Measles, Early September 2026

 In The Politics of Autism, I analyze the myth that vaccines cause autism. This bogus idea can hurt people by allowing diseases to spread. Examples include measles, COVID, flu, and polio. A top antivaxxer is HHS Secretary RFK Jr. He is part of the "Disinformation Dozen." He helped cause a deadly 2019 measles outbreak in Samoa.  Last year, he lied about it under oath.

Since  Trump took office in 2025, the U.S. has recorded more confirmed measles cases than in the previous 20 years combined.

CDC:

As of September 3, 2026, 3,134 confirmed* measles cases were reported in the United States in 2026. Among these, 3,118 measles cases were reported by 47 jurisdictions: Alabama, Alaska, Arizona, California, Colorado, Connecticut, Delaware, District of Columbia, Florida, Georgia, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Montana, Nebraska, New Jersey, New Mexico, New York City, New York State, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, and Wyoming. A total of 16 measles cases were reported among international visitors to the United States.

There have been 38 new outbreaks** reported in 2026, and 95% of confirmed cases (2,969 of 3,134) are outbreak-associated (1,594 from outbreaks starting in 2026 and 1,375 from outbreaks that started in 2025).

For the full year of 2025, a total of 2,289 confirmed* measles cases were reported in the United States.

American Oversight:

Thursday, American Oversight launched an investigation into the Centers for Disease Control and Prevention’s (CDC) apparently manipulated reporting surrounding two measles-associated deaths reported by the Pennsylvania Department of Health. The alterations reportedly came at the command of Health and Human Services (HHS) Secretary Robert F. Kennedy Jr.

We filed Freedom of Information Act (FOIA) requests with HHS and CDC seeking records that could shed light on why the agency departed from its normal classification practices and altered its public reporting on the deaths following Secretary Kennedy’s demands as well as unsubstantiated claims that the data may have been “manipulated” by Pennsylvania Governor Josh Shapiro.

The investigation comes amid a nationwide rise in measles cases, including in Lancaster County, Pennsylvania, home to the largest current outbreak in the country. On August 25, the Pennsylvania Department of Health confirmed two measles-associated deaths of unvaccinated residents, the state’s first deaths linked to the virus in 35 years. One of the deaths involved a newborn who died shortly after birth. The baby’s mother had reportedly been severely ill with measles during her pregnancy. Under standard CDC practice, deaths reported by state health departments — including deaths that occurred in Texas and New Mexico during last year’s outbreak — are included in the agency’s national tally and the CDC does not challenge the state’s determination.

According to reporting by multiple outlets, newly confirmed CDC Director Erica Schwartz directed agency staff to exclude the two Pennsylvania deaths from its measles outbreak web page, which is typically updated each Friday. The demanded change reportedly came directly from Kennedy. The web page update was delayed until Sunday, August 30, and the dashboard’s national death total changed several times over the weekend before the agency added a note stating, “At this time, available information does not establish whether measles caused or contributed to the deaths or whether the individuals died from other causes while infected with measles.” CDC employees reportedly said the repeated changes stemmed from confusion among staff about what they were supposed to do.

The CDC’s break from standard practice came after Secretary Kennedy publicly accused Governor Shapiro of “manipulating” the truth and suggested on social media, without evidence, that the two deaths may even have been “fabricated” by Shapiro’s staff. The repeated dashboard revisions raise the question of whether the CDC’s public data was reshaped to align with Secretary Kennedy’s demands and political messaging rather than with the agency’s own longstanding classification practice.

State health officials, who classified the deaths as “measles-associated,” have stood by their findings.

Family Stress and Resilience

In The Politics of Autism, I discuss the day-to-day challenges facing autistic people and their families.

Duncan, A. L., & Shepley, C. (2026). Stronger Yet Stretched: Resilience and Stress in U.S. Families Raising Autistic Children. Autism, 0(0). https://doi.org/10.1177/13623613261480171

Lay abstract:

Raising a child with autism presents families with unique challenges and strengths, often characterized by heightened stress but also remarkable resilience. This study looked at data from the 2022 and 2023 National Survey of Children’s Health administered by the U.S. Census Bureau to examine the resilience and stress of U.S. families with and without a child diagnosed with autism. Statistical models revealed that although families of autistic children experience significantly higher stress, they also report higher levels of resilience compared with families of nonautistic children. Specifically, families raising a child with autism reported higher ratings of family communication, problem-solving, inner strength, and hope. These findings offer evidence of the adaptability and emotional growth present in households raising a child with autism.

