared Savings Program
Repealing parts of the nursing home staffing rule
Increased FMAP for high poverty states – this is an Alaska-specific provision
Increased payment for outpatient hospital treatments in Alaska and Hawaii
Expansion of the orphan drug exclusion in Medicare drug price negotiations

What’s still in the bill?:
Provider tax language provision that remains unchanged from Saturday morning draft
Limiting receipt of Affordable Care Act (ACA) tax credits by certain immigrants
Barring Medicare participation for most non-citizens

What does this all mean?: Passage of any sort of reconciliation bill is not guaranteed! Thune continues to say a Monday vote is aspirational, and parliamentarian rulings are making that even harder. This makes all the more important that your Senators need to hear from you NOW that you oppose this budget and all cuts to Medicaid. Click here to tell them to vote NO on cuts to Medicaid and SNAP!

*If* the bill passes the Senate, it still has to be passed by the House. Speaker Mike Johnson (R-LA) says he will give House members 48 hours to return to DC to vote. As of now, several House Republicans are on record as no votes, with a potential final vote occurring Wednesday or Thursday.

Original Post from June 28, 2025:

This weekend, the Senate is trying to pass the budget reconciliation bill. AAPD is an outspoken opponent of the budget reconciliation bill, because of its significant cuts to Medicaid, SNAP, and other essential programs. 

The Senate Parliamentarian – a person whose job is to help the Senate follow its rules – found that some key parts of the bill violate budget reconciliation rules (read more about the budget reconciliation process here). In response, Senate leadership released a rewritten 1000-page bill early this morning. The Senate is trying to push through a vote on it today, even though there is no way Senators will be able to read all 1000 pages of the bill before they vote. 

This is especially concerning because the contents of this bill have the power to drastically change the country by taking away food and healthcare from millions of Americans, force millions of Americans into poverty, and kill at least 51,000 Americans every year whose deaths would have otherwise been preventable without this budget.

Your Senators need to hear from you NOW that you oppose this budget and all cuts to Medicaid. Click here to tell them to vote NO on cuts to Medicaid and SNAP!

The bill caps Medicaid provider taxes, which  makes it harder for states to fund Medicaid. Currently, Medicaid makes up 30% of state budgets, much of which is funded by Medicaid provider taxes. The bill also cuts federal Medicaid funding for states that expanded Medicaid under the Affordable Care Act, or currently provide coverage to undocumented immigrants with their own state funds. The bill also requires more people who receive Supplemental Nutrition Assistance Program (SNAP) benefits to work, also known as “work requirements.” SNAP is an essential program that helps millions of people with disabilities, seniors, and their families buy food each month.

These rules will add substantial new costs for states, which could result in state cuts to Medicaid, SNAP, or other key areas like education and transportation. 

In addition, the revised bill says that states are not allowed to regulate Artificial Intelligence (AI) platforms for ten years. States must agree to this if they want to access the bill’s funds for AI deployment and increasing access to broadband internet. States are more likely to agree to this because they want – or need – to access the bill’s $500 million in AI deployment and $42 billion in broadband internet funding. 

Artificial intelligence is a fast-evolving technology, and regulatory frameworks around AI are still under development. Without regulations and laws, it is easier for AI to discriminate based on disability, race, sex, sexual orientation, gender, or other identities. This leaves marginalized groups, including people with disabilities, at risk of discrimination by the AI platforms and algorithms the government and many companies are now  using for everything from hiring processes to approving (or denying) benefit applications.

There are some positive things in the bill that would help disabled people. The bill does include minor funding increases for Home- and Community-Based Services (HCBS) waivers. It also extends certain tax advantages for people with disabilities who have ABLE Accounts. These tax benefits help people with disabilities save money, which can be used for expenses that Medicaid or other insurance does not cover. 

However, these helpful parts are overshadowed by the bill’s massive cuts to Medicaid. These cuts would result in new, burdensome administrative and work requirements that will result in many people being unenrolled from Medicaid, even though they qualify for it. 

AAPD remains strongly opposed to the budget reconciliation bill. 

If successful, this afternoon’s procedural vote will trigger what is known as a “Vote-a-Rama”.  During this step of reconciliation, any Senator can offer an amendment to the bill to add or remove harmful provisions.  Once the Senate votes on final passage, the bill has to go back to the House of Representatives to work out the differences between the Senate Bill and the House Bill. Once the House approves the Senate’s version, the bill goes to the President to be signed into law. You can read more about the Budget Reconciliation process in AAPD’s Reconciliation Explainer here. 

