Disabled and chronically ill voters: What was your experience casting a ballot in person, either this week or in early voting?

Civil and voting rights protections like the Voting Rights Act and the Americans With Disabilities Act are supposed to protect disabled people’s right to vote in person, which means having the right accommodations: wheelchair-accessible entrances; lower voting booths; and chairs for people who have trouble standing for long periods. But polling stations often fall short, in both Democratic- and Republican-leaning areas.

Disabled and chronically ill voters: What was your experience casting a ballot in person, either this week or in early voting?@metraux_julia on voting access pic.twitter.com/D1Pck8tSmv

— Mother Jones (@MotherJones) November 9, 2024

Disabled people don’t all have the same preferences—or needs—when it comes to voting. Some people with fatiguing conditions like Long Covid may prefer mail voting to conserve energy and minimize Covid exposure; some Blind people may prefer to vote in person in order to cast an unassisted ballot with an accessible voting machine.

As I wrote for Mother Jones in April:

Counties are responsible for choosing the locations where their residents vote. The right response to inaccessible voting locations is not to have fewer of them—polling place closures disproportionately impact voters of color—but to find more locations that are accessible. The Department of Justice also provides guidance on temporary solutions to make sure disabled people can vote, such as installing a ramp and keeping doors propped open…As of now, no state mandates that poll workers be trained in accommodating disabled voters.

What may be accessible to some disabled people may not be for others. That’s why it’s crucial to move towards more accessible options both in-person and by mail—mail-in voting with paper ballots isn’t accessible, for example, to people who are Blind and have low vision, the subject of a lawsuit filed in Wisconsin…arguing that disabled voters should be able to vote electronically. 

If accessible voting—and disabled voters—were taken more seriously in America, more disabled people would take part in the electoral process. It’s that simple.

In the days and weeks after the 2020 election, more than 65,000 mail-in ballots were rejected for arriving too late—and given how much is at stake in 2024’s races, nationally and at the state level, it makes sense that American voters would do just about anything to make sure their vote gets counted. For millions of people, that includes waiting in long lines at polling places, sometimes for hours, even at the risk of fainting.

While waiting in line can be exhausting for anyone, it has unique impacts on disabled and chronically ill people. Standing for long periods can send some chronically ill people into weeks-long flares, a trade-off many were willing to make to try to stop a Trump victory—which, especially through the machinations of Project 2025, could greatly hurt disabled people.

The closure (or lack) of polling places is one factor in those wait times, particularly in Black neighborhoods, where the wait to vote is typically already longer. The burden falls disproportionately on disabled and aging Black people; in Texas, for instance, from 2016 to 2018, there were more closures of polling locations in counties where more Latino and Black Texans lived.

Meanwhile, Republicans across the country have launched many lawsuits trying to make the definition of “on time” stricter—which, as my colleague Abby Vesoulis has reported, is part of a bogus GOP strategy to try and turn the election in its favor. It may be working: Just one day before the election, the Georgia Supreme Court ruled that Cobb County could only count ballots received by 7 p.m. local time on Election Day.

When I spoke to Michelle Bishop, the National Disability Rights Network‘s voting access manager, in April, she told me that voting locations should consider “moving people with disabilities to the front of the line” if they cannot stand for long periods. While some polling places do have separate lines for disabled voters, as well as curbside voting, it’s far from uniform.

Rachel Green, who lives in North Carolina’s Davidson County, voted early—like more than half the county’s voters—at a local polling place. In person, they told me, they could trust that their ballot wouldn’t be rejected.

(Charles Stewart, the director of the Massachusetts Institute of Technology’s Election Data and Science Lab, told me that voters shouldn’t have much fear that mail-in ballots won’t be accepted—but that “it is simply a matter of fact that if you take the same person, have them vote in person, and then vote by mail, the mail ballot has a slightly lower chance of being counted.”)

But the wait was physically taxing on Green, who lives with arthritis in their knees and feet. The whole process took two to three times as long—an hour and a half—as in previous years. With invisible disabilities and no blue parking placard, Green didn’t expect to qualify for curbside voting, and there were no seats available, even once they got in. “I’m doing a shuffle from side to side, bending my knees,” they said to me. “People were looking at me funny.” Green thinks there just needed to be more chairs.

Standing isn’t the only challenge in long lines—so are rules against providing voters with food and water, known as “line warming,” which the American Bar Association says “can serve as a tool to make it easier to stay in line so eligible voters who want to vote can cast their ballot.” (Line warming has been illegal since 2021 in Florida, but similar laws have been limited in Georgia, and completely struck down in New York, by federal judges.)

It’s not just Republican-controlled areas that have long lines. In Philadelphia—the largest city in a crucial swing state—Eshani Surya, who lives with ulcerative colitis, had to leave a voting line on Election Day to go to the bathroom during her 45-minute wait. There was no line for disabled voters, and although her husband was there to save her spot, there was no guarantee that she could get back in line.

But, like many others, Surya still elected to vote in person to be involved in the real-life excitement of it all: “There was an energy about being there,” she said.

I love looking at pictures from my daughter’s first day of preschool. Three years old, wearing a dress with pink apples on it. I had perfected getting her hair into pigtails just a few weeks before. There was something joyous and hopeful about those little hair geysers sprouting straight off her head. In the photos from that day, we look like any other family on the first day of school. My boys, ages 4 and 6, wearing new future-oriented pants that look a little too long, are smiling proudly at the thought of their sister joining them. It was raining and unseasonably cold; our raincoats seemed out of sync with our end-of-summer tans. In one picture, Mae is leaning into my lap, her yellow raincoat and pigtails buried by my scarf as I give her one last kiss.