From the article:

Given the disproportionate levels of stress reported by families raising a child with autism, alongside the widespread recognition of stress as a major contributing factor to detrimental mental and physical health conditions, it is logical to assume that families may seek treatments to mitigate their stress or service providers may proactively recommend treatments targeting stress. Studies on parent-directed treatments for decreasing stress have surged in recent years (Mo et al., 2024), with small-scale efficacy trials suggesting that mindfulness-based interventions and acceptance and commitment therapy may demonstrate potential viability as effective treatments (Li et al., 2024). Regarding treatments that should be avoided for decreasing stress, the use of applied behavior analysis for improving child skills will likely not have spillover effects that impact caregiver stress (Duncan et al., 2024; Duncan & Shepley, 2022). Similarly, studies that aim to improve caregiver abilities by training them to implement interventions based on applied behavior analysis will likely not result in improvements to caregiver stress (Mo et al., 2024). There is ongoing research looking to modify well-established treatments for reducing caregiver stress (Parent-Child Interaction Therapy [University of California, Los Angeles, 2024]) for families raising a child with autism; however, results from these studies will likely not be available for some years.

2,903 Measles Cases in 2026

In The Politics of Autism, I analyze the myth that vaccines cause autism. This bogus idea can hurt people by allowing diseases to spread. Examples include measles, COVID, flu, and polio. A top antivaxxer is HHS Secretary RFK Jr. He is part of the "Disinformation Dozen." He helped cause a deadly 2019 measles outbreak in Samoa.  Last year, he lied about it under oath.

Since  Trump too office in 2025, the U.S. has recorded more confirmed measles cases than in the previous 20 years combined.

From CDC:

As of August 27, 2026, 2,903 confirmed* measles cases were reported in the United States in 2026. Among these, 2,887 measles cases were reported by 47 jurisdictions: Alabama, Alaska, Arizona, California, Colorado, Connecticut, Delaware, District of Columbia, Florida, Georgia, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Montana, Nebraska, New Jersey, New Mexico, New York City, New York State, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, and Wyoming. A total of 16 measles cases were reported among international visitors to the United States.

There have been 37 new outbreaks** reported in 2026, and 94% of confirmed cases (2,737 of 2,903) are outbreak-associated (1,362 from outbreaks starting in 2026 and 1,375 from outbreaks that started in 2025).

For the full year of 2025, a total of 2,289 confirmed* measles cases were reported in the United States.

IACC: Bad Stuff

 In The Politics of Autism, I discuss the Interagency Autism Coordinating Committee and research priorities.

Ed Pilkington at The Guardian:

Autism groups and researchers have reacted with alarm to a federal research roadmap drawn up by advisers handpicked by the US health secretary, Robert F Kennedy Jr, fearing it will promote unproven fringe therapies at the expense of promising genetic research.

A slew of scientific bodies and groups within the autism community are warning that the 336-page plan risks deflecting federal dollars away from potentially groundbreaking genetic research in favor of unreliable alternative therapies.

There is little or no evidence, they say, that many of the proposed treatments work, or that they even fit the definition of autism.

“So much of the plan is fringe science that is absolutely not ready for prime time,” said Helen Tager-Flusberg, an emeritus professor at Boston University and founder of the Coalition of Autism Scientists.

Alliances of autistic people are especially worried that the plan could make it easier for them to be sent to institutions. The plan calls for government agencies to try out “supported-living models” such as “farmstead or campus-based communities”, which the groups fear could revive forms of institutional confinement.

The strategic plan is the work of the Interagency Autism Coordinating Committee (IACC), a body that for 25 years has advised US health secretaries on federal efforts related to autism.

Alison Singer at MedpageToday:

Parents report that children with autism lose skills at all ages, including during toddlerhood, and through adolescence into adulthood. The new plan puts considerable emphasis on finding medical causes of early childhood regression (immune, metabolic, mitochondrial, infectious, gastrointestinal) but does not give comparable prominence to regression as a manifestation of the underlying genetics and neurodevelopmental biology of autism itself.

