ReAwaken Goes to Trump Doral

 In The Politics of Autism, I analyze the discredited notion that vaccines cause autism. This bogus idea can hurt people by allowing diseases to spread.   And among those diseases could be COVID-19.

Unfortunately, Republican politicians and conservative media figures are increasingly joining up with the anti-vaxxers.   Even before COVID, they were fighting vaccine mandates and other public health measures. 

The anti-vax movement has a great deal of overlap with MAGA, QAnon, and old-school conspiracy theory.  

Grethel Aguila at The Miami Herald via Yahoo News:

Starting Thursday evening, crowds are expected to gather at former President Donald Trump’s Doral resort for a weekend conference of conservative figures, some of whom have praised Hitler or espoused debunked claims about elections and vaccines.

Thousands are meeting at Trump National Doral Miami for the latest stop of the ReAwaken America Tour, an event that features Christian themes and appearances around the country by some of Trump’s inner circle. According to its founder, the gathering seeks to save the nation by exposing the truth about fraud in elections, healthcare and the media.

The event shows the extent to which election deniers, anti-vaxxers and Jan. 6 sympathizers continue to surround Trump, the leading candidate to secure the 2024 Republican nomination for president.

The tour, which began in 2021, has promoted conspiracy theories, such as the idea that the 2020 election was rigged against Trump and that “elites” operating a child sex-trafficking ring conspired against the former president. The event’s founder Clay Clark, an entrepreneur and former candidate for mayor of Tulsa, has described the COVID-19 vaccine as a “bio-weapon” on Rumble, an alternative to YouTube that gained popularity with conservatives during the pandemic.

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Here are some of the speakers on the conference’s lineup.

▪ Alex Jones is the founder of InfoWars, a website that promotes conspiracy theories. Jones claimed that the 2012 Sandy Hook shooting, in which 26 elementary school students and school professionals were killed, was a hoax. Jones was ordered to pay nearly $1 billion in damages to families of victims in 2022.

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▪ Robert F. Kennedy Jr. is a Democratic candidate in the 2024 presidential election. Kennedy is known for spreading anti-vax misinformation, including the debunked theory that vaccines cause autism, ADHD, cancer and autoimmune conditions.

CA Lags in Compensating Sterilization Victims

 In The Politics of Autism, I write about the dangers of eugenics and euthanasia.  Though it is hard to know for sure, it seems likely that some of those subjected to forced sterilization were autistic.

Phil Barter at The Press-Democrat:

On the final day of 2021, California Gov. Gavin Newsom announced a program meant to soothe some of the harm the state had inflicted on its wards over the span of a century.

Beginning Jan. 1, 2022, and continuing through the end of 2023, California would work to identify and compensate survivors among the 20,000-plus victims of involuntary sterilization in state institutions and prisons.

Well over a year later, the agency responsible for administering the program is reporting minimal gains.

By April 28, according to data furnished to The Press Democrat, the California Victim Compensation Board had approved just 80 applications, less than 20% of the number it had received.

More relevant to Sonoma County — where the former Sonoma State Home in Glen Ellen became the American epicenter of forced sterilizations in the first half of the 20th century — only three applicants from the so-called “eugenics era” had been approved. All three of those people had been sterilized at Sonoma State Home, later known as Sonoma Developmental Center.

...

How to apply for compensation as a victim of involuntary sterilization


Applications will be accepted through Dec. 31, 2023, and are completely confidential. Compensation paid to any claimant or claimant’s trust will not impact a survivor’s Medicaid or Social Security status or benefits, and will not be considered income for state tax purposes or for community property, child support, restitution or a money judgment.

There are four ways to get connected.

Online: www.victims.ca.gov/fiscp

Call the California Victim Compensation Board: 800-777-9229

Email: fiscp@victims.ca.gov

Mail: P.O. Box 591, Sacramento, CA 95812-0591

Diagnosis Problems for Adults and Children

In The Politics of Autism, I discuss evaluation, diagnosis, and the uncertainty of prevalence estimates.

Lily Altavena at The Detroit Free Press:

It wasn't until Ashley Marchuck started experiencing frequent anxiety attacks at work — almost every day — that she started to suspect she might be autistic.

Working at Starbucks, she was bombarded with loud noises such as the whirr of the coffee machines, the music playing and the conversations among customers. The sensory overload was too much. The anxiety attacks, leaving her sweaty and panicked, wouldn't stop. Marchuck took a leave of absence to figure out what was going on. At 31 years old, she was diagnosed with autism spectrum disorder.

