Trump administration reverses stance on integration of people with disabilities
For nearly 50 years, the federal government has said people with disabilities should live, work and learn in the most integrated setting possible rather than be segregated in institutions like nursing homes.
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people → reverse → homes
The Trump administration just took its most concrete step yet to reverse that position.
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administration → take → position
Last week, a federal judge agreed to strip out mentions of "integration" from federal regulations tied to Section 504 of the Rehabilitation Act, a landmark civil rights law that prohibits disability discrimination.
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that → agree → discrimination
The judge did so after the Justice Department declined to defend its own rules in a lawsuit brought by several states challenging the legality of those rules.
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Department → do → rules
Part of what is so striking about Texas v. Kennedy is that the federal government was originally the defendant in that lawsuit, brought by states fighting what's known as the integration mandate.
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what → bring → mandate
Then, it switched sides and agreed with the states that the requirement should be undone.
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requirement → switch → states
Bruce Darling, president and CEO of the Center for Disability Rights, says when he heard about the ruling, it felt "like a knife in your chest.
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it → say → chest
Because what we're hearing, what people are hearing, is that the federal government has made a determination that [disabled people] don't have a right to live in freedom, that they can be locked up against their will.
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they → hear → will
The court's decision removes regulations from Section 504 that explicitly required federally funded programs to provide services in the "most integrated setting."
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that → remove → setting
"That lack of clarity will impact people's rights.
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lack → impact → rights
It will likely impact what states do and how they behave," says Jennifer Mathis, a disability rights lawyer who helps lead the Bazelon Center for Mental Health Law.
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who → impact → Law
Mathis says it's important to note that the court's decision did not undo integration protections tied to the Americans with Disabilities Act (ADA) or those established by decades of case law, including the landmark Supreme Court decision known as Olmstead.
"My concern is that right now, where we're at is disabled people have a right to integration on paper.
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people → say → paper
It is in the law, but whether it gets practically enforced is a serious question," Darling says.
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Darling → enforce → law
His organization is putting its energy behind a proposed law that would cement protections around integration, while others are working with states to strengthen their disability laws.
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others → put → laws
The Justice Department did not respond to multiple requests from NPR asking why it is changing course after decades of legal and bipartisan support for community-based services.
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it → respond → services
After 50 years, the government changes its position
In 1973, Congress passed the first civil rights law for people with disabilities: Section 504 of the Rehabilitation Act.
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Congress → change → Act
But it took advocates years of fighting — until 1977 — to get actual regulations that would make that law enforceable.
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law → take → regulations
The Department of Health and Human Services, under President Joe Biden, updated the regulations in 2024 so it would be clearer to states what they had to do to uphold the law.
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they → update → law
"They thought it was important to do that so those rights would be as clear as possible," Mathis says.
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Mathis → think → that
In recent months, the federal government, under President Donald Trump, began to publicly change its position: First, in June, the Justice Department issued an opinion saying it no longer interpreted disability law to "require states to treat mentally disabled patients in the most integrated setting appropriate to their needs."
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law → begin → needs
The memo even noted its position is "out of step with the common understanding" of the Olmstead decision.
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position → note → decision
Then in July, the Justice Department announced it would stop relying on its own longstanding guidance explaining how it enforces the integration mandate.
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it → announce → mandate
These actions led up to the federal government switching sides in Texas v. Kennedy.
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government → lead → Kennedy
Finally, last week, a federal judge agreed to throw out the integration mandate rules under Section 504, including language that was first introduced nearly 50 years ago.
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that → agree → language
Mathis says this kind of about-face is highly unusual.
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kind → say → face
"It is pretty significant and pretty unprecedented to see the federal government asking a court to vacate its own rules.
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government → see → rules
"
That could leave more of the work of defining and enforcing the right to community living to people with disabilities, private litigators, advocacy organizations and the courts.
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That → leave → disabilities
All this, says Mathis, comes at a time when states are already under immense pressure from the federal government to cut Medicaid spending, which pays for disabled people to get many of the services they need.
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they → say → services
"States are looking for things to cut," she says.
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she → look → things
Mathis worries that because the government has changed its stance on integration, states would be freer to cut spending on programs for community-based living.
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states → worry → living
How enforcement is already changing
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enforcement → change → ?
One of the clearest examples of the effects of the federal government's changing position involves children with complex medical needs in Florida.
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One → change → Florida
Back in 2013, the Justice Department sued the state of Florida, arguing that it failed to provide adequate services to children who needed in-home care.
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who → sue → care
As a result, some of their families were forced to put their children in nursing facilities.
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some → force → facilities
The federal government won its case in 2023, and the state of Florida was required to provide these families the services they needed to keep their children at home.
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they → win → home
But in August, the government told the federal court to throw out its victory and allow Florida to have the case heard again in district court, citing the Justice Department's new opinion on the issue.
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case → tell → issue
Mathis calls the reversal shocking.
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Mathis → call → reversal
"To do that in a case that involves ripping children away from families, taking them out of the homes where they have families that want to take care of them, and to force those children to grow up in an institution, really is just unthinkable to me and is incredibly heartless."
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that → involve → me
The Florida case suggests that coming battles for community integration may increasingly play out not through federal enforcement, but case by case, in the courts.
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battles → suggest → courts
What disability advocates are doing now
The disability rights community is rallying around a number of actions to try to combat the federal government's latest actions.
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community → do → actions
…and 15 more, not listed.
The Aporia
