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Sunday, February 9, 2020

Emerging Democratic Consensus on Disability

Harold A. Pollack and Samuel R. Bagenstos at JAMA Health Forum write of "the emerging consensus" among Democratic candidates about disability policy.
Three of the leading Democratic contenders—Senator Warren, Senator Sanders, and Mayor Buttigieg—present particularly detailed and actionable plans. Some of what they propose will only be possible with the (unlikely) passage of their ambitious and comprehensive health care plans. Whatever the fate of their overall proposals, many of their specific disability provisions could be readily translated into discrete pieces of legislation should a Democrat win the presidency. Some of what they propose might be legislated right now, with at least some possibility of bipartisan support.

A short commentary cannot engage the full complexity of these proposals. Some components to address social determinants bear brief mention. Most Democratic candidates endorse full or greatly expanded funding for the Individuals with Disabilities Education Act (IDEA) to address educational barriers faced by students who live with disabilities. The underfunding of IDEA has been a persistent problem for Americans with disabilities, and one is entitled to be skeptical that—finally, this time—the candidates will truly follow through on their promise of full funding. But the broad consensus on the issue in the Democratic primary suggests that the proposal now has its strongest chance in recent history of being enacted.
Democrats’ 2020 proposals also mark a departure from the curiously marginalized role of disability policy and disability constituencies within prior health reform efforts.2 In retrospect, the ACA must be regarded as a substantial missed opportunity to address many gaps in our current disability system. Democrats don’t want to make the same mistakes again.
Many Democrats’ positions appear to have been crafted in response to questions raised by leaders within the disability community itself—particularly the influential questions raised by the Center for American Progress’s Rebecca Cokley