She'd realized that her anxiety attacks were a symptom of sensory issues related to autism, she said.

"It basically takes a mental crisis to get diagnosed," said, Marchuk, now 32. "And that's how it was with me, unfortunately, you know, having those anxiety attacks for months."
...

Brian Calley, former Michigan lieutenant governor and vice chair of the Autism Alliance of Michigan Board of Directors, said identification will expand as early childhood programs expand in the state. And he said pediatricians are conducting more developmental screenings but noted that such screenings won't help vulnerable populations who can't regularly go to the pediatrician's office.

Calley, who is the father of a child with autism, added that society also needs to reduce stigma around the condition. He remembers feeling unsure about seeking a diagnosis at first for his child, fearing what a diagnosis could mean.


"There's still some of that, that happens where people might notice that there's issues challenges, problems, delays, and not ready to seek a diagnosis because of societal stigma," he said.

Misdiagnosis

In The Politics of Autism, I discuss diagnosis and gender differences in autism identification.

Claire Jack at Psychology Today:

[B]ecause autistic adolescents and adults may also experience other psychiatric issues, such as mood disorders, suicidality, and anxiety, they often come into contact with healthcare professionals because of those symptoms, as opposed to because of autism itself.3 Mental health professionals may therefore mistake autistic characteristics for those of other psychiatric disorders.4

There are also gender differences in terms of which misdiagnoses people are likely to receive. One small study found that out of 10 women who were misdiagnosed, the most common misdiagnosis was a personality disorder (one person was diagnosed with an anxiety disorder and one with psychotic spectrum disorder). In contrast, the majority of a group of seven men were diagnosed with ADHD, while two received a diagnosis of psychotic spectrum disorders and one received a diagnosis of behavioural issues.5 This and other research strongly suggest that not only is misdiagnosis a possibility but that diagnosis may be influenced by the biases and past experience of psychiatrists.

References

1. https://www.bbc.co.uk/programmes/m001kgzr Women's Hour, BBC Radio 4, 29th March 2023

2. Huang Y., Arnold S. R., Foley K. R., Trollor J. N. (2020). Diagnosis of autism in adulthood: a scoping review. Autism 24, 1311–1327. doi: 10.1177/1362361320903128, PMID: [PubMed] [CrossRef] [Google Scholar]

3. Tromans S., Chester V. (2020). Commentary on “being diagnosed with autism in adulthood: a personal case study”. Adv. Autism 7, 262–265. doi: 10.1108/AIA-03-2020-0023 [CrossRef] [Google Scholar] [Ref list]

4. Au-Yeung S. K., Bradley L., Robertson A. E., Shaw R., Baron-Cohen S., Cassidy S. (2019). Experience of mental health diagnosis and perceived misdiagnoses in autistic, possibly autistic and non-autistic adults. Autism 23, 1508–1518. doi: 10.1177/1362361318818167, PMID: [PubMed] [CrossRef] [Google Scholar]

5. Gesi C, Migliarese G, Torriero S, Capellazzi M, Omboni AC, Cerveri G, Mencacci C. Gender Differences in Misdiagnosis and Delayed Diagnosis among Adults with Autism Spectrum Disorder with No Language or Intellectual Disability. Brain Sci. 2021 Jul 9;11(7):912. doi: 10.3390/brainsci11070912. PMID: 34356146; PMCID: PMC8306851.

Disability Representation

In The Politics of Autism, I discuss the civil rights of people with autism and other disabilities. Employment remains a challenge.

Andrew Pulrang at Forbes:

Every casting of a model with a disability, especially a visible one, sets a precedent for hiring more. This increases the chances that people with disabilities might realistically make a successful career in fashion modeling. It’s a pretty simple equation, though of course not very large-scale in an industry as relatively small as modeling.

The same hope is more significant in other professions where people with disabilities have traditionally been seen as longshots, niche performers, or incompatible – like medicine, acting, and sports. The hope for disabled people is that one or two high-profile disabled people can generate more opportunities for others, including possibly themselves.

Seeing disabled people in jobs and activities that seem to contradict old, ableist ideas about disability can help change those ideas. Candace Owens’ assumption that the sight of a woman in a wheelchair is unattractive and therefore incompatible with modeling is a case in point. And deliberately hiring and featuring disabled models is a simple, direct way of demonstrating that disability is entirely compatible with beauty and sex appeal.