Senator Ron Wyden (D-OR), Ranking Member of the Senate Finance Committee, plans to offer an amendment to the reconciliation bill during the “Vote-a-Rama” that would strike all provisions that cut Medicaid from the bill, and ensure that the ultra-wealthy and large corporations pay their fair share of taxes. AAPD has endorsed Sen. Wyden’s amendment.

The bill’s text could still change, especially during Vote-a-Rama. Several Senators have expressed continued reservations about the bill’s contents, and there are many hours of debate to come. AAPD will share updates as this process continues. 

Your Senators need to hear from you NOW that you oppose this budget and all cuts to Medicaid. Click here to tell them to support Sen. Wyden’s amendment and vote NO on cuts to Medicaid and SNAP!

The post Action Alert: Senate Budget Reconciliation Update appeared first on AAPD.

Contact: Jess Davidson at jdavidson@aapd.com; 202-465-5528

WASHINGTON, D.C. — The American Association of People with Disabilities (AAPD) strongly condemns the Senate Finance Committee’s recently released budget reconciliation proposal, which makes devastating cuts to Medicaid that will disproportionately harm disabled people across the country. The proposal guts funding for Home and Community-Based Services (HCBS), creates needless paperwork requirements that will push eligible individuals out of Medicaid, and imposes requirements that are proven to fail to improve employment and healthcare outcomes.

This proposal is a direct assault on the civil and human rights of disabled Americans. Medicaid is a lifeline that enables millions of disabled people to live and work in their homes and communities rather than in institutions. Disabled people already struggle to have consistent access to personal attendant care and direct support work. Care workers currently face lack of job security and low wages.

When combined, this creates an ongoing national care worker crisis, which would only deepen if the Senate proposal passes. Receiving care at home enables disabled people to live at home instead of being forced into an institution. If this bill passes, our nation will see an increase in unnecessary institutionalization, and disabled people will be denied the basic dignity of living independent, self-directed lives.

The bill puts community engagement requirements on certain Medicaid enrollees, requiring them to work, volunteer, or be enrolled in an educational program for at least 80 hours a month. The inclusion of work requirements in the bill for people ages 19-64 is particularly harmful and is a policy specifically designed to decrease the number of people receiving Medicaid. Research has shown that such requirements do not improve employment rates, but do cause harm by penalizing people for losing their job. 

When workers lose their jobs, they lose their Medicaid because of these penalties. People with chronic illnesses, mental health disabilities, or fluctuating health conditions or employment situations are especially vulnerable to being dropped from coverage due to job loss penalties and administrative burdens. In many cases, the employment supports provided through Medicaid are what enable people with disabilities to be able to work in the first place.

Without employment supports, such as assistance getting ready for and transporting to work, occupational therapy, or other job assistance, many people will be forced off of Medicaid and unable to work, leading to certain financial devastation. Finally, the resources that states will be required to use to implement these bureaucratic policies will cause further delay in access to critical health, financial, and food support for all Americans, not just people on Medicaid.

In addition, the proposal’s requirement that Medicaid recipients re-certify their eligibility every six months is a particularly burdensome barrier to care. Many people with disabilities lack consistent access to the identification and medical documents needed to meet such requirements. Additionally, many Medicaid recipients do not have a computer, smartphone, broadband internet, or reliable transportation to assist with navigating complex administrative systems. These requirements will lead to widespread disenrollment from Medicaid, not because people are no longer eligible, but because the system makes it too hard to stay enrolled.

The Senate Finance Committee’s proposal also contains billions of dollars in cuts to the Supplemental Nutrition Assistance Program (SNAP), which helps millions of low-income families, seniors, and people with disabilities afford to buy groceries each month. The plan also shifts 5% to 15% of SNAP benefit costs to the states, which will force many states to make difficult budget decisions to reduce benefits or cut other vital programs instead. We know that when states face budget shortfalls, disability programs are often the first programs to get cut.