We appeared to be a conventional family from afar, but we weren’t. Mae wasn’t like my other two children. She made repetitive noises and movements, barely slept, never spoke, and seemed plagued by a never-ending carousel of ear infections and rashes. When she started school, she was classified as PDD-NOS, or “pervasive developmental disorder-not otherwise specified.” Although she was 3 years old, developmentally, her age was estimated to be between 13 and 17 months. A month after her first day in preschool, she was officially diagnosed with autism. With the right therapies and some good luck, we were told the gap between our daughter and her peers might be narrowed—if not closed. So, for the next decade, we did everything we could to solve the puzzle that was our daughter’s brain: hours and hours of therapy, specialists, the occasional snake-oil salesperson, chat rooms, lawyers, and—yes—the public school system.

That was 14 years ago. Mae has grown into a young woman who loves music, bubble baths, and peanut butter. She can get a map of a place in her head in seconds and can quickly scan a room and identify who would be most likely to bend to her needs. In other ways, though, her developmental age is still under 2 years old. She is still in diapers; she communicates with hand gestures and noises that make perfect sense only to those of us who know her. As her older brothers’ academic and social lives have traced the predictable trajectories of adolescence, hers have been characterized far more by what hasn’t changed than what has.

This is where the current model of education for children with disabilities is a mismatch for her: Even though her developmental age is that of a preschooler, well-intentioned policies known under the blanket term of “inclusion” put her in a building of high school students with whom she has little in common.

My daughter’s school-based occupational therapist and I have often spoken wistfully of a school site with an OT space where students could learn practical life skills, where my daughter would spend her days learning to make a peanut butter sandwich or brush her teeth or make a bed or comb her hair. Or, most importantly, learn how to take herself to the toilet. The hours and hours she and I spend together in the summer on potty training are paused every time school starts. It is lovely to think that putting her in a small classroom adjacent to neurotypical students would somehow improve her experience. However, if she learned through osmosis or observation, she would be someone else altogether.

Still, I see this issue from two perspectives. I am the parent of a child with complex needs—and for the last eight years a general education middle school teacher. I believe that she has every right to a high-quality education in our public school system. I also believe, however, that what she learns is more important than where she learns it. The gap between my daughter and her neurotypical peers has grown into a galaxy. I am pretty sure she does not look at the long-legged teens twirling car keys at her school and wish she were one of them. (I think one of the gifts of her condition is that envy or insecurity aren’t part of her experiences.) But one of the liabilities of including her in classes with her chronological peers is that the important life skills that she lacks are not on the curriculum.

Students in my classroom also have a range of needs; some are neurodivergent, others aren’t, but none of them have demands as complex as Mae’s. As a parent and as an educator, I have been increasingly troubled by the gap between good intentions and lived experience in our schools, one that seems especially sharply drawn with children like my daughter. This question of where a child with disabilities learns and with whom is deeply complicated, in part because the term “disability” is applied very broadly. It now includes everyone from a child with mild dyslexia or similar processing issues to a child like mine. Is there a unified strategy that can meet these varied needs? Have we progressed from a time when children like my daughter were shut away from society to the present day when we use the myth of inclusion to mask the fact that we are still not truly creating schools to meet the needs of all children effectively?

Inspired by the desegregation of schools and the civil rights movement, in the late ’60s and early ’70s, disability rights advocates started pressuring Congress to address education for children with disabilities. Leading disability rights activist Judy Heumann, who worked with a congressional team to draft legislation, recalled in her book Being Heumann: “The country was so inaccessible, disabled people had a hard time getting out and doing things—which made us invisible.”

Disability rights activism changed this. Back then, many children with disabilities never went to school at all. There was no expectation that a local public school could or would meet their needs. In 1975, the Individuals With Disabilities Education Act, known as IDEA, passed. The New York Times around that time quoted Dr. Philip R. Jones, president of the Council of Exceptional Children, describing the measure as “a landmark for education of the handicapped in our country,” adding, “It is overcoming 200 years of sin.” After describing the bill’s emphasis on individualized curricula, the Times also reported: “Another sensitive portion of the legislation deals with what has come to be known in education as the issue of mainstreaming. That is the extent to which the handicapped should be isolated in classes of their own or mixed in the so-called mainstream with the nonhandicapped.”

Today, nearly 50 years later, across the United States, there are 7.3 million children with disabilities currently receiving services in the public school system, according to the Pew Research Center. They represent about 15 percent of all public school students. IDEA seeks to help them by mandating “free and appropriate education” for all children and requiring that students be educated in the “least restrictive environment,” or LRE. The law states that “to the maximum extent appropriate, children with disabilities, including children in public or private institutions or other care facilities, are educated with children who are not disabled.” LRE is descended from another legal standard—the least restrictive means test, which is used any time a law or government may impede on a person’s civil liberties. These days, it’s often the rationale for placing children with disabilities in schools with their chronological peers—often referred to as “inclusion or mainstreaming.”

