A head shot of a young woman with Down syndrome, smiling.

Equal Lives, Equal Rights: Challenging Organ Transplant Discrimination Against People With Disabilities

Over 100,000 individuals in the United States are waiting for an organ transplant, including many people with intellectual and developmental disabilities (IDD). Thousands of people die each year waiting for a transplant. Unfortunately, many people with IDD get rejected at such high rates that it has become an ethical medical issue.1 For example, a study showed that individuals with IDD were 62% less likely to receive a kidney transplant.2

The National Council on Disability released a report about organ transplant discrimination. The report shared beliefs that some medical professionals had about people with disabilities. Some doctors believe that those with IDD would not be able to comply with postoperative care. Other doctors believe that disability impacts the likelihood of having a successful transplant.3 However, research has shown that these are myths. Many studies show that transplant outcomes for people with disabilities are not worse than those who do not have disabilities.4

Thankfully, some professionals understand that having a disability does not mean a person should be less eligible for an organ transplant. Thanks to organ donations, people like Charlotte Woodward can survive and live fulfilling lives!

A head shot of a young woman with Down syndrome, smiling.Charlotte is an advocate with Down syndrome who was born with a congenital heart defect. She had to undergo multiple surgeries as a child and finally received a heart transplant in 2012. The journey to get her heart transplant had its challenges, but she used her experience to fight to make sure everyone had access to organ transplants. To make this a reality, Charlotte spoke with policymakers about creating a bill about organ transplant discrimination. Members of Congress created the Charlotte Woodward Organ Transplant Discrimination Prevention Act. This bill would prohibit health care entities from denying a person access to a transplant due to their disability.

For decades, The Arc has supported legislation, regulations, and policies that address organ transplant discrimination. Charlotte’s bill’s introduction in Congress was successful. The Arc will continue to advocate that organ transplant discrimination is wrong and needs to end.

Charlotte is also a member of The Arc’s National Council of Self-Advocates. Charlotte offers this advice for other self-advocates who are tirelessly working to advance legislation: “Never give up. If you don’t speak up for yourself and don’t demand what you want and need, you’re not going to get it.”

If you are a self-advocate looking for effective advocacy tips, join our National Council of Self-Advocates.

 

 

 

1 https://www.washingtonpost.com/national/health-science/people-with-autism-intellectual-disabilities-fight-bias-in-transplants/2017/03/04/756ff5b8-feb2-11e6-8f41-ea6ed597e4ca_story.html

2 https://jamanetwork.com/journals/jamasurgery/fullarticle/2801511

3 https://www.ncd.gov/assets/uploads/reports/2019/ncd_organ_transplant_508.pdf

4 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9932938/

A crowd of graduating students against a black backdrop. They are all raising their right arm and turning the tassels on their caps to the other side.

Unlocking Dreams: The Power of Student Loan Forgiveness for People With Disabilities

Many see college as a path to a better life and unlocking their dreams. But student debt often stops this, especially for people with disabilities. A major reason is due to income. People with disabilities experience poverty more than double the rate of individuals without disabilities.

A study found that nearly 3 in 5 people with disabilities with student loans struggle with food insecurity and paying house or utility bills. Facing these challenges can force borrowers to take additional jobs to pay for debt. It can stop people from buying houses or cars or seeking more education. On average, people with disabilities graduate with $27,490 in student loan debt and many have a debt of over $100,000.

The Arc has been a leader in advocating for changes to the Total and Permanent Disability (TDP) Discharge Program to include automation, simplifying the program, and eliminating the monitoring period. TDP is a program that relieves people who are totally and permanently disabled from repaying certain federal student loans.

The Biden administration has made significant changes to TDP. Now, more than half a million people with disabilities have received student loan forgiveness since 2021.

A woman wearing a graduation cap and gown. One of those people is Renee.