We can read between the lines. Committee members' comments make clear that this framing is intended to justify further research into vaccines as a cause of autism, despite decades of research and dozens of studies finding no causal link between vaccines and autism.

Also, despite a significant number of public comments calling for substantial revisions to the plan, and the fact that thousands of pages of public comments were not distributed to committee members until the night before the meeting, the IACC chair completely shut down efforts by committee members to delay voting on the plan until all the comments could be read and considered.

 

Measles and RFK Jr's Lies

In The Politics of Autism, I analyze the myth that vaccines cause autism. This bogus idea can hurt people by allowing diseases to spread. Examples include measles, COVID, flu, and polio. A top antivaxxer is HHS Secretary RFK Jr. He is part of the "Disinformation Dozen." He helped cause a deadly 2019 measles outbreak in Samoa.

Since  Trump took office in 2025, the U.S. has recorded more confirmed measles cases than in the previous 20 years combined.

Michelle R. Smith at The Guardian:

A senior Democratic senator is calling for a criminal investigation into the US health secretary, Robert F Kennedy Jr, following reporting by the Guardian that indicated he lied during Senate confirmation hearings last year.

Ron Wyden of Oregon said: “RFK’s platform is built on lies and grifts that leave a trail of dead children in their wake. There are consequences for lying to Congress.”

The Guardian’s reporting was based on letters that were obtained – by this news outlet and the Associated Press – following a Freedom of Information Act lawsuit.

Wyden said in a statement to the Guardian that he would be pressing Republican colleagues, who currently control the Senate, to issue a criminal referral of Kennedy to the Department of Justice for a criminal investigation. “And when Democrats retake the majority in the Senate, RFK will be at the top of the list of Trump officials the finance committee will hold accountable for endangering American families,” he said. Wyden currently serves as the top Democrat on the finance committee.

Also on Thursday, the government watchdog group American Oversight sent a letter to the justice department requesting that it immediately open an investigation into whether Kennedy violated the law by making false statements to Congress.

Michelle R. Smith at The Guardian:

Newly obtained documents indicate that the US health secretary, Robert F Kennedy Jr, lied during two congressional hearings last year, when he told lawmakers who held the key to his confirmation that a 2019 visit to Samoa had “nothing to do with vaccines”.

Letters obtained by the Guardian and the Associated Press contradict that testimony. In one he wrote to the Samoan prime minister before the trip, Kennedy explicitly said he wanted to study the measles, mumps and rubella (MMR) vaccine in the Pacific island nation. In it, he used the words “vaccine” or “vaccination” eight times.

“I am writing this letter to you in the hope that we might be helpful to the people of your great nation,” he wrote, adding that he believed the deaths of two children there after an MMR vaccine could have resulted from manufacturing issues.

“I would propose my team conduct detailed health informatics assessment in Samoa of what happened with your MMR vaccines,” Kennedy wrote.

Kennedy’s Samoa visit – just months before a measles outbreak swept through the island, killing 83 people – has become one of the most controversial events in his career. At the time, he was leading a non-profit known for its anti-vaccine activism. The visit was seen by critics as having emboldened anti-vaccine activists in Samoa.

Beyond shedding light on the intent of Kennedy’s visit, the letter raises questions about the health secretary’s integrity and how truthful he was in testimony before Congress. During the confirmation process, Kennedy also pledged to maintain vaccine policies that, once in office, he moved to change.

Administration Cuts Research On Parents with Disabilities

Many posts have discussed Trump's bad record on disability issues. As his words and actions have shown, he despises Americans with disabilities. He told his nephew Fred that severely disabled people -- such as Fred's son -- should "just die."

Project 2025 proposed to turn IDEA into a "no strings" block grant, effectively gutting the law and destroying protections that disability families have long relied upon. During the 2024 race, Trump denied any connection to the project, but now he proclaims it, praising OMB director Russ Vought "of Project 2025 fame."

Trump and Vought are now accomplishing their goal of ravaging the law. Instead of shifting it to a block grant, they are firing most of the staff who enforce it.  A judge has temporarily paused the attack, but the administration will likely find ways to ignore or circumvent the order.

Roni Caryn Rabin at NYT:

The Trump administration has eliminated a funding stream that for the last 30 years has supported the only U.S. government-backed national research center focused on parents with disabilities.