Big Geographic Differences in ASD Prevalence

In The Politics of Autism, I discuss evaluation, diagnosis, and the uncertainty of prevalence estimates.

Jessica Bradshaw and colleagues have an article at The Journal of Autism and Developmental Disorders titled "County-Level Prevalence Estimates of Autism Spectrum Disorder in Children in the United States"
Abstract:

Prevalence estimates of autism spectrum disorder (ASD) point to geographic and socioeconomic disparities in identification and diagnosis. Estimating national prevalence rates can limit understanding of local disparities, especially in rural areas where disproportionately higher rates of poverty and decreased healthcare access exist. Using a small area estimation approach from the 2016–2018 National Survey of Children’s Health (N = 70,913), we identified geographic differences in ASD prevalence, ranging from 4.38% in the Mid-Atlantic to 2.71% in the West South-Central region. Cluster analyses revealed “hot spots” in parts of the Southeast, East coast, and Northeast. This geographic clustering of prevalence estimates suggests that local or state-level differences in policies, service accessibility, and sociodemographics may play an important role in identification and diagnosis of ASD.

From the article:

States differ significantly in services covered by private insurance mandates, timing of adoption of insurance mandates, and availability of service providers, all unique factors that may impact whether and when parents seek an ASD diagnosis (Choi et al., 2020; Johnson et al., 2014). While statewide mandates certainly contribute to regional differences, county and neighborhood resource allocation and access play an important role in regional differences. Indeed, large variation exists even within small, relatively densely populated states (Shenouda et al., 2022). For example, regional hotspots observed in this study may be explained in part by clusters of high-resource areas within states, which can be examined using proximity to high-volume medical or autism centers. In the current study, this may be the case where some hotspots include areas with a high density of university-based medical research centers with autism diagnostic programs in the Northeast (including New York, NY, New Haven, CT, Providence, RI, Boston, MA), the Southeast (Atlanta, GA; Charleston, SC), and parts of Southern California (San Diego, Los Angeles). In addition, the observed contrast in ASD prevalence between hotspot regions in Southern California (San Diego/Los Angeles) and cold spot regions Northern California surrounding San Francisco (e.g., San Francisco, Marin) partially align with recent findings of increasing ASD diagnoses among white children in middle income counties, including San Diego, Los Angeles and decreasing ASD diagnoses among white children in wealthier counties surrounding San Francisco (e.g., Marin) (Nevison & Parker, 2020). These data highlight the importance of county- and region-specific examinations of ASD resources and suggest a combination of sociodemographic and geographic features that may serve as facilitators and barriers to ASD diagnosis. Future research should explore the intersection of ASD prevalence with neighborhood sociodemographics as well as the co-location of high or low ASD prevalence and the corresponding high or low density of healthcare providers (e.g., pediatricians, behavioral health providers, etc.) to determine the potential relationship with local access to care.

Improving Medicaid Access

 The Politics of Autism includes an extensive discussion of insurance and Medicaid services for adults with intellectual and developmental disabilities. Home and Community-Based Services (HCBS) are particularly important.

An April 27 release from HHS:

The Centers for Medicare & Medicaid Services (CMS) today unveiled two notices of proposed rulemaking (NPRMs), Ensuring Access to Medicaid Services (Access NPRM) and Managed Care Access, Finance, and Quality (Managed Care NPRM), that together would further strengthen access to and quality of care across Medicaid and the Children’s Health Insurance Program (CHIP), the nation’s largest health coverage programs. These rules build on Medicaid’s already strong foundation as an essential program for millions of families and individuals, especially children, pregnant people, older adults, and people with disabilities.

If adopted as proposed, the rules would establish historic national standards for access to care regardless of whether that care is provided through managed care plans or directly by states through fee-for-service (FFS). Specifically, they would establish access standards through Medicaid or CHIP managed care plans as well as transparency for Medicaid payment rates to providers, including hourly rates and compensation for certain direct care workers. The rules would also establish other access standards for transparency and accountability, and empower beneficiary choice.

...

Covering nearly one in four Americans and over half of all children in the country, Medicaid is the single largest health coverage program in the U.S. Medicaid and CHIP provide robust benefits with little to no out-of-pocket costs for over 92 million people. Many of those enrolled in Medicaid or CHIP come from underserved communities whose populations have disproportionately higher uninsured rates, and who often experience chronic health issues. Over 70 percent of people with Medicaid or CHIP coverage are enrolled in managed care plans. Ensuring families and individuals can find an in-network provider and access health care coverage in a timely way is a foundational principle of health equity, and a critical priority for the Biden-Harris Administration.