Broadly speaking, authentic inclusion of disabled children is necessary and important because, just as with any child, these children are as deserving of a high-quality education that meets them where they are. But for my daughter, and for children with similar profiles, the practical effect is that, rather than spend her days on skills she needs—brushing her hair and teeth, going to the bathroom—she spends them in a large public high school, sitting in a classroom located beside a loud, distracting cafeteria, working on some pseudo-academic curriculum that is based on videos of current events. The thought of her sitting and watching videos on the marvels of weather and then being asked to fill out a worksheet on what she just watched is absurd. Her worksheets about tornadoes or growing potatoes appear to have been scribbled on by a toddler.

The thought of her sitting and watching videos on the marvels of weather and then being asked to fill out a worksheet on what she just watched is absurd. Her worksheets about tornadoes or growing potatoes appear to have been scribbled on by a toddler.

As we have seen, in practice, the whole concept of LRE is often reduced to the setting where a child learns. But Dr. Mitchell Yell, a professor at the University of South Carolina and an expert on legal issues in special education, explains: “It is actually much more than that. It’s the facilities, personnel, and location. It’s a web of services.” When I asked Yell about how the concept of LRE had come to represent a physical place, he said he wished they had instead called it “LRAE—least restrictive appropriate environment.” He added, “Perhaps then the emphasis would have remained on what is appropriate for that individual child, rather than simply what was available.”

As a teacher of social studies, I see 86 middle school students a day; at any given time, I can have as many as 35 in a class. In order to succeed, one of them may need to sit in the front row away from his peers, while another may need to be in the same seat every day flanked by his best friends. One may never remember to bring his backpack, so may need to keep a folder in the room and a steady supply of pencils and other reminders; another may complete every assignment the day that it is given and ask for additional reading. Teachers are like short-order cooks serving up our subjects. At best, we can tailor every lesson, assignment, fact, and expectation to the child in front of us. It is why the job is both so hard and so rewarding. When you crack the code of how a kid learns, you open up some small but important part of the world to them.

About two-thirds of children with disabilities are included in the same classrooms as their general education peers. Some, with dyslexia, for instance, or ADHD, have modified assignments, tests without time limits, or support for note taking; others are pulled out for speech or OT services. In some cases, students are accompanied by one-to-one aides. For the most part, these students are able to operate in a general education classroom and still get the support they need.

Children like my daughter, whose needs are more complex, tend to be in “special day classes” (SDCs), usually in the same building as their typically developing peers but in a dedicated classroom. Part of the intention of LRE was to avoid the segregation of people with disabilities, so they could attend their neighborhood schools and build relationships in their community. Plus, these schools already exist, equipped with cafeterias, art rooms, and athletic facilities. It is far less expensive for districts and counties to tuck disabled children on the edges of existing facilities than to really address their needs.

I live in Northern California, and the SDCs are managed by the county, not the local school. In functional terms, the county-run SDC is a guest at the high school, but local school or general education teachers have no authority or responsibility to monitor what is happening in that classroom. I have often worried about Mae’s safety in these siloed little classrooms an hour from our home with no daily on-site administration. Her program manager visits her class twice a week, and that is the only oversight or accountability for the teachers and staff who work with her.

Midway through the last school year, we got word that our daughter was struggling in class—huge tantrums every day, screaming, crying, hitting herself. We learned about this because the school nurse reached out to ask whether we were seeing the same behaviors at home (we were not). Only then did I learn that her dedicated one-to-one aide had been away from the school for a month. (My daughter, of course, was not able to tell us.) Then we learned that some complex medical issues would keep the head teacher out of the classroom for the rest of the year. Plus, the program lacked a consistent occupational therapist. The replacement teacher had no teaching credentials at all, let alone experience with children with disabilities. I was told by a county administrator that the replacement teacher’s wife had taught disabled children, so I needn’t worry. The result was that Mae spent most of the school year in a classroom without a credentialed teacher and with a rotating cast of occupational therapists. Had it not been for the consistency of her one-to-one aide (who returned after the first month of school), my nonspeaking child would have found herself surrounded by under- or unqualified strangers.

When parents believe that schools are failing to provide an appropriate education for their child, they can sue for a better placement or services, such as a special school or home-based care or what is classified as “most restrictive,” which means a hospital or residential facility. Unsurprisingly, parents with resources tend to be able to hire lawyers and advocates so their children will have access to specialized private schools or obtain additional services and support. In some cases, these parents can get public funds to cover the cost of a private school that best meets the needs of a student, though this puts heavy financial burdens on school districts and creates serious equity issues.

Inclusion works well for some children with significant disabilities. Not long ago, I spoke with Janee Adams, whose daughter Ruby has Down syndrome and recently graduated from high school. Ruby went to a large public high school in her district, where her mother said she “got to be one of one, everyone knew her.” However, Adams had to fight every step of the way. She hired an advocate and created alliances within the school community so other parents supported Ruby’s presence in the classroom. With Adams’ daughters so close in age, they often were in the same class—one of the reasons Ruby loved school. Some of the more challenging social elements of inclusion were easier because the girls could have friends sleep over at their house together. Now that Ruby has finished high school, Adams told me that she is in a day program that has helped her find employment and holds her accountable in ways that often didn’t happen in school. “Ruby loves it,” Adams says. “She has never been in a place where she completely belonged before, and she is just so happy.”