Renee’s dream was to be a nurse. She was excelling in a nursing program and working in an intensive care unit while she finished her degree. Unfortunately, she injured her spine while moving a patient and that started her personal disability journey. Due to this injury, Renee’s nursing education ended. Determined to earn a degree to help others, she returned to school to pursue a bachelor’s degree in human and community services and a master’s degree in social and public policy.

Right before graduating from her master’s program, Renee needed emergency spine surgery. The surgery and recovery made her unable to complete the required internship for her program. Because of this, she couldn’t work in her chosen field.

By this point, Renee was over $100,000 in debt with no way to get a good-paying job in her field. Her family was unable to make the $1,000 monthly student loan payments, and it made it more difficult for them purchase the things they needed for their family. Renee learned about the TPD loan forgiveness opportunity. She applied and she later discovered that her student loans were discharged. Renee stated that this relief was a blessing. Not only were they able to purchase things that their family needed, but it opened doors for her family to buy a home.

Student loan debt is a disability rights issue. The Arc has relentlessly advocated for changes to relieve people with disabilities from student loan debt. Learn more about TDP here.

There is an exam table at a doctor's office in the forefront. In the background is a counter with papers, a sink, medical equipment, and posters hanging on the wall.

“He Isn’t Worth Helping” – Devastating Stories of Medical Ableism

Our health care system is failing people with intellectual and developmental disabilities (IDD) – and costing them their lives. Their shared experiences are eye-opening and egregious, including doctors outright refusing to provide services, wrongly attributing health issues to their disability, not viewing people with IDD as reliable communicators of their own health issues, making assumptions about quality of life and worthiness, refusing to allow a support person to accompany them, discounting their pain, and more.

People with IDD are being denied life-saving treatments or even routine preventative health care at disproportionately high rates. The research reinforces what we hear every day: people with IDD have poor experiences at hospitals and medical centers, which leads to poorer health outcomes and shorter life expectancies. Explicit bias and discrimination are directly limiting lifespans and causing unconscionable, avoidable suffering. Many of these discriminatory policies and practices were laid bare by the COVID-19 pandemic.

To combat these health inequities, the U.S. Department of Health and Human Services (HHS) is proposing updates to Section 504 of the Rehabilitation Act, landmark legislation prohibiting disability discrimination. Unrevised in 50 years, reforms would forbid medical discrimination against people with disabilities and improve accessibility. These urgent updates are important steps forward for protecting rights and ensuring equitable health care access.

The Arc has been a longtime advocate on this issue, and we jumped at the opportunity to submit comprehensive comments to HHS on these proposed updates. We shared research on the wide-ranging discrimination people with IDD face in health care settings and highlighted the need for reasonable modifications and plain language communications.

Most crucially, we included direct stories of discrimination collected from people with IDD and their loved ones nationwide. Here are a few of their stories.

  • A parent in Washington state has been told by doctors and health care providers that their child with Down syndrome “isn’t worth helping… isn’t worth saving.”
  • A child with autism in New York was denied care from a pediatrician for basic primary care services out of concern that his care needs would “overwhelm” the pediatrician’s practice.
  • When her son with Down syndrome experienced febrile seizures and stopped talking, his parent was told, “He has Down syndrome. What do you expect? They don’t talk.”
  • People with IDD are frequently denied clinically-appropriate treatment that would be offered to a person without IDD. For example, a parent in Connecticut was told by multiple doctors that her 10-year-old son’s chronic joint pain “is part of his disability” or “growing pains” before finally receiving a Lyme disease diagnosis three years later and being told the damage is permanent.
  • A parent in Maryland reported that it took 6 years to find a therapist for her daughter, who has Down syndrome. “[My daughter] is verbal but it is difficult for her to verbalize her feelings… I thought she had been sexually assaulted. I was finally able to get her [help], but it was temporary.”
  • Accessing mental health and dental services are particularly challenging for people with IDD. For example, Michigan parents of a young child with autism who was denied service by a dentist, were “dismissed with a warning not to come back until he no longer expressed the behaviors of an autistic child.”