Together, the Access NPRM and Managed Care NPRM include new and updated proposed requirements for states and managed care plans that would establish tangible, consistent access standards, and a consistent way to transparently review and assess Medicaid payment rates across states. The rule also proposes standards to allow enrollees to easily compare plans based on quality and access to providers through the state’s website. Other highlights from the proposed rules include:

• Establishing national maximum standards for certain appointment wait times for Medicaid or CHIP managed care enrollees, and stronger state monitoring and reporting requirements related to access and network adequacy for Medicaid or CHIP managed care plans, which now cover the majority of Medicaid or CHIP beneficiaries.
• Requiring states to conduct independent secret shopper surveys of Medicaid or CHIP managed care plans to verify compliance with appointment wait time standards and to identify where provider directories are inaccurate.
• Creating new payment transparency requirements for states by requiring disclosure of provider payment rates in both fee-for-service and managed care, with the goal of greater insight into how Medicaid payment levels affect access to care.
• Establishing additional transparency and interested party engagement requirements for setting Medicaid payment rates for home and community-based services (HCBS), as well as a requirement that at least 80 percent of Medicaid payments for personal care, homemaker, and home health aide services be spent on compensation for direct care workers (as opposed to administrative overhead or profit).
• Creating timeliness-of-access measures for HCBS and strengthening necessary safeguards to ensure beneficiary health and welfare as well as promote health equity.
• Strengthening how states use state Medical Care Advisory Committees, through which stakeholders provide guidance to state Medicaid agencies about health and medical care services, to ensure all states are using these committees optimally to realize a more effective and efficient Medicaid program that is informed by the experiences of Medicaid beneficiaries, their caretakers, and other interested parties.
• Requiring states to conduct enrollee experience surveys in Medicaid managed care annually for each managed care plan to gather input directly from enrollees.
• Establishing a framework for states to implement a Medicaid or CHIP quality rating system, a “one-stop-shop” for enrollees to compare Medicaid or CHIP managed care plans based on quality of care, access to providers, covered benefits and drugs, cost, and other plan performance indicators.

For fact sheets about the Ensuring Access to Medicaid Services NPRM, please see:

Summary of CMS’s Access-Related Notices of Proposed Rulemaking: https://www.cms.gov/newsroom/fact-sheets/summary-cmss-access-related-notices-proposed-rulemaking-ensuring-access-medicaid-services-cms-2442-p

Summary of Medicaid and CHIP Payment-Related Provisions: https://www.cms.gov/newsroom/fact-sheets/summary-medicaid-and-chip-payment-related-provisions-ensuring-access-medicaid-services-cms-2442-p

Summary of Key Home and Community-Based Services (HCBS) Provisions: https://www.cms.gov/newsroom/fact-sheets/ensuring-access-medicaid-services-cms-2442-p-notice-proposed-rulemaking

Summary of the Medical Care Advisory Committee and Beneficiary Advisory Group Provisions: https://www.cms.gov/newsroom/fact-sheets/ensuring-access-medicaid-services-cms-2442-p-notice-proposed-rulemaking

For a fact sheet about the Medicaid or Children’s Health Insurance Program (CHIP) Managed Care Access, Finance, and Quality NPRM, please see: https://www.cms.gov/newsroom/fact-sheets/notice-proposed-rulemaking-medicaid-and-childrens-health-insurance-program-chip-managed-care-access

Both NPRMs can be downloaded from the Federal Register at https://www.federalregister.gov/public-inspection. CMS looks forward to receiving feedback on both during the public comment period, which ends July 3, 2023.

Self-Diagnosis Is Controversial

In The Politics of Autism, I discuss evaluation and diagnosis.  Prominent people sometimes publicly engage in casual self-diagnosis.  Jerry Seinfeld did so years ago, and got a great deal of negative reaction, causing him to walk back his remarks.  

Laura Newberry at LAT:

As autistic social psychologist Devon Price points out, the diagnostic tools weren’t designed with a diverse patient population in mind. “The procedure for diagnosing autism was designed with young, white, cisgender male patients with visibly obvious symptoms in mind,” Price wrote on his blog. “To this day, it remains very common to be turned away from even being assessed for autism for being too old, too feminine (or effeminate), too socially appropriate, too good at eye contact, too Black, too brown, or too trans.”