Our family also has had experiences when inclusion was truly remarkable. Two years ago, my daughter’s teacher collaborated with the theater teacher to create a performance that was written and performed by both general education students and the students in Mae’s class. When the play began, Mae was sitting on a couch while Nirvana blasted through the speakers. She loves music and the students working with her had realized that Nirvana was a special favorite. The student actors would weave it into their story when occasionally Mae would jump up off the couch or laugh loudly. It was a wonderful experience to be at my daughter’s school for something other than a meeting, where the typical kids described how much they learned from working with their disabled peers. In our home, my sons have gained so much from having a sister with complex needs. Their friends who have grown up with Mae also display a level of understanding and empathy that only comes from authentic relationships.

“I feel like I’m stuck in a cage with only special needs students that can see me and interact with me. And the mainstream girls think I’m invisible.”

Some school districts offer a partial inclusion model for students who fall in between inclusion and SDC, where students with disabilities share some low-intensity classes—such as PE or art— with their typically developing peers but are sequestered in other classes for academic programs. I spoke to a neurodivergent student who attends one such program at the large public high school from which my sons graduated. She also holds a job at a local smoothie shop. “I met these mainstream girls last year in PE who I wanted to be good friends with because we had a good conversation,” she told me. “I don’t think they knew how to interact with the neurodivergent kids.” She continued: “I feel like I’m stuck in a cage with only special needs students that can see me and interact with me. And the mainstream girls think I’m invisible.”

She may take PE or electives with her neurotypical peers, but when she wanted to take the genetics section of a science class or manage the swim team, she was told she could not. When her parents pushed back, they were told that the coach of the team did not have the capacity to have her on as a swimmer or manager. They were told that the science class was “not a good fit” even though their daughter had independently done hours of research about her own chromosomal deletion. She longs to be included in the daily goings-on at the school, but without the concerted efforts of both students and staff, she and her peers will operate as though they are of a different caste—functional enough to be adjacent to their typically developing peers, but never admitted into what seems to be an exclusive club.

Without standards to define or measure “inclusion” or its benefits, it becomes one of those educational policies that sound good on paper but are rarely as beneficial to the students they are designed to help. When we make inclusion the goal over excellence, we are “putting the where before the how,” says Douglas Fuchs, a leading researcher on human development and education for children with disabilities at Vanderbilt University.

Fuchs told me his research team created a national database of reading data from 1998 through 2015 for students grades K-12. After analyzing the data using “multilevel growth models,” they found “that mainstreaming, or general classroom placements, did not strengthen the academic achievement of most students with disabilities.” In 2022, the Campbell Collaboration, an international research organization, published a report saying inclusion did not seem to show any positive academic or social-emotional benefit to students. In fact, students who were taught separately in settings designed for them experienced better outcomes.

The longitudinal studies are clear about how blanket policies of inclusion can actually inhibit student progress. In summarizing what we know about inclusion, Fuchs says, “Fifty years of research indicates that placing students with disabilities in general classrooms fails to provide the necessary intensive and expert instruction these children and youth need to succeed in school and in life afterwards.” This means that for some students, the general classroom is an appropriate placement, but for many, there need to be other school-based options that are better suited to meet their specific needs.

“Fifty years of research indicates that placing students with disabilities in general classrooms fails to provide the necessary intensive and expert instruction these children and youth need to succeed in school and in life afterwards.”

In my classroom, there were students with various diagnoses who spent most of their days in general education and were able to follow much of the curriculum. I have seen moments of enormous grace: when students connect over a beloved video game or when a child with autism will blurt out a question that their peers are too shy to ask. For a moment, they are a hero. I have also cringed as the same child picks their nose, not noticing that their peers are recoiling, or doesn’t realize that the clothes they refuse to change may smell. The parent in me dies a little every time I catch the flicker of irritation on a student’s face at the thought of having to work with a peer with disabilities. Or when I look out at lunch and see clusters of students all over campus and then one or two lone kids not really excluded, but not fluent in the language of adolescence. I have often wondered whom our well-intentioned efforts benefit. Do the kids really learn to be tolerant of people who are different than they are? Do kids with disabilities learn to live more easily in the world simply because they are surrounded by it?

I know they sometimes feel left out, aware that there are sleepovers they don’t attend and jokes they will never get. Are those painful feelings worth the experience of being in their local public school classroom? I’ve seen how students with complex needs can often confirm the biases of their peers by behaving strangely or having inappropriate outbursts in the classroom. It is one thing to be polite to a kid with disabilities in the context of your eighth-grade classroom; it is another to invite them to your birthday party.

So what would the best option be? I asked Bill Koski, the founder of Stanford’s Youth and Education Law Project, about which country might have the most advanced models for raising children with disabilities. Finland, he said, thrives at addressing the needs of very different learners by focusing more on integration than inclusion. He explains that there is no “labeling and classification” of students, but “three tiers of intervention” for those who are struggling: general support, intensified support, and specialized support. “As a result,” he says, “a fairly high percentage of Finnish students receive interventions for children with disabilities.” No matter where or who they teach, good teachers do this instinctively, but what sets Finland apart is that it has normalized the concept that every learner has an individual style and those needs should be met by a highly qualified staff of teachers.

Only students with the most complex needs aren’t in classrooms with their peers. A child like Mae would probably stay with her peers through early childhood and then move to a school or classroom where she could be taught life or vocation skills appropriate to her developmental level. One reason this system works is because it’s well funded; the idea that every student needs to learn life skills and independence is seen as fundamental for all students—and a long-term benefit to society at large.

