I never imagined I’d find myself agreeing with a Chicago-born politician, but high five to Congressman Jim Sensenbrenner, the first Republican cosponsor of the proposed Disability Integration Act (DIA). Now that Congress is back in session, it is imperative that people with disabilities reach out to their representatives and express support. Although pieces of the DIA may be unpopular among some fellow conservatives, certain arguments can be offered to allay their concerns.
This election cycle has not cultivated meaningful discussion regarding disability policy, so it would not be surprising if your legislative staffers – or even you – are unfamiliar with the DIA’s requirements. To read the bill in its entirety and learn more about cosponsors, go here: https://www.congress.gov/bill/114th-congress/house-bill/5689/cosponsors. Generally, the bill adds teeth to the ADA’s integration mandate, and requires states and other long-term care insurers to offer community-based supports and services. Wait lists and insufficient caregiver wages, for example, are deemed forbidden forms of disability discrimination. Moreover, states and their respective housing agencies must ensure an adequate supply of accessible, affordable housing to enable those in need of long-term care to live in the community.
I believe that most Americans, nasty nursing home operators and developers aside, fundamentally support the right of people with disabilities to freely exercise of their civil rights within the greater community. After all, the ADA received bipartisan support when President Bush signed it more than 25 years ago. However, because the DIA has the potential to fundamentally alter both healthcare and housing operations, fellow conservatives may have some questions prior to openly offering full support.
First, it’s no secret that Republicans oppose “big government,” or federal mandates imposed upon state and municipal authorities. In fact, this year’s Republican Platform informs that Medicaid is too big to remain a federal program and advocates for near-complete administration to be transferred to states through block grants. Passage of the DIA will expressly entail increased regulation. Nevertheless, I would direct those opposing the DIA to read its preamble, which explains that the ADA’s vision has yet to be achieved after more than 25 years. States continue to place people with disabilities in segregated and institutional settings. The federal government must act because, to date, the states have collectively failed.
For similar reasons, I support the DIA’s teeth, which include damages – actual and punitive –, injunctive relief, and attorney’s fees. The ADA has not been effective, largely due to the fact that people with disabilities are stuck having to enforce it. It’s exhausting to seek an attorney and file lawsuits when amicable resolution cannot be reached, and it’s even more draining to put forth effort into fighting discrimination faced on a regular basis. Under the DIA, the Attorney General will have responsibility for investigation and enforcement, and people with disabilities can also bring independent complaints forward. If the pocketbook is where it hurts violators, then people with disabilities need access to that pocketbook.
Next, Republicans strive to be good stewards of taxpayer dollars. Some may express concern about costs that will be imposed if the DIA is enacted. To these concerns, I would reinforce that the DIA mandates that services and supports can be delivered in the community, which is less costly than care delivered in institutional settings. Moreover, many people with disabilities will likely choose self-directed services, where available, which also reduce the cost of care, in that there is no agency middleman. In fact, I would support the DIA mandating self-directed care be offered in every state.
Hopefully, if the DIA is passed, states will also mandate that all new housing must be visitable. That is, people in wheelchairs should be able to enter a house through at least one entrance and use the bathroom once inside. A visitability mandate has the potential to reduce the costs of retrofitting housing for accessibility purposes, which will presumably save money in the long run. More importantly, doing so will enable people with disabilities to visit others and participate in neighborhoods in which they feel they belong. Finally, it would also be a gesture from state legislators to demonstrate commitment to the spirit of the DIA.
My main concerns in regard to DIA are the effects that will be felt by those needing long-term care who do not receive public assistance. For example, the federal mandate for “adequate” caregiver payment rates or structures could have unintended consequences; those with disabilities who are not eligible for Medicaid and pay out-of-pocket for care may be forced out of the market if rates are dramatically increased by states and large insurers. While I do believe Medicaid reimbursement rates in Indiana (my home state) are abysmally low, I am concerned that the DIA focuses on those who are not currently self-supporting at the potential neglect of those who are barely making ends meet independently. Relatedly, Medicaid beneficiaries may consume all accessible housing in a given location, given potential relationships and economies of scale between landlords and the state.
Regardless of – or, in fact, because of – these concerns, I believe it is crucial that we begin a conversation with legislators about the DIA. The principles of the DIA are universal; we just need to iron out the details. Even though I’m not an elected official, you can count me as the second Republican in favor of the DIA.
Contact: Emily Munson