In response to these barriers, a growing number of people are using social media and knowledge from those with lived experience in online communities to diagnose themselves with autism and ADHD without a psychologist’s rubber stamp, either out of necessity, principle, or both..

 ...

Critics inside and outside of neurodivergent spaces are debating the validity of self-diagnosis.

Some autistic people with a formal diagnosis argue that self-diagnosed people are silencing and diluting the power of “real” autistic people, and taking away resources from those who need them the most.

But [Jane] Wise notes that self-diagnosed people are unlikely to receive accommodations or funding — like disability benefits — from institutions that usually requires “proof” of these conditions.

Meanwhile, medical professionals and academics have warned against the dangers of people misdiagnosing themselves.

“The widespread popularization of disorders has made them virtual ‘floating signifiers’ for all manner of troublesome, frustrating, and disappointing experiences, from poor performance at work or school to feelings of being beleaguered and overwhelmed by all one has to do,” wrote sociologist Joseph E. Davis for Psychology Today. “Often enough, it is fair to say, the everyday distress, role conflicts, and lifestyle issues that motivate the personal appropriation of these categories have little to do with a mental disorder.”

RFK Jr is Still Pushing the Autism Myth

 In The Politics of Autism, I analyze the discredited notion that vaccines cause autism. This bogus idea can hurt people by allowing diseases to spread.   And among those diseases could be COVID-19.

Antivaxxers are sometimes violent, often abusive, and always wrong. A leading anti-vaxxer is presidential candidate Robert F. Kennedy, Jr.  He has repeatedly compared vaccine mandates to the Holocaust.  Rolling Stone and Salon retracted an RFK article linking vaccines to autism.

Isabelle Han at The Dartmouth:

On April 26, the Concerned Alumni of Dartmouth College hosted a sold-out roundtable discussion titled “Important Conversations Never Had — College COVID-19 Vaccine Mandates: Scientific, Legal and Ethical Considerations” at the Hanover Inn, followed by a speech from lawyer and presidential candidate Robert F. Kennedy Jr. A Q&A session had originally been scheduled to take place after the panel, but the segment was canceled after Kennedy announced his last-minute appearance at the event, according to Michael Koss, a member of Concerned Alumni of Dartmouth College.

...

Kennedy’s speech, which replaced the advertised Q&A, lasted for approximately 30 minutes and focused on the claim that vaccines cause autism in children.

“We have solid proof that they are causing more harm than [good]… that they are killing our children,” Kennedy said. “And yet a thousand colleges in this country still have these [COVID-19 vaccine] mandates.”

Kennedy added that he has met multiple women with children who have intellectual disabilities, which they believe “were caused by vaccines.” He pointed to the statistic that the rate of autism in children has increased as vaccination numbers have also increased.

“In my generation, [the rate of autism] is still one in 10,000,” Kennedy said. “In my kids’ generation, one in 34 kids have the diagnosis.”

According to the National Institutes of Health, while the rate of autism among children has risen since initial estimates in the 1960s, the diagnostic criteria used to classify the disorder has also expanded. The claim that vaccines cause autism has also been disproven, according to the CDC.

Kennedy added that he is not “anti-vaccine” but skeptical because there is no “placebo-controlled” study that proves that vaccines are safe. However, all vaccines approved for use in the United States are subject to placebo testing, according to the Food and Drug Administration.

Adding ADDM Sites

In The Politics of Autism, I discuss evaluation, diagnosis, and the uncertainty of prevalence estimates.

 An April 25 release from Autism Speaks:

This week, we proudly celebrate a historic expansion of the Autism and Developmental Disabilities Monitoring (ADDM) Network, from 11 to 16 sites across the country. The ADDM Network is the only collaborative network to track the number and characteristics of children with autism spectrum disorder (ASD) and other developmental disabilities in multiple communities throughout the United States. This is the first time since 2010 that the ADDM Network has added sites to its prevalence and surveillance work. The data and knowledge provided by the ADDM Network continues to inform and drive us forward in identifying gaps in diagnosis, improving screening tools and developing programs to reach underserved communities.