“These proposed Medicaid cuts are not only cruel and unprecedented — they are extremely dangerous,” said Maria Town, AAPD President and CEO. “The Senate’s budget reconciliation proposal doubles down on the harms contained in the House bill, cutting hundreds of billions of dollars from Medicaid. This will only worsen the care crisis and increase our national debt at the expense of society’s most vulnerable members. People with disabilities, older adults, and low-income communities will pay the price with their health, their independence, and in too many cases, their lives.”

In addition to the significant barriers to Medicaid and SNAP access, AAPD is concerned about several other provisions of the Senate Finance Committee’s proposed bill.

The proposed bill includes a moratorium that would block all state and local governments from enforcing any law or regulation governing artificial intelligence (AI) for the next 10 years — including existing laws. State laws creating safeguards against exploitative AI mental health chatbots and misuse of patient data and as well as state laws prohibiting algorithmic discrimination in employment, housing, banking, and benefits determinations have provided necessary protection for disabled people and others who are at extreme risk for algorithmic discrimination. 

The bill also includes a provision that would give the federal government new authority to withhold or claw back all existing Broadband Equity Access and Deployment Program funding from states that try to enforce safeguards from discriminatory and exploitative artificial intelligence systems for their citizens, forcing states into an impossible decision – protect people from exploitation, or lose billions of dollars meant to expand access to high speed internet for underserved communities, including people with disabilities.  

The Senate’s proposal does include some good provisions, including an extension of the increased contribution limits and other enhancements to ABLE Accounts, which allow individuals with disabilities to save money tax-free for future disability-related expenses. However, the positive impact of these ABLE provisions would be greatly diminished by the cuts to Medicaid, which will significantly reduce the ability of people with disabilities to save money and drastically reduce disabled people’s economic security overall. 

“AAPD calls on all Senators to reject this cruel and unjust legislation and instead work toward policies that strengthen, not cut, Medicaid and HCBS,” Town concluded. “We urge the public to contact their Senators and urge their friends, families, and neighbors to do the same. All Americans must unite to defend the rights of disabled people to live, work, and thrive in their communities.” 

Use AAPD’s tool to write and call your Senators in just a few clicks here. 

If calling isn’t accessible for you, you can submit a letter only by clicking here. 

The post AAPD Strongly Condemns Senate Proposal That Slashes Medicaid and Threatens Disabled Lives appeared first on AAPD.

What Does the Administration for Community Living (ACL) Do?
The Administration for Community Living (ACL) was created in 2012 to advance the idea that older adults and people of all ages with disabilities should be able to live where they choose, with the people they choose, and with the ability to participate fully in their communities. ACL does this by funding services and supports provided primarily by networks of community-based organizations and by investing in research, education, and innovation.

ACL brings together aging and disability programs from across the federal government to efficiently administer similar programs that promote similar goals. Through its programs, grants, regulations, and policy advocacy, ACL makes community living possible for more disabled people and upholds our civil rights, including those rights defined by the 1999 Olmstead v. L.C. Supreme Court decision.

What Does the Office for Civil Rights Do?
HHS’ Office for Civil Rights (OCR) investigates violations of, and enforces federal civil rights law related to HHS’ work, like civil rights violations made by a healthcare provider or hospital. Federal civil rights protect people from discrimination based on gender, race, disability, nation of origin, and religion.

At HHS, OCR also enforces the Health Insurance Portability and Accountability Act (HIPAA) Privacy, Security, and Breach Notification Rules, and the Patient Safety Act and Rule. HIPAA’s Privacy, Security, and Breach Notification Rules protect your private health information and make sure you know if your private health information was given to any person or organization who doesn’t have your permission to have that information. The Patient Safety Act and Rule created a voluntary reporting system to make complaints if you have a concern about your safety as a patient or the quality of your healthcare.

You do not have to be a lawyer to file a complaint with OCR, which makes it more accessible than lawsuits or other legal processes.

What Does SAMHSA Do?
HHS’ Substance Abuse and Mental Health Services Agency (SAMHSA) promotes mental health, prevents substance misuse, and provides treatments and supports to foster recovery while ensuring access and better health outcomes for all. SAMHSA provides information, resources, and guidance for providers as well as advocates for policies that help make SAMHSA’s vision a reality.

SAMHSA’s mission and vision state that SAMHSA envisions a world where “people with, affected by, or at risk for mental health and substance use conditions receive care, achieve well-being, and thrive.” This is very important because many people with mental health disabilities and/or substance misuse disorders often face stigma in their communities. Stigma makes it harder to receive proper care, and isolates people with these conditions.