The National Research Center for Parents with Disabilities will begin to phase out its operations on Aug. 31, when the current five-year grant ends, officials from the center said.

The center, based at Brandeis University’s Heller School for Social Policy and Management, is a multiple university collaboration aimed at improving the lives of the 4.5 million U.S. parents with disabilities and their families. The center, which funds researchers in Boston and around the country, analyzes health care access and economic hardships faced by parents with disabilities and tracks state laws, serving as a clearinghouse for information on the issue.

The government has supported the center for decades through a competitive grant that has provided $500,000 a year in recent years and was slated to increase. Monika Mitra, the center’s director, said that an initial notice announcing the grant was posted a year ago, as is usually the case. But the more detailed information required to submit an application, which normally arrives in the grant application portal by February, never appeared. In July, the original link announcing the grant vanished.

...

The withdrawal of the funding comes in the wake of a series of administration announcements that have raised concerns for people with disabilities. In June, the Justice Department’s Office of Legal Counsel issued a memo indicating that states were not required to provide services enabling people with disabilities to remain in their homes and not be forced into institutions. The administration also announced plans to move special education programs and civil rights enforcement in education out of the Education Department, which raised concerns among advocates who said the step would weaken oversight.

Measles Deaths

In The Politics of Autism, I analyze the myth that vaccines cause autism. This bogus idea can hurt people by allowing diseases to spread. Examples include measles, COVID, flu, and polio. A top antivaxxer is HHS Secretary RFK Jr. He is part of the "Disinformation Dozen." He helped cause a deadly 2019 measles outbreak in Samoa.

Since  Trump took office in 2025, the U.S. has recorded more confirmed measles cases than in the previous 20 years combined.

Antivaxxers downplay the human and economic costs of measles.

Lena H. Sun and Rachel Roubein at WP:

Two Pennsylvania residents have died after contracting measles, the first such deaths in the state in 35 years and the first reported in the United States this year. The deaths prompted Gov. Josh Shapiro (D) to sharply confront the nation’s health secretary over federal vaccine messaging that he said is confusing and harmful.

Both the people who died were residents of Lancaster County. The Pennsylvania Health Department declined to release their ages or other information, citing the privacy of the people and their families.

Pennsylvania has confirmed 393 measles cases in 28 counties this year, including 86 in the past week. Nearly half of the cases are in Lancaster County, authorities said. Seventy people, nearly 20 percent of those infected, have been hospitalized, Shapiro said, and every confirmed case has occurred in someone who was not fully vaccinated.

“We hope and we pray that those deaths will be the last,” Shapiro said at a news conference Tuesday.

Shapiro, widely seen as a presidential contender, said he was late to the news conference because he had been speaking by phone with Health Secretary Robert F. Kennedy Jr.

“I was very, very blunt with him,” the governor said. “Made very clear that his actions and the rhetoric that’s coming from this administration are having a negative impact on communities across America, particularly right here in Pennsylvania.”

Shapiro said Kennedy’s statements were confusing parents and making it harder for them to know whom to trust. “There’s real-life consequences to spreading misinformation. There’s real-life consequences to scaring people and not relying on actual doctors, actual medical professionals, to provide unbiased information to parents so that we can make reasonable decisions for our kids,” he said.

The federal government’s public health decisions are not driven by facts and science, Shapiro said. That makes it even more confusing for parents. “All we want to do as parents is what is right for our kids,” he said.

The Cost of Measles

In The Politics of Autism, I analyze the myth that vaccines cause autism. This bogus idea can hurt people by allowing diseases to spread. Examples include measles, COVID, flu, and polio. A top antivaxxer is HHS Secretary RFK Jr. He is part of the "Disinformation Dozen." He helped cause a deadly 2019 measles outbreak in Samoa.

Since  Trump took office in 2025, the U.S. has recorded more confirmed measles cases than in the previous 20 years combined.

Antivaxxers downplay the human and economic costs of measles.

Naema Ahmed,  Lena H. Sun and Aaron Steckelberg at WP:

Half a million dollars.

That’s about how much it cost several public health agencies to contain one small measles outbreak in the Denver area this year. Though it was a relatively modest cluster — a total of 10 cases involving nine children and one adult — it nevertheless consumed 6,785 hours of labor by state and local workers to track and snuff out the outbreak after exposed individuals traveled through grocery stores, schools, fast-food restaurants and more.