The stories are innumerable, infuriating, and heartbreaking. But they power our advocacy. We will continue advocating for Section 504 reforms addressing the pervasive and longstanding discrimination that people with IDD experience from medical professionals. Everyone deserves equal access to health care.

By uplifting the voices of people with lived experiences, we’re holding health systems accountable and pushing them to see all patients as equally deserving of quality, individualized care. Join us in speaking out against medical ableism until equity is reality. Health care is a human right that must not be denied for any member of our community.

The US Capitol in Washington, DC

Disability Advocates Urge Support for Emergency Funding Bill to Address Medicaid Care Crisis

Washington, DC – Every person deserves the freedom of living in their own homes, being a part of their communities, and choosing how they spend their days. Medicaid’s home and community-based services makes that possible for millions of people with disabilities and older adults, yet chronic underfunding is forcing them into institutions and putting families in crisis. Today, the Home and Community-Based Services (HCBS) Relief Act was introduced by Senator Bob Casey (D-PA), a bill that would provide emergency funding to state Medicaid programs and have a profound impact on disabled and older Americans. The Arc applauds this pressing bill and urges lawmakers to pledge their support for independence and inclusion.

“Marginalized for far too long and facing catastrophic shortages of direct care workers, people with disabilities and their families are desperate for help,” said David Goldfarb, Director of Long-Term Supports and Services Policy at The Arc of the United States. “Without access to basic support for daily living, disabled people are at risk of being confined, isolated, and neglected in institutions or trapped in their homes. This is about the basic human right to live in the community. It’s time that we show people with disabilities that their lives not only matter, but that they are valued members of our society. The HCBS Relief Act would support and strengthen their daily lives, while also improving health, economic stability, and quality of life for their families and direct care workers.”

Millions of people rely on HCBS for daily activities, such as dressing, bathing, meal preparation, taking medication, employment support, mobility assistance, and more. The HCBS Relief Act would provide dedicated Medicaid funds to states for two years to stabilize their HCBS service delivery networks, recruit and retain HCBS direct care workers, and meet the long-term support and service needs of people with disabilities and older adults. The HCBS Access Act, which was introduced in March 2023, would make a transformational impact on the care crisis, but emergency relief is needed right now, which this bill would provide.

“My disability means I need assistance getting around and sometimes with communicating,” said Steve Grammer, a Disabled Self-Advocate living in Virginia. “When I was 22, my mom fell ill and I was placed in a nursing home. I got to see her just once before she passed away. After 9 long years, my dream of independence came true. With the help of in-home caregivers, I have my own apartment and I can choose what I want to eat, where I want to go, and what I want to do. I no longer worry about my food being served cold or my medications being administered late. I can stay out late with friends while we listen to our favorite bands. I have freedom—and a life like yours. I’m living proof that people who have been barricaded away can live on their own and thrive while contributing to their communities.”

“I started out in an institution,” said Veronica Ayala, a Disabled Self-Advocate living in Texas. “I was there for 18 really long months, and I was a child, so that was really traumatic. For 18 months, I didn’t have my mother to put me to bed, tell me a story, give me a bath. There was no love or attention given. Thankfully my mother realized that she could do it on her own with home and community-based services. With the right supports, anyone with a disability can live in their community. Anyone with a disability can succeed.”

Recent research from The Arc and the University of Minnesota shows that 35% of people with intellectual and developmental disabilities (IDD) are trapped on waiting lists for supports and services they desperately need, 19% of which have been waiting for more than ten years. This doesn’t just impact their lives – it’s having a ripple effect on their families and our economy. Nine in ten family caregivers reported that their careers have been negatively affected due to a lack of supports, and 66% have had to leave the workforce entirely. This is ultimately leaving families significantly stressed and financially strained.