This timely letter demonstrates strong, broad support for the critical work of ACL, OCR, and SAMHSA. You can learn more and read the full letter by clicking this link.

The post 450+ Organizations Join AAPD In Letter to Congress re: HHS Restructuring appeared first on AAPD.

As Americans begin to vote , AAPD is providing information about some of those key disability issues, and relevant policy changes in those issue areas since the last presidential election. 

One of the major policy priorities for the disability community is home- and community-based services (HCBS) and community integration more broadly.

Many people with disabilities rely on Medicaid for their healthcare and for services that help them live interdependently  in their communities. These services, called home- and community-based services (HCBS), allow individuals to get the care they need while staying in their own homes instead of being forced to move to a nursing home or institution. HCBS can include help with everyday tasks like getting dressed and taking medication, as well as therapy and other types of support. According to the Centers for Medicare and Medicaid Services (CMS), over 7 million people get HCBS through Medicaid. In addition, these services are provided by care workers who are often people of color, many of whom have disabilities themselves. The turnover rate is high because employees work long hours, have heavy workloads, and receive low pay and benefits.

There are many barriers to accessing HCBS successfully: a persistent shortage of direct support workers, inadequate funding for services that leaves people receiving fewer hours of services than they need, and years-long waiting lists to access HCBS to name a few. More than 700,000 Americans are estimated to be stuck on HCBS waiting lists, even though they have had a doctor certify that they qualify for and would benefit from receiving care at home. Further, there are many, many more people in need of Medicaid funded HCBS who have not even been able to make a waiting list in there first place. There are many states where people with disabilities are being erroneously dropped off the Medicaid rolls and losing their HCBS as states review Medicaid eligibility after the federal Public Health Emergency was ended.

Thankfully, decades of advocacy from a movement of disability and labor activists fighting to increase access to care have paid off, and recent changes in rules and policies have made great strides toward strengthening the care economy, improving the quality and dignity of jobs in the care workforce, and increasing access to healthcare.

The Biden-Harris administration made a significant achievement by investing $40 billion in the HCBS care workforce as part of the American Rescue Plan Act. States have used these funds to recruit and train new care workers and improve pay and benefits for their existing care workers. Maine used its share of funding to pay well-deserved bonuses to provide financial stability for care workers last summer. 

The Biden-Harris Centers for Medicaid and Medicare Services has also worked with disability advocates and issued several new regulations this year to strengthen access to care and services for individuals with Medicaid, improve pay for care workers, and ensure safe staffing levels for long-term care facilities. 

The Managed Care Access, Finance, and Quality Rule (Managed Care Rule) ensures that people with Medicaid don’t have to wait too long to see a doctor. It sets limits on how long they should have to wait for appointments, like 15 days for regular check-ups and women’s health services and ten days for mental health and substance abuse appointments. Ensuring timely access to routine and preventive healthcare is critical for disabled people and helps prevent loss of independence, hospitalization, and even institutionalization. 

The Ensuring Access to Medicaid Services Rule (Access Rule) makes it easier for people to get home- and community-based services by ensuring that the planning process is focused on the individual and their choices. States will also have to set up a system for people to complain if they have problems with their services and to report if they are being mistreated. The rule will also require that 80% of the money Medicaid pays for HCBS goes to those who provide the care rather than administrative costs or profits. Lastly, states will have to have groups of people who receive home care, the workers, and others to help decide how much Medicaid will pay for home care and how much the workers will be paid.

These investments are a big step in supporting the care workforce, but it’s just a fraction of what the disability community truly needs and what was initially promised in the Build Back Better plan. The President has proposed a $150 billion investment in HCBS over the next ten years as part of his 2025 budget proposal. AAPD and the broader disability community will be working to ensure that HCBS receives the funding it needs in any final budget enacted by Congress. We are strongly advocating for the passage of the HCBS Access Act, which establishes mandatory funding for HCBS, eliminates waiting lists, and expands access across states.

This election will have significant consequences for the future of HCBS and access to care. Vice President Kamala Harris has proposed a comprehensive plan that would expand access to Medicaid to give more people Medicaid-covered access to care at home. Former president Donald Trump recently expressed support for a tax credit for family caregivers. This article from the Kaiser Family Foundation can help you better understand the different candidates’ plans for access to care. 