Measles is the most contagious vaccine-preventable disease, and time is of the essence to contain the spread. Most children recover after several miserable days of fever, cough, congestion and pink eye, but measles can also cause pneumonia, brain swelling, deafness, intellectual disability and death. In Colorado, dozens of investigators traced patient movements, checked vaccination records and quarantined people at risk while also examining how often air circulated through a medical clinic.

Trump v. Autistic People

Many posts have discussed Trump's bad record on disability issues. As his words and actions have shown, he despises Americans with disabilities. He told his nephew Fred that severely disabled people -- such as Fred's son -- should "just die."

Project 2025 proposed to turn IDEA into a "no strings" block grant, effectively gutting the law and destroying protections that disability families have long relied upon. During the 2024 race, Trump denied any connection to the project, but now he proclaims it, praising OMB director Russ Vought "of Project 2025 fame."

Trump and Vought are now accomplishing their goal of ravaging the law. Instead of shifting it to a block grant, they are firing most of the staff who enforce it.  A judge has temporarily paused the attack, but the administration will likely find ways to ignore or circumvent the order.

At CBS and KFF,  Claire Sibonney reports that the Trump administration has effectively gutted the Office for Civil Rights at the Department of Education.

For families who believe their child's rights were violated based on race, disability, or gender in school, the federal agency often has been one of the main places to turn. But the White House cut its offices and weakened its ability to follow up with cases, as well as slashed funding to research on disparities that people of color face in getting diagnosed and attaining resources for disabilities.

About 1 in 31 U.S. kids by age 8 had been diagnosed with autism spectrum disorder as of 2022. Although previous research on disparities in childhood autism diagnoses has had mixed results, a recent study from the State University of New York at Albany's Institute for Social and Health Equity found that race, gender, and socioeconomic gaps persist. Among fourth graders from 2003 to 2022, students of color, girls, low-income students, and multilingual learners were less likely than peers to be identified with autism in school, even as diagnoses rose among children from historically marginalized groups, the study found. A large forthcoming study by the same researchers found the biggest gaps among overlapping identities. Black and Hispanic girls were especially unlikely to be identified.

All this has happened as President Donald Trump's second administration has put autism in the spotlight. In early August, Trump signed an executive order to whittle down routine immunizations for kids while falsely tying vaccines to autism. He has presented it as a personal priority and one of "the most alarming public health developments in history." Health and Human Services Secretary Robert F. Kennedy Jr. in April 2025 called autism a "tragedy" that "destroys families," and he's lent credence to ungrounded claims of autism's causes, including unfounded links to childhood vaccines and Tylenol during pregnancy

.

RFK Jr. and Wandering

The Politics of Autism discusses the dangers facing autistic people, including wandering and drowning.

Molly Castle Work at Minnesota Public Radio:

 U.S. Department of Health and Human Services Secretary Robert F. Kennedy Jr, who has a track record of spreading disinformation around autism, visited Rochester Friday to announce the launch of his new National Autism Missing Person Initiative.

Standing inside the Olmsted County Sheriff’s training center, Kennedy announced his agency’s partnership with the U.S. Department of Justice and the Federal Emergency Management Agency (FEMA) to better support residents on the autism spectrum who are prone to wandering and getting lost. He said he wants to ensure individuals are recovered quickly and safely before they get into dangerous situations.

...

Kennedy has made autism a priority in his agency, but he consistently spreads false information about the condition, including claims that Tylenol causes it.

Kennedy says he hopes to set up an alert system, sort of like an Amber Alert, so that the public and local law enforcement are notified immediately when a resident with autism goes missing. And as part of the initiative, HHS, FEMA, and the Department of Justice will collaborate to provide communities across the country with best practices and training for first responders.

While the initiative launched Friday, Kennedy did not specify a timeline for implementation, and it’s unclear when the alert system will be active.

RFK Jr. is interrupted by his "quack" ring tone while discussing autism conspiracy theories. pic.twitter.com/fOcIC0wEbw

— Headquarters (@HQNewsNow) August 21, 2026

Gender Differences

In The Politics of Autism, I discuss gender differences .