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About The Arc of the United States: The Arc advocates for and serves people with intellectual and developmental disabilities (IDD), including Down syndrome, autism, Fetal Alcohol Spectrum Disorders, cerebral palsy, and other diagnoses. Founded in 1950 by parents who believed their children with IDD deserved more, The Arc is now a network of nearly 600 chapters across the country promoting and protecting the human rights of people with IDD and actively supporting their full inclusion and participation in the community throughout their lifetimes. Through the decades, The Arc has been at the forefront of advances in disability rights and supports. Visit www.thearc.org or follow us @TheArcUS to learn more. Editor’s Note: The Arc is not an acronym; always refer to us as The Arc, not The ARC and never ARC. The Arc should be considered as a title or a phrase.

The US Capitol in Washington, DC

How the Government Shutdown Could Impact People With Disabilities

If Congress fails to reach a deal to fund the federal government by September 30, the government will shut down, which means federal agencies will cease non-essential operations until a deal is reached. We want you to be fully informed about how the looming government shutdown could impact you!

Many people with disabilities rely on a range of public programs, such as Social Security, Medicaid, Medicare, Supplemental Nutritional Assistance Programs (SNAP), and others that support their daily needs, health, and independence. They also benefit from programs that provide housing assistance, job training, special education, childcare, and developmental disability programs for supports and services. What’s more, many federal agencies enforce critical laws against disability discrimination, including the Americans with Disabilities Act.

Here’s what we want you to know. Social Security and Supplemental Security Income (SSI) payments will continue during a shutdown. While these critical needs will continue to be met, a prolonged shutdown could exacerbate ongoing customer service issues created by the underfunding of the Social Security Administration (SSA). Many people with disabilities need SSA’s support in navigating benefits and already endure long wait times for disability determinations.

Many of the other programs that people with disabilities rely on are administered by state governments, with critical oversight and administration conducted by the federal government. Currently, all 90 million Medicaid beneficiaries must go through a renewal process following the end of the COVID-19 public health emergency. According to the Kaiser Family Foundation, nearly three-quarters of all people losing Medicaid had their coverage terminated for procedural reasons. CMS recently took the major step of making 30 states pause their renewal process for failing to comply with federal law. The lack of this critical federal oversight could result in many more people with disabilities unjustly losing their Medicaid benefits. Make sure you don’t lose yours.

There is also considerable concern about the impact of the childcare funding crisis resulting in tens of thousands of childcare centers potentially closing and millions of kids potentially losing this critical avenue for early development. This is happening because of the expiration of pandemic emergency relief funds that were used to support struggling daycare centers. Families already experience significant hardship finding childcare options for kids with disabilities, which could worsen without action by Congress.

Looking to the future, a government shutdown raises the potential for additional cuts to government funding in order to reach a deal to reopen. The agreement to stop a default in May 2023 already set new caps on spending for FY 2024 and 2025. Those agreed-upon caps undermine critical programs and services. The Social Security Administration, for example, is facing a customer service crisis and programs like the Individuals with Disabilities Education Act (IDEA), which ensures students with a disability are given a free appropriate public education, have never been fully funded.

The reality is that funding for programs for people with disabilities needs to be significantly expanded, not cut. A government shutdown creates the political environment for cuts, going in the wrong direction for people with disabilities and their families. If that happens, you can expect that The Arc will use its power and influence to fight back.

The Arc logo

New Bipartisan Bill Would Advance Economic Security for Disabled Americans

Washington, DC – The Supplemental Security Income (SSI) program was designed to combat poverty among people with disabilities, but the program’s outdated rules do just the opposite—forcing people to live in poverty to qualify for monthly assistance. Today, The Arc celebrates the introduction of the SSI Savings Penalty Elimination Act by Senator Sherrod Brown (D-OH), Senator Bill Cassidy (R-LA), Representative Brian Higgins (D-NY), and Representative Brian Fitzpatrick (R-PA). This bipartisan bill, which is also supported by over 370 organizations, makes long-overdue reforms to the SSI program that would empower millions of people with disabilities to earn and save more money for their futures.