When the focus of education is the integration of all learners, the idea that everyone is worthy of an education is reinforced for both students and families. Even without a national initiative, there are models for children like mine that could work in any school district. One of them is a school within a school. The current model in my county puts one teacher for children with disabilities at a school with their own classroom—an island of “special” in a world of general. What if there were three or four classrooms for children with disabilities on the site of a general education school? The focus could be on providing authentic inclusive experiences when it was appropriate and on fostering independent living skills. Perhaps the general education students could even work with their disabled peers on building those life skills, like, for instance, figuring out how to manage a small business or practice some simple cooking techniques.

Paul Owens is the principal of Cedar Lane School in Fulton, Maryland. Sharing a campus with a middle school and located down the road from a high school, Cedar Lane offers a kind of school-within-a-school model. Owens described “buses going back and forth all day” and said all three school sites share a music and art teacher, allowing for the kind of authentic inclusion that my daughter experienced in last year’s theater program. By having a disabilities school within a general education school, districts would be able to provide better oversight, consistency of staffing, sharing of institutional resources and knowledge, and authentic, thoughtful experiences of inclusion as opposed to just proximity.

When I asked Owens what he would wish for Cedar Lane School, I expected his answers to be predictable: probably more money and more staff. Instead, he said, “I wish my staff had more time for connection instead of compliance,” which is to say spending more time building relationships with students and families and less time on the cumbersome paperwork that defines education for children with disabilities. He added that he wished they could be more effective in helping students transition out of Cedar Lane at the end of high school. For many students with disabilities, graduation from high school is the end of a clear path of state-run services. “Once students graduate and leave Cedar Lane,” he said, “the availability and quality of services is inconsistent and support for students and families is very limited.”

“Once students graduate and leave [school], the availability and quality of services is inconsistent and support for students and families is very limited.”

As Congress is winding down this session, Rep. Jared Huffman (D-Calif.) and Sen. Chris Van Hollen (D-Md.) have sponsored a measure to fully fund IDEA. I asked Huffman what this measure could mean for students with disabilities in this county. For him, the question is personal. He is also a “special needs parent,” he said. In the unlikely event that this bill were to pass, the burden on school districts and counties would be eased considerably, with the federal government funding up to 40 percent of the cost of educating students with disabilities, in contrast to the approximately 14.7 percent of costs that are covered today. This means that in the 2022–2023 school year, counties, states, and districts had to make up a $23.92 billion gap between what the federal government funded and what it would be funding if it committed to the originally intended 40 percent.

As Huffman said: “Every student deserves a quality educational experience, regardless of their physical or developmental disabilities. What’s been missing is the money to make that happen.” Fully funding IDEA would signal to schools and families that the federal government is invested in students with disabilities. However, without high standards for training teachers, precise definitions of concepts like inclusion, and nationwide standards for services that children with disabilities receive, the system may still perpetuate inequity by offering the minimum to those who need it most.

When we insist on the pseudo-inclusion of proximity, my daughter’s humanity gets lost. Mae is not her age, nor should she become some symbol of vulnerability used to teach empathy to those fortunate enough to drive cars and spend hours on TikTok. She is a person who deserves an education that meets and acknowledges her specific needs, that focuses on best practices and authentic, inclusive experiences that help her develop the skills she will need to be as independent as possible. When parents fight for full inclusion, what they really are fighting for is the recognition that their child is as valuable as anyone else’s. When the focus is compliance over consistency, when chronological age overshadows developmental needs, and when we say we want to foster empathy but instead confirm second-class citizenship on those for whom appropriate is all we are willing to concede, we send a clear message to children and families like mine about their value.

This week, soon after his 100th birthday, former President Jimmy Carter was able to vote in his home state of Georgia—in part thanks to protections under the Voting Rights Act. As his grandson Jason Carter explained in a CNN interview with Jake Tapper, voting assistance protections in Georgia allow family members to help cast absentee ballots (the vote can still be discarded if a signature or mark on the ballot does not match what is on file, per Georgia law).

“He sat down and told everybody what he wanted to do, and was excited about it,” Jason Carter told Tapper. “My aunt dropped his ballot [at] an absentee drop box, just like thousands and thousands of other Georgians.”

Jimmy Carter just voted. His grandson explains how. pic.twitter.com/Ax1Ulvt9RR

— The Lead CNN (@TheLeadCNN) October 17, 2024

Even if Carter doesn’t consider himself disabled, many aging people benefit from disability rights laws and protections. Section 208 of the Voting Rights Act guarantees that “any voter who requires assistance to vote by reason of blindness, disability, or inability to read or write may be given assistance by a person of the voter’s choice.”

In recent years, Republicans have attacked voters’ right to assistance, sometimes with carve-outs for close family members. But courts have repeatedly found such actions unconstitutional. In Texas, in 2022, a federal court ruled that people assisting voters can further explain ballot measures if asked; just last month in Alabama, a federal judge also ruled that the state was obligated to let voters get help from any person of their choice. While some people, like Carter, choose to, it’s not an option—or preference—for everyone.

Some aging people in Georgia still face barriers to voting, even if their right to assistance hasn’t been as harshly attacked. A recent lawsuit argues that a state law enacted this year, under which votes can be challenged if a voter is registered at a nonresidential address, could impact people living in nursing homes, assisted living communities, and similar facilities.