Gundeslioglu, H., Gray, K.M., Hewitt, O.M. et al. Are There Sex or Gender Differences in Autistic Characteristics? An Umbrella Systematic Review. J Autism Dev Disord (2026).  https://doi.org/10.1007/s10803-026-07484-0.'

Abstract

Purpose

The aim of this umbrella systematic review was to synthesise evidence about sex/gender differences in autism across existing systematic reviews, meta-analyses, and scoping reviews.

Methods

MEDLINE, Embase, Embase Classic, CINAHL, and APA PsycINFO were searched for peer-reviewed articles focused upon sex/gender differences in autistic children, adolescent, or adults, and published in English or Turkish.
Results

Analysis of 34 studies showed no conclusive evidence of sex/gender differences in social communication, friendships, play behaviours and motor stereotypies in autistic children, adolescents, and adults. There was evidence that autistic females had fewer restricted and repetitive behaviours and were more capable in their use of camouflaging although autistic males also engaged in camouflaging. There was weak evidence to suggest that autistic male children have superior visuospatial skills, and evidence to indicate sex/gender differences in some aspects of brain development. Chronological age and general intellectual functioning appear to interact with some of these sex/gender differences.

Conclusion

There was evidence that sex/gender differences amongst autistic people are similar to those seen amongst the general population and are not autism specific. More studies involving equal numbers of both autistic and non-autistic individuals of different sexes/genders are needed to draw more conclusive evidence.

2,777 Measles Cases

In The Politics of Autism, I analyze the myth that vaccines cause autism. This bogus idea can hurt people by allowing diseases to spread. Examples include measles, COVID, flu, and polio. A top antivaxxer is HHS Secretary RFK Jr. He is part of the "Disinformation Dozen." He helped cause a deadly 2019 measles outbreak in Samoa.

Since  Trump took office in 2025, the U.S. has recorded more confirmed measles cases than in the previous 20 years combined.

CDC:

As of August 20, 2026, 2,777 confirmed* measles cases were reported in the United States in 2026. Among these, 2,761 measles cases were reported by 47 jurisdictions: Alabama, Alaska, Arizona, California, Colorado, Connecticut, Delaware, District of Columbia, Florida, Georgia, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Montana, Nebraska, New Jersey, New Mexico, New York City, New York State, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, and Wyoming. A total of 16 measles cases were reported among international visitors to the United States.

There have been 36 new outbreaks** reported in 2026, and 94% of confirmed cases (2,614 of 2,777) are outbreak-associated (1,239 from outbreaks starting in 2026 and 1,375 from outbreaks that started in 2025).

For the full year of 2025, a total of 2,289 confirmed* measles cases were reported in the United States.

Assault on Integration

In The Politics of Autism, I discuss court cases involving the civil rights of people with autism and other disabilities. 

Trump does not care.  He despises people with disabilities.  His head of the DOJ Civil Rights Division is a political hack who uses the r-word as a slur.

Last week, the Department of Justice quietly released a memo pertaining to the landmark 1999 disability civil rights case Olmstead v. L.C.  That precedent, the memo claimed without evidence, increases homelessness.

Jonaki Mehta at NPR:

[In 1999] the Supreme Court handed down the Olmstead decision. It reinforced the ADA's integration mandate, which says people with disabilities should get to learn, live and work in their communities rather than in institutions. The government made that promise after people with disabilities fought against segregation in institutions, which have a long history of abuse and neglect.

...

In practice, the integration mandate requires that states provide people with disabilities the services they need to thrive in their homes or communities — in other words, in the most integrated setting possible. For someone with intellectual or developmental disabilities, that could mean a personal care worker helping them to get dressed or eat, or a case manager helping them find a job or housing, among other services.

Now, a lawsuit brought by several Republican-led states, Texas v. Kennedy, is working its way through the courts. The plaintiffs argue that the federal government cannot require states to provide disability services in the community rather than in institutions. Then, in June, the Department of Justice (DOJ), which enforces the integration mandate, issued a legal opinion taking a similar position — essentially aligning itself with the plaintiffs in the case. "Congress has not imposed an integration mandate on states," the memo reads. It goes on to say the Olmstead decision "held only that a state cannot institutionalize such patients without justification. … What counts as adequate justification remains an open question." In July, the DOJ also clarified that it would no longer enforce Olmstead in the same way it had in the past.