The SSI program was established 50 years ago and provides critical benefits to over 7.5 million people with disabilities and older adults to help them pay for basic needs like food, clothing, and shelter. But outdated eligibility rules punish SSI beneficiaries for saving money, pushing them into poverty. SSI also guarantees access to Medicaid in most states, which covers long-term services and supports and health care. Right now, people who get SSI cannot have more than $2,000 in financial resources and married couples can only have $3,000. Resources that count towards the SSI asset limit include cash, money in bank accounts, most retirement accounts, stocks and bonds, the value of life insurance policies and burial funds over $1,500, and some personal property. This strict asset limit has not been updated since 1984 and is not indexed to inflation.

“Decades of inflation and inaction have turned a crucial safety net program into a tightrope,” said Darcy Milburn, Director of Social Security and Healthcare Policy at The Arc of the United States. “The maximum amount of money an SSI beneficiary can have in a bank account is 80% less than what beneficiaries were allowed to save in 1972. SSI’s strict asset limits force people with disabilities to live on a financial knife’s edge. It’s an incredibly difficult administrative burden and a very delicate balancing act that can easily tip to losing benefits altogether – which can be catastrophic.”

The SSI Savings Penalty Elimination Act would raise the SSI asset limit to $10,000 for individuals and index it to inflation moving forward. It would also raise the limit for married couples to $20,000 to help correct a harmful marriage penalty. The bill would significantly improve the lives of millions of people with disabilities and allow SSI beneficiaries to use their own savings to address needed emergencies when they arise.

SSI’s low asset limits combined with meager cash benefits are leaving 4 in 10 beneficiaries in poverty. People with disabilities live in poverty at more than twice the rate of those without disabilities, and SSI is a driving factor. These barriers are compounded by the Social Security Administration being in a state of crisis, where millions are waiting for appointments, decisions on applications, and appeals on rejected claims.

“Raising the SSI asset limit is one of the most important things we can do right now to improve financial security for millions of older adults and people with disabilities,” said Milburn. “The current asset limits trap people in poverty, create barriers to work, and make financial independence virtually impossible. SSI beneficiaries cannot save for necessary expenses like a security deposit or car repairs without the risk of losing their benefits, leaving many just one emergency away from homelessness and hunger. The negative impacts of the current SSI asset limits extend beyond individual SSI beneficiaries to their families, communities, and our economy as a whole.”

The Arc has advocated relentlessly for changes to SSI asset limits and against the existing unfair and discriminatory caps. For many years, we have urged Congress to update SSI requirements and benefits so that people with disabilities can have greater financial security and support, as well as pursue opportunities to build their futures.

To meet real-life people who are impacted by SSI asset limits, read these stories from Lauren and Jen and Eddie.

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About The Arc of the United States: The Arc advocates for and serves people with intellectual and developmental disabilities (IDD), including Down syndrome, autism, Fetal Alcohol Spectrum Disorders, cerebral palsy, and other diagnoses. Founded in 1950 by parents who believed their children with IDD deserved more, The Arc is now a network of nearly 600 chapters across the country promoting and protecting the human rights of people with IDD and actively supporting their full inclusion and participation in the community throughout their lifetimes. Through the decades, The Arc has been at the forefront of advances in disability rights and supports. Visit thearc.org or follow us @TheArcUS to learn more. Editor’s Note: The Arc is not an acronym; always refer to us as The Arc, not The ARC and never ARC. The Arc should be considered as a title or a phrase.

Media Contact: Jackie Dilworth, dilworth@thearc.org

A man wearing a dark suit sits in a wheelchair. Behind him is a wall of books.

The ADA’s Promise Must Still Be Realized: A Conversation With Sean Pevsner

For 33 years, the Americans with Disabilities Act (ADA) has protected the civil rights of people with disabilities.

We recently talked to disability rights lawyer Sean Pevsner about why the ADA matters and why there’s still so much to do to see its full promise fulfilled.

A man wearing a dark suit sits in a wheelchair. Behind him is a wall of books.Sean founded a law firm with his best friend, Mark Whitburn. At their firm, Sean works on special education law and practice, guardianship and probate proceedings, and other civil rights cases. He focuses on the ADA, the integration of individuals with developmental disabilities into society, and ensuring that students with disabilities receive the appropriate services under the Individuals with Disabilities Education Act (IDEA).