What is unclear, as my colleague Michael Mechanic recently wrote, is whether Georgia will count Carter’s ballot should he pass away before Election Day. What is clear, during the CNN interview, is how crucial Carter finds his right to vote, and the Voting Rights Act disability protections that enable him to do so.

“He has done that forever,” his grandson said, “and is excited to keep doing it.”

This week, soon after his 100th birthday, former President Jimmy Carter was able to vote in his home state of Georgia—in part thanks to protections under the Voting Rights Act. As his grandson Jason Carter explained in a CNN interview with Jake Tapper, voting assistance protections in Georgia allow family members to help cast absentee ballots (the vote can still be discarded if a signature or mark on the ballot does not match what is on file, per Georgia law).

“He sat down and told everybody what he wanted to do, and was excited about it,” Jason Carter told Tapper. “My aunt dropped his ballot [at] an absentee drop box, just like thousands and thousands of other Georgians.”

Jimmy Carter just voted. His grandson explains how. pic.twitter.com/Ax1Ulvt9RR

— The Lead CNN (@TheLeadCNN) October 17, 2024

Even if Carter doesn’t consider himself disabled, many aging people benefit from disability rights laws and protections. Section 208 of the Voting Rights Act guarantees that “any voter who requires assistance to vote by reason of blindness, disability, or inability to read or write may be given assistance by a person of the voter’s choice.”

In recent years, Republicans have attacked voters’ right to assistance, sometimes with carve-outs for close family members. But courts have repeatedly found such actions unconstitutional. In Texas, in 2022, a federal court ruled that people assisting voters can further explain ballot measures if asked; just last month in Alabama, a federal judge also ruled that the state was obligated to let voters get help from any person of their choice. While some people, like Carter, choose to, it’s not an option—or preference—for everyone.

Some aging people in Georgia still face barriers to voting, even if their right to assistance hasn’t been as harshly attacked. A recent lawsuit argues that a state law enacted this year, under which votes can be challenged if a voter is registered at a nonresidential address, could impact people living in nursing homes, assisted living communities, and similar facilities.

What is unclear, as my colleague Michael Mechanic recently wrote, is whether Georgia will count Carter’s ballot should he pass away before Election Day. What is clear, during the CNN interview, is how crucial Carter finds his right to vote, and the Voting Rights Act disability protections that enable him to do so.

“He has done that forever,” his grandson said, “and is excited to keep doing it.”

California’s statewide rent control law, the Costa-Hawkins Act, has been contentious since it was signed into law in 1995. California politicians saw Costa-Hawkins, which made it illegal for localities to impose rent control on homes, condominiums, and new apartment housing, as a way to appease the interests of landlords.

Nearly 30 years later, Costa-Hawkins increasingly limits disabled and aging people’s ability to get accessible, affordable housing—practically impossible on a fixed income. The law was enacted less than four years after the Fair Housing Act’s accessibility requirements left some Californians stuck between old homes they couldn’t use and new ones they couldn’t afford.

Compounding the problem, the Americans With Disabilities Act, which requires shared common spaces to be accessible, was also signed into law just five years before Costa-Hawkins, in 1990. And Costa-Hawkins also froze previous local rent control laws—in San Francisco, only buildings built on or before June 13, 1979, are subject to rent control.

Ending Costa-Hawkins stands to increase the number of accessible apartment buildings.

“We have one member that spent two years coming out of a shelter trying to find a mobility-accessible unit that was affordable,” said Ocean Coast, a housing community organizer with San Francisco–based advocacy group Senior and Disability Action.

Ending Costa-Hawkins stands to increase the number of accessible apartment buildings—and Proposition 33, on California’s November ballot, would do just that. (San Francisco Supervisor Aaron Peskin, a mayoral candidate, has already introduced a bill to expand rent control if Proposition 33 passes.)

The proposition’s main backer is the AIDS Healthcare Foundation (AHF), which provides treatment and preventative services, including housing—though it has been criticized for, among other things, conditions in the residential units it owns.

Zeenat Hassan, a senior attorney with Disability Rights California, which supports ending the state’s rent control ban, said newer buildings come with irreplaceable benefits.

“For buildings, as much as for anything else, it’s usually easier to build accessibility into the front end that to try and retrofit things later on,” Hassan said.

But Prop 33 has earned the AHF a powerful enemy: California’s landlord lobby. Proposition 34, also on November’s ballot, would restrict AHF’s ability to fund ballot initiatives that are not explicitly related to health care—commercials for that bill position it as an innocuous pro-patient ballot initiative that might, on paper, sound appealing for disabled people with complex health conditions.

Konstantine Anthony sits on the city council of Burbank, in Los Angeles County. Anthony is also Burbank’s ex-mayor—the country’s first openly autistic mayor—and recently headed the state Democratic Party’s disability caucus. California’s landlord lobby was “fed up with fighting the AIDS Healthcare Foundation, and so they put a bill on the November ballot,” Anthony said. “It’s a revenge bill.” 

It may “sound weird,” Anthony acknowledges, that the AIDS Healthcare Foundation is leading the fight to un-ban rent control. That’s part of a holistic approach, he says: people need to be housed to get effective medical treatment. A Los Angeles County report found that, in 2022, 13 percent of people recently diagnosed with HIV were experiencing homelessness. 

And believes that expanding rent control, including into single-family homes, intertwines with disability rights.