Autism Speaks has advocated in support of the CDC's autism activities for decades, through our advocacy for the Autism CARES Act, as well as supporting annual appropriations requests that have sustained and grown the level of funding for federal autism programs. It is thanks to our champions in Congress, the advocacy of Autism Speaks, partner organizations and countless advocates that spent years fighting for additional funding and successfully saw that the Consolidated Appropriations Act of 2023, enacted earlier this year, provided the Centers for Disease Control and Prevention (CDC) with support for the expansion of their work. As a result, the ADDM Network is now in its sixth phase of funding and includes fifteen funded sites and one CDC-managed site in Georgia (MADDSP).

The newly awarded sites include locations in Indiana, Pennsylvania, Texas (Austin) and Texas (Laredo) as well as Puerto Rico, marking the first time a US territory will be included in this research. Each ADDM site’s surveillance activities are different so that they collectively contribute to a fuller picture of what we know about autism. While every ADDM Network location will track ASD among 4- and 8-year-old children, nine sites will now also track transition planning and co-occurring conditions among 16-year-old children with ASD. This is almost a two-fold increase from five sites in previous years.

IDEA Funding Formulas

 In The Politics of Autism, I write about social services, special education and the Individuals with Disabilities Education Act. 

 Tammy Kolbe, Elizabeth Dhuey, and Sara Menlove Doutre, "More money is not enough: The case for reconsidering federal special education funding formulas," Brookings, October 3, 2022:

[A]midst anticipation for increased federal funding for special education, another important consideration has largely been overlooked: The formula used to determine how IDEA funds are allocated to states. IDEA’s funding formula is one of the law’s most critical components. Since the law’s inception, Congress has attempted to allocate IDEA appropriations to states according to each state’s share of children needing special education services.

That said, there are concerns that IDEA’s existing formula falls short of meeting policymakers’ expectations. In our recent work, we evaluated whether IDEA’s existing formula equitably distributes federal funding for special education among states and what will happen if the current formula is used to distribute potential future increases in IDEA appropriations. What we found is concerning.

The existing formula generates substantial differences among states in the amount of federal funding available to pay for a child’s special education services, and these differences have grown over time. For FY2020, the difference in IDEA grant amounts between the states at the top and bottom of the distribution was about $1,442 per child; Wyoming received about $2,826 for each child receiving special education and Nevada received $1,384 per child (see Figure 1). To put this difference in context, for that year federal IDEA funding covered about 23% of the national average additional cost of educating a student with a disability in Wyoming, whereas federal dollars covered about 11% of additional spending in Nevada.

Right-Wing Kooks Praise RFK Jr.

 In The Politics of Autism, I analyze the discredited notion that vaccines cause autism. This bogus idea can hurt people by allowing diseases to spread.   And among those diseases could be COVID-19.

Antivaxxers are sometimes violent, often abusive, and always wrong. A leading anti-vaxxer is presidential candidate Robert F. Kennedy, Jr.  He has repeatedly compared vaccine mandates to the Holocaust.  Rolling Stone and Salon retracted an RFK article linking vaccines to autism.

Alex Seitz-Ward at NBC:

Former Trump adviser Steve Bannon said he received a “standing ovation” from a “hardcore MAGA” crowd at a recent speaking engagement for floating the idea of a bipartisan Trump-Kennedy ticket. “Bobby Kennedy would be, I think, an excellent choice for President Trump to consider” as a running mate, Bannon said this week on his War Room show.

Roger Stone, the former Richard Nixon aide who was one of Trump’s early political advisers, called Trump-Kennedy a “dream ticket” on the news program Real America.

While Stone said he disagrees with Kennedy on some issues, he likes the candidate's opposition to “globalists” and skepticism of continued U.S. support for Ukraine against Russia. “On those geopolitical ideas, he makes a lot of sense. In fact, he sounds a lot like Donald Trump,” Stone said.

Michael Flynn, Trump’s former national security adviser who has promoted the QAnon conspiracy theory, on Friday tweeted, “I am really starting to like this presidential candidate’s attitude.”

Turning Point USA head Charlie Kirk on April 6 called Kennedy “one of the most articulate and thoughtful political activists going after the administrative state.”

A day earlier, conservative talk show host Steve Deace posted a picture with Kennedy on Twitter saying, “As long as he doesn’t go trans, a man with high character and courage like RFK Jr will be tempting.” And QAnon influencer Jordan Sather posted to Trump’s Truth Social platform saying he hopes to see “RFK Jr. redpilling the hell out of libs on the vaccine.”