Project 2025, a 900-page governing agenda put forth by the Heritage Foundation as a blueprint for a new administration, threatens cuts to Medicaid funding, work requirements and time limits for Medicaid, and guts funding for Home- and Community-based Services, which would add to the more than 700,000 people on the waiting list for care and services necessary for them to live independently, forcing many into nursing homes and other congregate care settings against their will.

Have you voted yet? Be sure to check out AAPD’s state guides for information on accessible voting, and make a plan to vote on or before November 5, 2024.

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Contact: Jess Davidson at jdavidson@aapd.com; 202-975-0960

WASHINGTON, DC – Yesterday, the United States Supreme Court announced its unanimous decision in Alliance for Hippocratic Medicine v. Federal Drug Administration (FDA) not to roll back FDA approval for Mifepristone, claiming that the plaintiffs did not have legal standing to sue. This drug is used to end pregnancy, as well as treat certain chronic conditions like Cushing’s disease and uterine fibroids. The American Association of People with Disabilities (AAPD) applauds this decision, declaring it a win for people with disabilities who need to access healthcare, including abortion.

Mifepristone (miff-ay-priss-tone) is one of two medications used to end a pregnancy by blocking the development of a hormone called progesterone, which pregnancies need to continue. It is also used to help manage pregnancy loss by helping the body to miscarry safely. It is also regularly used to help manage symptoms of dozens of conditions from Cushing’s disease, Gulf War illness, and cancer because it also blocks the hormone cortisol. In the wake of the Dobbs decision, many states restricted access to mifepristone, which created barriers to effective treatment for many people with disabilities, either seeking abortion care or other kinds of healthcare.

After a comprehensive review, the FDA approved mifepristone more than twenty years ago and determined it to be completely safe and effective. Yet in November of 2022, the Alliance for Hippocratic Medicine sued the FDA, claiming that the FDA went beyond its authority in its approval for Mifepristone. The lawsuit further challenged the FDA’s approval process and the conditions for distributing mifepristone.

Overriding the FDA’s scientific processes for approval and review of any medication on a basis not rooted in scientific fact but in individual physicians’ personal, religious, or political views would set an alarming precedent. This case called into question the future of drugs and treatment control – if it was not under the control of the FDA, whose staff and clinicians are experts in these areas, then whose control would it be under? And if access to mifepristone is denied, what treatment is next?

“A physician’s personal beliefs should not affect whether or not they will prescribe any drug, including medication used for medication abortion,” said Maria Town, AAPD President and CEO. “The Supreme Court rejected a dangerous precedent, one that would have been enacted not in the name of scientific fact or patient safety but because of physicians’ personal beliefs. When a doctor decides to prescribe or not prescribe any medication, the only factor should be what is in the patient’s best interest. The Court made the right decision by dismissing the attempt to restrict access to mifepristone, enabling this drug to stay on the market, and upholding the FDA’s regulatory authority.”

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Contact: Jess Davidson at jdavidson@aapd.com; 202-975-0960 

WASHINGTON – Yesterday, the Department of Health and Human Services announced the finalization of a new regulation to prevent disability discrimination under Section 504 of the Rehabilitation Act. The new rule, Discrimination on the Basis of Disability in Health and Human Service Programs or Activities, is one of the greatest advancements towards health equity for disabled people in American history. 

“The enactment of this rule is the direct result of more than fifty years of advocacy from the disability community, and the community’s influence on the rule shows,” said Maria Town, AAPD President and CEO. “These new regulations are one of the strongest and most meaningful tools our community has ever possessed to defend ourselves against disability discrimination. People with disabilities routinely experience discrimination in medical settings, where ableism can be a matter of life and death. While this rule will not end ableism, it  provides us with a meaningful tool if and when we do encounter bias while interacting with child welfare systems, adoption agencies, and in healthcare settings that receive federal funds. This rule is going to save and lengthen lives, keep families together and keep people in their communities, and improve access to and quality of medical care disabled people receive.” 

“I am grateful for the leadership of Secretary Xavier Becerra and the team at HHS’ Office for Civil Rights for their work to make this historic advancement happen. I am also especially grateful to the members of the disability community who took the time to share their stories with AAPD to help HHS create a rule that centered us as much as possible,” Town concluded. 