“A lot of folks who have mobility issues, balance and illness issues, need a larger space,” Anthony said. That’s partly space for “wheelchairs or bedding or medical equipment, something that doesn’t typically fit into smaller apartments,” and potentially for live-in caregivers. 

While Proposition 34 does not mention AHF by name, its effective targeting of the group has been widely reported—and it would be the sole organization affected by the measure. The San Francisco Chronicle editorial board, which came out against Prop 33, called Prop 34 “cheap political gamesmanship.” The Los Angeles Times editorial board also opposed Prop 34, saying it has a “hidden agenda.” A request for comment to the California Apartment Association, which lobbies on behalf of the state’s landlords, was replied to directly by the Yes on 34 campaign.

Major developers and corporate landlords have funneled millions of dollars to make sure rent control isn’t expanded.

“Prop 34 simply ensures that taxpayer dollars meant to provide medical care for low-income patients actually are spent for that purpose,” said Yes on 34 spokesperson Nathan Click, a former top communications official for California Gov. Gavin Newsom. “It’s why it’s supported by more than a dozen patient rights organizations.” One such organization is the ALS Foundation—which, unlike the California Apartment Association, is not spending millions to stop a bill that could expand rent control.

The state’s major developers and corporate landlords, like Blackstone CEO Stephen Schwarzman, have funneled millions of dollars to the California Apartment Association to make sure rent control isn’t expanded. As of September 25, the Association’s Issues Committee had spent nearly $35 million to oppose Proposition 33, and almost another $30 million backing Proposition 34, according to records from the California Secretary of State. Two firms funding the campaigns, Essex Property Trust and Equity Residential, did not respond to requests for comment.

Jerry Flanagan, litigation director with the consumer rights group Consumer Watchdog, said that “this kind of initiative sets a horrible precedent for the idea that if you don’t like what a nonprofit organization is doing in terms of advocacy, just sponsor a ballot initiative to take that up—to kill it—and just dress it up as something else.”

Even if Prop 33 does not pass, and California’s rent control ban stays in force, Anthony, the Burbank city councilor, said the state could build on a model like the state’s Tenant Protection Act of 2019, which caps rent increases once an apartment building is 15 years old, unlike Costa-Hawkins’ fixed date.

Hassan, of Disability Rights California, also noted that the lack of affordable, accessible housing could force disabled people into institutions like nursing homes.

“When we allow the private market to continue the financialization of housing,” she said, “you increase the risk of perpetuating that segregation for people with disabilities.”

When the US Department of Health and Human Services finalized a rule in May asserting that gender dysphoria can be considered a disability under federal anti-discrimination laws, it codified what the overwhelming majority of courts have found for nearly a decade. The new rule put states on notice: Discrimination against transgender people in employment, education, health care, child care, housing, and elsewhere may violate federal disability protections, and the Biden administration was prepared to fight it.

Now, in a lawsuit led by Texas Attorney General Ken Paxton, 17 states are asking a federal court to strike down the rule in its entirety, including numerous provisions that have nothing to do with trans people. This isn’t a random collection of states; 15 of them have passed restrictions on gender-affirming care, and all have embraced myriad anti-trans policies. 

Among the states’ objections to the new federal rule: They would have to “expend time, money, and resources” to accommodate employees with gender dysphoria, including using the pronouns that align with their identities, eliminating sex-specific dress codes, and letting employees use gender-aligned bathrooms or locker rooms. Nebraska’s attorney general is concerned that his state’s restrictions on gender care put it at risk of disability rights complaints and federal investigations. South Dakota objects to the rule “essentially add[ing] a new category of potentially disabled individuals” whose gender care must be covered by Medicaid.

But gender dysphoria is just part of the 130-page federal rule. It also protects disabled parents’ rights in child welfare cases and prevents hospitals from using disability as a factor in determining who gets care in crisis situations, such as equipment shortages during a pandemic. It adds Long Covid to the list of conditions that may constitute a disability and strengthens protections against unnecessary institutionalization, requiring that care be offered in the least restrictive setting and, ideally, in a patient’s community. 

“The attack is really about the regulatory process of the federal government, and this will impact almost every interaction that a disabled person has with the services and supports that they receive.”

Striking down the entire rule would have wide-reaching implications for all disabled Americans and other marginalized groups who rely on federal agencies’ interpretations of decades-old laws to enforce their rights, says Mia Ives-Rublee, senior director of the Center for American Progress’ Disability Justice Initiative. “They’re utilizing LGBTQ issues as a wedge,” Ives-Rublee says. “The attack is really about the regulatory process of the federal government, and this will impact almost every interaction that a disabled person has with the services and supports that they receive.”

The new rule pertains to two federal statutes passed decades ago to protect people with disabilities on multiple fronts. The Rehabilitation Act of 1973 prohibits discrimination on the basis of disability by the federal government, federal contractors, and—in its Section 504—by any organizations or employers that receive federal funds. The Americans with Disabilities Act (ADA), signed into law in 1990, broadened disability protections into most aspects of public life, including education, access to businesses open to the public, and public transportation. Both statutes define a disability as “a physical or mental impairment” that “substantially limits” one or more major life activities. 

When the Rehabilitation Act and ADA were passed, gender dysphoria was not a recognized medical condition, and both statutes expressly excluded “transvestism, transsexualism,” and “gender identity disorders not resulting from physical impairments” from the definition of disability. But over the decades, medical experts and courts have come to understand that for many people who identify with a gender different from the one assigned to them at birth, there can be profound psychological distress and other major negative effects in their work and social lives. In 2013, gender dysphoria was added to the Diagnostic and Statistical Manual of Mental Disorders.