Sean has cerebral palsy and operates a motorized wheelchair using head movements. Due to his quadriplegia, he cannot write and must rely on an interpreter or a specialized computer to communicate.

People have underestimated Sean since the moment he was born. He was born clinically dead, and an anesthesiologist had to administer CPR for 45 minutes until Sean could breathe on his own. The anesthesiologist likely thought Sean wouldn’t survive, but Sean proved him wrong.

Sean began his schooling just as the IDEA was passed into law. When he wanted to leave the segregated private school to attend mainstream public school, he and his family had to fight to demonstrate that he could thrive there.

When his high school threatened to put him in remedial classes despite his excellent grades, Sean, his family, and Mark fought for his right to attend the same classes as his peers. They fought against teachers who thought he couldn’t handle the workload and administrators who thought he wouldn’t graduate. Despite doubters, Sean graduated from the University of Texas in 1998 with majors in Greek and Latin and, later, from the University of Texas Law School.

In 2011, Sean passed the Texas State Bar. It took him eight days to deliver every answer orally to interpreters. In the end, he was exhausted. At the swearing-in ceremony, Texas Supreme Court Chief Justice Wallace Jefferson specifically acknowledged Sean.

Sean was surprised to learn that the judge’s sister had invited the child of a family friend, a 9-year-old with cerebral palsy. She was seated in the front row so she could see someone like her become a professional advocate. “I did not believe anything could top my passage of the eight-day Texas Bar Exam,” says Sean, “but I was proven wrong.”

Q: What does the ADA mean to you? Why is it important to you in your personal life and your work?

The ADA means that individuals with disabilities have an equal opportunity to live and contribute to their community. It has broken down a lot of barriers to community-based services, such as community attendants, education, and employment. It also helps people with disabilities access many things that people without disabilities take for granted, like the ability to live independently in your community, without worrying about being forced into institutions, accessing education, and finding employment.

As someone with severe cerebral palsy, the ADA has helped me in many ways. My personal life has improved in terms of getting a quality education and becoming a licensed Texas attorney. I have equal access to public accommodations, such as hotels, office buildings, restaurants, and other public establishments. I have equal access to both state governmental and private entities’ programs and activities as well.

Q: In what ways is the ADA falling short 33 years after being passed?

The ADA has fallen short in increasing the employment rate for people with disabilities. While the ADA requires employers to provide effective job accommodations, it has not increased the recruitment and hiring of qualified employees with disabilities.

It also fails to eliminate institutional bias in the U.S.’s long-term care system. Even though the ADA requires state governmental entities to place people with disabilities in the most integrated setting (as the U.S. Supreme Court interpreted it in Olmstead v. LC), institutional bias is still a major issue in our country today.

Congress must pass, and the President must sign, the HCBS Access Act that would end this institutional bias. The HCBS Access Act would eliminate waiting lists for community-based services and increase wages for direct care workers.

Q: What has been the biggest or most important case you have done around the ADA?

I use the ADA to help others with disabilities get funding for community-based services to live in and contribute to society instead of being institutionalized. In Harrison v. Young, my law firm convinced a federal judge that the Texas Health and Human Services Commission (HHSC) violated Title II of the ADA by failing to provide funding to our client with multiple disabilities to live in a community group home. The HHSC attempted to place that person in an institution against their will. My law firm argued that this violated the integration mandate provision in the ADA.

Q: How can others get involved in advocacy to support the implementation of the ADA and disability rights progress?

We should conduct serious disability etiquette training to educate people about the ADA and the importance of including people with disabilities in all aspects of society. Generally, the public is uninformed about disability rights, the tenets of the ADA, and the importance of equality and inclusion of all people with disabilities.

There is also a myth that it is too expensive for the public and businesses to include and accommodate people with disabilities, both online and in person. However, the reality is that any cost is made up in increased employee productivity and access to new customers.