Section 504 of the Rehabilitation Act is a law that prevents discrimination based on disability by entities that receive federal funding. 

Specifically, the rule:

• Requires that medical treatment decisions are not made on the basis of ableist biases or stereotypes about disabled people, assumptions or judgments that an individual with a disability will be a burden on society, or dehumanizing beliefs that the life of an individual with a disability has less value than the life of a person without a disability.
• Prohibits, consistent with a recommendation by the National Council on Disability, the use of any measure, assessment, or tool that discounts the value of a life extension on the basis of disability to deny, limit, or otherwise condition access to any HHS-funded aid, benefit or service.
• Defines what accessibility means for websites and mobile applications and sets forth a specific technical standard to ensure that health care and human service activities delivered through these platforms are readily accessible to and usable by individuals with disabilities.
• Adopts the U.S. Access Board’s standards for accessible medical diagnostic equipment, such as exam tables and mammography machines.
• Detailed requirements to ensure that parents and prospective parents with disabilities are not discriminated against in the services provided by HHS-funded child welfare or adoption agencies, including, but not limited to, reasonable efforts to prevent foster care placement, ensure that home assessment tools and parenting skills programs are not biased against parents with disabilities, parent-child visitation, reunification services, child placement, and in- and out-of-home services The rule also requires child welfare agencies to establish procedures for referring qualified parents or prospective parents, who because of disability, need or are believed to need modified or adaptive services.
• Clarifies obligations to provide services in the most integrated setting, like receiving services in one’s own home, appropriate to the needs of individuals with disabilities.This brings HHS 504 rules into alignment with the Supreme Court’s landmark Olmstead v. L.C. decision.

Additionally, the Final Rule updates existing requirements to make them consistent with the American with Disabilities Act (ADA), as many HHS funding recipients are also covered by the ADA. This consistency will improve and simplify compliance. 

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WASHINGTON, DC – On Thursday, June 8, the United States Supreme Court issued a decision in a Supreme Court case vital to preserving civil rights for disabled and other low-income people: Health and Hospital Corporation of Marion County, Indiana (HHC) v. Talevski.

The American Association of People with Disabilities (AAPD) released the following statement in response: 

AAPD is pleased that the power to hold state, municipal, and other government entities accountable for abuses and violations of rights was upheld in the recent U.S. Supreme Court ruling in HHC v. Talevski. 

The court issued a 7-2 decision, with Justice Jackson writing for the majority. In this case, the family of Mr. Gorgi Talevski, a Medicaid recipient and a person with disabilities, sued the Marion County-owned agency that managed Mr. Talevski’s care in Indiana. In their lawsuit, the Talevski family alleged that the county-owned nursing home abused Mr. Talevski and violated his rights when the nursing home involuntarily transferred him to more restrictive facilities far away from his family and chemically restrained him. Health and Hospital Corp (HHC) of Marion County argued that the Talevski family did not have a right to sue them at all and brought the case to the Supreme Court. HHC questioned whether people who receive public benefits through programs like Medicaid and SNAP could sue states, counties, and other local government entities when their rights are violated.

This ruling upholds and affirms these kinds of lawsuits as a means of pursuing justice and enforcing civil rights for people who receive public benefits. This is a win for Medicaid beneficiaries, disabled individuals, low-income people, and anyone else who relies on  government funding for housing, healthcare, and more. AAPD collaborated with other partners to file an amicus briefing in this case. 

AAPD President and CEO Maria Town said, “This ruling is an enormous victory in the ongoing fight for equality and inclusion of disabled and other multiply marginalized people. 

In HHC v. Talevski, disabled people’s use of litigation to address abuses by state entities is affirmed. Accountability for violations of Medicaid law and other disability rights legislation, such as the ADA, often relies on a private right of action to enforce the civil rights these laws establish. Lawsuits have been and will continue to be a vital tool in the continued protection and advancement of disability rights. As threats to civil rights grow, people with disabilities must use  every opportunity possible to assert our dignity.

AAPD joined other disability and low-income advocates across the country in consistent awareness and education efforts on this case. As we reflect on the solidarity that contributed to this victory, we express our sincere gratitude to the Talevski family, who in their time of loss and grief, chose to pursue justice for their loved one and ultimately contributed to affirming civil rights for millions of Americans.”

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