..
An environmental lawyer by trade, Kennedy has devoted much of his adult life to attacking what he views as an unholy alliance between the pharmaceutical industry, the government and the media to promote vaccinations, which he claims are responsible for autism and other chronic diseases, despite the overwhelming scientific evidence against that theory.

...

I don’t agree with Robert F. Kennedy Jr. on some topics, but he’s a man of integrity that fights fluoride and poison shots and fentanyl and everything else. He’s a good man,” Alex Jones, the right-wing conspiracy theorist said on his Infowars broadcast this month. “He’s got a lot of guts, and I really support him for the Democratic nomination.”

Debt Bill and Disabilities

The Politics of Autism includes an extensive discussion of insurance and Medicaid services for adults with intellectual and developmental disabilities. Home and Community-Based Services (HCBS) are particularly important.

A March release from Drexel University:

In the latest edition of the National Autism Indicators Report series, researchers at Drexel University’s A.J. Drexel Autism Institute explore how autistic individuals use Medicaid and how their service use changes across the lifespan – from infants to older adults – using data from the Centers for Medicaid and Medicare Services (CMS) from 2008-2016.

“Medicaid is a critical public benefit for an increasing number of autistic people,” said Anne Roux, a research scientist and director of the Policy Impact Project at the Autism Institute. “We found the number of autistic people enrolled in Medicaid tripled between 2008 and 2016 to nearly 600,000. Almost 70% of the enrollees were children.”

 A Wednesday release from The Arc:

Today, the U.S. House of Representatives passed H.R. 2811, The Limit, Save, Grow Act of 2023, which includes radical new work requirements for Medicaid enrollees in exchange for lifting the debt ceiling. This Medicaid benefit test will harmfully transform our country’s primary health care for people with disabilities, deepen health inequities experienced by people with disabilities, and do little to boost employment. The Arc urges Senators and the President to reject this extreme benefit test and other harmful cuts contained in the bill as they work towards a deal to lift the debt ceiling.

The bill requires Medicaid beneficiaries to meet an 80-hour per month work-reporting requirement unless they meet an exemption. This doesn’t just apply to new enrollees or people eligible under the Affordable Care Act’s Medicaid expansion provisions – it applies to everyone ages 19-55 receiving Medicaid. Millions of enrollees will be forced to go through an obstacle course and navigate complicated red tape to keep coverage, including many who rely on home and community-based service waivers and Supplemental Security Income. The Congressional Budget Office estimates that 1.5 million adults will lose federal funding for their Medicaid coverage and the bill will cut Medicaid by an estimated $109 billion over the next decade.

“Medicaid is a lifeline for people with disabilities,” shared David Goldfarb, Director of Long-Term Supports and Services Policy at The Arc of the United States. “This policy not only undermines their access to life-sustaining health care and community living, but it also undermines their inclusion in the workforce. Navigating these complex and extreme benefit tests will be particularly difficult for people with intellectual and developmental disabilities, over 45% of which have a co-occurring health condition. In addition, many of the exemptions for the rule are vague and highly subject to the stigmas and biases of those with the power to determine eligibility. Millions of people who rely on these safety net programs will fall through the cracks in a system that is already difficult to grasp – and these changes will compound that problem.”

People with disabilities would need a doctor or other medical professional to deem them “physically or mentally unfit for employment,” which is not a standardized disability determination. Many people with disabilities already face barriers to accessing health care and discrimination from providers, which, if this legislation passes, would now come with the risk of losing Medicaid coverage. There is also an exception for caregivers who give care to an “incapacitated person.” This terminology is vague, subjective, crude, and could extremely limit the definition of caregivers.

All of this chaos and administrative burden comes at the misguided hope that this new benefit test will boost employment opportunities and outcomes. In fact, most adults that utilize Medicaid are working, the majority of which are working full-time. Those who are not working or are working part-time face barriers to employment, such as having a disability or caregiving responsibilities. What’s more, Arkansas had a short-lived work requirement for Medicaid back in 2018, which failed to increase employment and caused 18,000 people to lose coverage. The reality is that having Medicaid supports people’s ability to join the workforce, not hinders it.

The proposal comes at a time when:states are expected to drop millions of beneficiaries due to the end of the Medicaid continuous coverage requirement during the COVID-19 pandemic;
over 650,000 people with disabilities desperately wait for home and community-based services, some of them for years;
and the nation is experiencing major labor shortages in health and long-term care.

Congress should be focusing on ways to expand access to services, not on cutting Medicaid.