Finally, to achieve true inclusiveness and equality, the disability community must lead by example. We must accept others with different types of disabilities. People with polio or paraplegia must accept people with cerebral palsy, speech impairments, and intellectual disabilities. We should ensure our own community is fully inclusive of all people with disabilities and get rid of hierarchies of disabilities that separate us from working together.

The Arc logo

Why the Debt Ceiling Matters and How You Can Help

The United States could hit the debt ceiling as early as June 1.

Right now, Congress and the President must decide what to do about the debt ceiling.

These decisions could have a BIG impact on people with disabilities and their families.

What is the debt ceiling?

The federal government regularly borrows money to pay for things.

The debt ceiling is the largest amount of money the federal government can borrow at one time. It can’t borrow more than the debt ceiling allows.

When the government gets close to hitting the debt ceiling, Congress must decide whether to:

  • Raise the debt ceiling, so the government can borrow more money to pay for things, or
  • Do nothing and fail to pay for the things it promised to do.

So far, Congress has always raised the debt ceiling.

This has happened 78 times since 1960.

Congress typically raises the debt ceiling high enough to last only a short time, from a few months to a few years.

What is happening with the debt ceiling debates now?

On April 26, the House of Representatives passed a bill to raise the debt ceiling.

It agreed to raise the debt ceiling for one year in exchange for over $3.6 trillion in budget cuts over 10 years.

The bill also adds radical work rules for all Medicaid enrollees who are ages 19 to 55.

These work rules would likely result in millions of people who rely on Medicaid getting kicked off the program.

The bill says that Medicaid enrollees would have to work at least 80 hours a month.

This includes enrollees who:

  • Get Social Security Disability Insurance or Supplemental Security Income and Medicaid
  • Have Medicaid waivers for home and community-based services

There would be only one way for people with disabilities enrolled in Medicaid to get out of this work requirement.

They would have to get a note from a doctor or medical professional saying they are “physically or mentally unfit” to work.

This adds a lot of red tape for people with disabilities and their families.

It also fails to understand that people with disabilities can and do want to work.

Medicaid’s rules related to work, savings, and disability are already complicated enough.

Adding more red tape will hurt people with disabilities and their families who rely on Medicaid.

What happens if Congress decides not to raise the debt ceiling?

If Congress does not raise the debt ceiling, the federal government may not be able to pay for important things like:

  • Medicaid, Medicare, and Social Security
  • The Supplemental Nutrition Assistance Program (SNAP)
  • Our military and the salaries of military service members
  • Tax refunds
  • And many more programs and services

The economy and stock market could also have trouble. It may cost people even more money to get a loan, and people could lose their jobs.

Everyone may struggle if Congress does not increase the debt ceiling.

But people with disabilities who depend on government services may be hurt more if the programs and services they need stop.

What You Can Do

Congress and the President can agree to raise the debt ceiling without cutting Medicaid or other essential programs.

Contact your members of Congress today and tell them to keep Medicaid out of debt ceiling negotiations.

The Arc logo

New Bill Would Advance Equity & Independence for Millions of Americans With Disabilities

People with disabilities and older adults want to live in their own homes and communities, and they deserve that right just like everyone else. Today, Sens. Bob Casey (D-PA), Chair of the Senate Aging Committee, Tim Kaine (D-VA), Sherrod Brown (D-OH), and Maggie Hassan (D-NH) along with Rep. Debbie Dingell (D-MI) introduced a critical bill – developed with The Arc and other advocates – that will fundamentally change how these populations live full and inclusive lives. The Arc stands unwaveringly behind the Home and Community-Based Services (HCBS) Access Act and urges Congress to pass this long overdue bill.

HCBS waivers were established under Medicaid in the early 1980s, and millions of people rely on it today for daily activities, such as dressing, bathing, meal preparation, taking medication, employment support, mobility assistance, and more. Yet HCBS has been chronically underfunded for years, resulting in a national shortage of direct care workers, years-long wait lists for access to services, and, ultimately, isolation that strips people with disabilities and older adults of their dignity.

