This month marks the 12th anniversary of the Supreme Court’s landmark decision in Olmstead V. L.C., ruling that the needless institutionalization of people with disabilities is illegal discrimination. Despite that decision, misguided Medicaid rules continue to force millions of people with disabilities to remain in nursing homes, against their wishes and at a much greater cost to taxpayers than many home and community-based alternatives.
Today, as we seek ways to reduce budget deficits, we must seize on the opportunity to make our Medicaid dollars go farther while finally giving millions of individuals with disabilities one of the most fundamental of rights: the choice to live independently.
Rather than taking steps to reduce wasteful spending on institutional settings, many states have cut the services that keep people with disabilities in their own homes and communities. Courts have found that many of these service cuts violate Olmstead, because they are likely to force people with disabilities into nursing homes and other institutions, at greater expense to the state and federal government. Federal judges in California have issued preliminary injunctions stopping cuts to in-home support services and adult day health services designed to keep people with disabilities out of institutions. Other courts have stopped similar cuts, including federal courts in North Carolina, Tennessee, and Florida.
Modernizing Medicaid's approach to supporting people with disabilities can save money and bring a people a better quality of life. It would also promote compliance with the ADA and the Olmstead decision. If Medicaid cuts are not done in a thoughtful manner, however, they will have disastrous consequences and will lead to systemic civil rights violations.