The following blog entry is a cross-post from ACL Blog, the official blog of the Administration for Community Living at the U.S. Department of Health & Human Services. The blog is written by Kathy Greenlee, Administrator for the Administration for Community Living and Sharon Lewis, Commissioner for the Administration on Intellectual and Developmental Disabilities.
For 23 years, the landmark Americans with Disabilities Act (ADA) has helped ensure equal opportunity and access for people with disabilities in all areas of society. In order to see this law become a reality, disability rights advocates worked together for decades to fight discrimination and remove the many barriers that excluded people with disabilities. Key to the movement’s success was raising awareness of the injustices and prejudice experienced by people with disabilities and changing public perceptions of disability. Disability rights advocates fought for basic civil rights protections, fairness, respect and the inherent worth of every individual.
Much of the ADA is about full inclusion, independence and accessibility; access to the physical environment, to jobs, public spaces, transportation, even communication and information. The law changed American society by eliminating barriers and making discrimination on the basis of disability illegal. However, despite the many important changes implemented under the ADA, the crucial area of access to healthcare has remained to be addressed. The Affordable Care Act helps fill in this missing piece by addressing healthcare discrimination and expanding access to affordable health care and long-term services and supports.
Arguably the most important portion of the Affordable Care Act for people with disabilities takes effect in 2014, when the successes of the ADA will be taken a step farther as health insurers are barred from discriminating against any individual by denying health coverage, charging higher premiums or excluding benefits based on a disability or other pre-existing conditions. Since 2010, children under age 19 have already had this protection, and young adults have been able to stay on their parent’s insurance until age 26. In 2014, this protection will be extended to all people, including people with disabilities or other pre-existing conditions. The law also ends the discriminatory practice of allowing insurance companies to impose lifetime dollar limits on health benefits—freeing people from having to worry about going without treatment because of these caps.
Health care coverage is also expanded in other ways through the Affordable Care Act. Medicaid is expanded by allowing more people with low-income access to affordable coverage, including many people with disabilities. State Medicaid programs will also be able to offer additional services to help those who need long-term services and supports at home and in the community. The Act also sets standards for accessible medical diagnostic equipment and requires additional training for medical professionals in serving people with disabilities.
At the Administration for Community Living and Administration on Intellectual and Developmental Disabilities, our work aligns with the ADA’s goals to assure equality of opportunity, full participation, independent living, and economic self-sufficiency for people with disabilities. Our efforts also support provisions in the Affordable Care Act that work to improve the lives of people with disabilities and older Americans and help them exercise choice and participate more fully in their communities.
Specifically, the Affordable Care Act strengthens community living options and helps people with disabilities by:
- Extending the Money Follows the Person Program, which provides funding to help individuals to move from institutions to community settings and receive necessary services and supports. According to a recent progress report, more than 31, 000 people with disabilities and chronic conditions have transitioned from institutions into the community through this program. Currently, forty-five states and the District of Columbia have Money Follows the Person programs.
- Providing Medicaid funding through the Balancing Incentives Program, which helps states increase access to community-based long-term services and supports.
- Offering more options for community living through the Community First Choice program, which increases federal Medicaid funds for states that provide home and community-based services to people who might otherwise be placed in institutions. This program allows individuals to develop a person-centered plan, where the individual determines how services are provided, thus helping Medicaid beneficiaries avoid unwanted institutional placement.
- Providing funding to Aging and Disability Resource Centers, which support states in developing “one-stop shop” entry points into long-term care at the community level. ACL is partnering with the Centers for Medicare & Medicaid Services to fund options counseling to help people better understand the supports that are available in their community.
While the Affordable Care Act addresses a number of barriers people with disabilities face in accessing health care and long-term services and supports, there are still challenges, as evidenced by the stories captured in the Disability Rights Education & Defense Fund project, dredf.org/healthcare-stories/ . On this site, Fred Nisen, an attorney with cerebral palsy who uses a motorized wheelchair and other people with disabilities and their family members discuss some of those obstacles. At AIDD and ACL, we will keep working to end discrimination against people with disabilities in health care, bolstered by the initiatives and opportunities provided by the Affordable Care Act and the legacy of the ADA.
The ADA’s legacy includes enforcement of the Supreme Court’s Olmstead decision. The life of Lois Curtis, the plaintiff known as “L.C.” in the Olmstead case, demonstrates the potential and opportunity that can be achieved under the ADA. Ms. Curtis, who had spent years living in an institution—denied access to a community-based program with appropriate services and supports and the greater independence that she sought—was released from the state-run hospital and had been able to live in a home of her own choosing with a roommate she selected, pursuing her passion for painting.
Last month, the U. S. Department of Justice entered into a settlement agreement with Rhode Island to resolve ADA violations for about 200 Rhode Islanders with intellectual and developmental disabilities. The agreement will help people receive daytime and employment services in the community, rather than in segregated, sheltered workshops and day programs. For more information about the impact of the ADA and the Olmstead decision on the lives of individuals, please visit DOJ’s Faces of Olmstead at www.ada.gov/olmstead/faces_of_olmstead.htm. There you can learn about the experiences of people like people like John, a man with an intellectual disability who was able to move from Central State Hospital in Milledgeville, Georgia to his own apartment. And met Steven Porcelli, a man with an intellectual disability who will be able to work in an integrated setting after many years in segregated, sheltered workshop where he earned far below minimum wage. We must continue to build on this promise and prevent unnecessary segregation of people with disabilities.
Progress continues toward achieving full and equal participation for all. New requirements for accessible airline websites and airport kiosks under the ADA can help facilitate travel by people with disabilities. The United Nations Convention on the Rights of Person with Disabilities is a step toward the elimination of discrimination on the basis of disability world-wide, including for Americans with disabilities and their families traveling abroad, and we encourage U.S. ratification in support of these principles. Although people with disabilities continue to battle discrimination, on this ADA anniversary we celebrate the significant gains in the past few years made possible by the passage of the Affordable Care Act, and we recognize the potential to achieve even more in the future.
At ACL and AIDD, we will continue to work to advance policies and systems that support access and opportunity for people with disabilities, helping people to live full lives, make their own choices, and participate in their communities.