“We know that everyone benefits when people with disabilities are a part of the fabric of their communities, not locked away in institutions or nursing homes,” said David Goldfarb, Director of Long-Term Supports and Services Policy at The Arc of the United States. “Yet this country has treated the independence of people with disabilities as an idea, not a right. One in four U.S. adults live with a disability. These are your neighbors, your relatives, your coworkers, your friends, and they deserve better. We applaud the bill’s sponsors, Senators Casey, Hassan, Brown, and Kaine, and Representative Dingell, for their commitment to helping people with disabilities live with dignity.”

The HCBS Access Act would:

  • Make home and community-based services a mandatory Medicaid benefit and increase funding for these services;
  • Provide grant funding for states to expand their capacity to meet the needs of people who prefer HCBS;
  • Make steps to improve the stability, availability, and quality of direct care providers to help address the decades-long workforce shortage crisis;
  • Provide states with resources so that caregiving workers—who are disproportionately women of color—have stable, quality jobs and a living wage;
  • Provide training and support for family caregivers; and
  • Create better evaluation measures to assess the quality of HCBS being provided.

To meet real-life people who are impacted by the inadequacies of HCBS, watch Susan’s story.

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About The Arc of the United States: The Arc advocates for and serves people with intellectual and developmental disabilities (IDD), including Down syndrome, autism, Fetal Alcohol Spectrum Disorders, cerebral palsy, and other diagnoses. The Arc has a network of nearly 600 chapters across the country promoting and protecting the human rights of people with IDD and actively supporting their full inclusion and participation in the community throughout their lifetimes and without regard to diagnosis. Visit www.thearc.org or follow us @TheArcUS to learn more. Editor’s Note: The Arc is not an acronym; always refer to us as The Arc, not The ARC and never ARC. The Arc should be considered as a title or a phrase.

Close up of a person holding a small leather wallet in their left hand and pulling out a folded dollar bill

For Tyson, Marriage Changed Everything – Including His SSI

By Tyson from North Carolina

Married people with disabilities often experience penalties that force the couple to give up necessary benefits. Congress must address marriage penalties so everyone has the chance to marry without endangering the key supports they need to live in the community. Tyson is one of the many people with disabilities who have experienced this penalty, and he shares his experience below.


I have been getting Supplemental Security Income (SSI) since I was 19 years old. I’m now 46. These benefits are important to me; they help me pay for things I need, like rent and food. I have always been vigilant to report my earnings and document everything Social Security asked of me.

In 2021, I got married to the love of my life. My wife works for our local school system and is a wonderful partner. I didn’t know, though, that getting married would so greatly impact my SSI.

In late 2021, I got a call from Social Security. It was time to do the regular review, where Social Security asks the same questions over and over to make sure I am sharing all the information and earnings I have. During the call, I shared that I got married, gave them the date and information, and shared my wife’s income information.

Because I got married, I was told that my SSI would be cut from about $800 a month to $500. This was because of my wife’s income. But SSI is my only source of income, and it felt like I was punished for getting married. At the same time, I also found out my rent would increase by $200 a month. So, my wife and I had to do more with even less.

The Social Security office also told me I could get a Social Security Disability Insurance (SSDI) benefit through my dad’s work record. I spent hours tracking down school records to make sure Social Security had what they needed. Several times, people who worked at Social Security told me I would get SSDI. But, in the end, they rejected my application. I felt like I was lied to and that my time was wasted.

I do my best to pay my bills and live the best life I can. But I am trapped in poverty.

I can’t help that I have a disability, and I want to do more to contribute to our household and have planned to get a part-time job. I am worried that doing this will make me lose my SSI and other benefits. My wife and I have thought about moving to another state to be near other family members, but that may cause me to lose my other benefits, too.

I don’t know what to do, but I know that people should not have to live like this or be punished for marrying the person they love.