Since then, lawsuits by individuals—the primary way the ADA is enforced—have forged a body of legal decisions that recognize gender dysphoria as a protected health condition and its exclusion from disability protections as discriminatory, says Ben Klein, senior director of litigation and HIV law at GLBTQ Legal Advocates and Defenders. The exclusion of gender dysphoria “was based on obvious animus toward a disfavored group. That is a concept that judges who look at petitions have easily understood—the bias is so clear,” Klein says. 

The 4th Circuit Court of Appeals broke legal ground in 2022 when it became the first federal appeals court to rule on the issue of whether gender dysphoria could be considered a disability under federal disability protection statutes. The court determined that the basis of a gender dysphoria diagnosis—whether it causes a noticeably negative impact on daily life—distinguishes it from the ADA’s definition of gender identity disorder. (The US Supreme Court declined to hear the case in June 2023, letting the decision stand.) Lower federal courts have found, similar to the 4th Circuit, that gender dysphoria is distinct from gender identity disorder. Others have found that even if gender dysphoria is a gender identity disorder, it results from a physical impairment: a mismatch between a person’s physical body and gender identity that can be remedied through gender care. 

In finalizing its new rule—the first administrative update to Section 504 in half a century—the Department of Health and Human Services alluded to this body of case law, which it said has “shifted the legal landscape of disability discrimination protections.” But none of that matters much to the states that joined the Texas lawsuit, which was filed with little national media attention in late September. 

The lawsuit seizes upon the original exclusionary language in the ADA, claiming that what the medical community now considers gender dysphoria falls under the law’s concept of gender identity disorder. “The Biden Administration is once again abusing executive action to sidestep federal law and force unscientific, unfounded gender ideology onto the public,” Paxton said in a press release announcing the suit. “Texas is suing because HHS has no authority to unilaterally rewrite statutory definitions and classify ‘gender dysphoria’ as a disability.”

Beyond the gender dysphoria issue, the lawsuit also makes broad claims about “new regulatory burdens” and “substantial costs” associated with the rule’s impacts to state Medicaid programs. Alaska, Montana, and Nebraska, for instance, argue that the rule’s “least restrictive setting” requirement will be difficult to implement because of health care worker shortages and their states’ unique geographies. 

“One of the goals of the ADA is to address discrimination and stereotypes, particularly about stigmatized health conditions. Gender dysphoria is the quintessential stigmatized health condition.”

Klein and Ives-Rublee emphasized that both the Rehabilitation Act and ADA were written vaguely with the intent that, over the years, experts working for federal agencies would reexamine and refine the regulations implementing the statutes, as scientific and public understanding of disability evolves. When the ADA was passed, trans identity was pathologized, Klein says. “One of the goals of the ADA is to address discrimination and myths and stereotypes, particularly about stigmatized health conditions,” he tells me. “Gender dysphoria is the quintessential stigmatized health condition.”

The new Texas case is just one of many avenues GOP officials are using to enforce their anti-trans beliefs. As I’ve reported, Republican attorneys general—many from the same states as in the Paxton lawsuit—are also threatening major medical associations with criminal investigations for promoting trans youths’ access to gender care.

Ives-Rublee warns that the Texas suit is also part of a multifaceted attack on the power of federal agencies to interpret civil rights laws, including protections for pregnant workers and access to reproductive health care. This broad conservative effort to rip the teeth out of the administrative state was emboldened by a series of Supreme Court decisions last term, including one that ended courts’ expected deference to federal agency interpretations of vague laws. 

Because the gender dysphoria lawsuit was filed in the federal district court in Lubbock, Texas, any appeal will go to the 5th Circuit Court of Appeals, home to some of the most radically conservative decisions in recent legal history. If the 5th Circuit sides with the states in this case, it would create a conflict with the 4th Circuit decision that could force the Supreme Court, with its far-right supermajority, to weigh in. “I am almost 100 percent sure this is their intention,” Ives-Rublee says.

Three years ago, after developing Long Covid, 62-year-old Martha applied for Social Security Disability Insurance, which provides a modest monthly benefit to aging and disabled adults. Martha has no health insurance, which prevents her from getting the medical treatment she needs, and is homeless.

On Thursday, when she asked Vice President Kamala Harris about the issue at a town hall hosted by the Spanish-language news network Univision, she still hadn’t received a decision.

In the twelve-month stretch from October 2022 through September 2023, 30,000 people died while waiting for federal disability determinations, according to Social Security Commissioner Martin O’Malley. Martha asked Harris what she would do as president for people, like herself, who are waiting for disability decisions while in desperate need of health insurance.

Delays in those decisions, driven in part by understaffing and a Covid-related rise in disability rates, have driven the typical wait time from four months in 2019 to seven months today, often coupled with the need to appeal an initial rejection, which can take years. The processing times represent a mounting crisis for the more than 1 million Americans who apply for disability in a given year.

Harris, starting off on track, highlighted her recent push for Long Covid to be recognized under the Americans with Disabilities Act. But the vice president didn’t acknowledge the issue of wait times for federal disability benefit determinations, talking instead about how medical debt impacted credit scores.

Harris’ push to incorporate Long Covid into the ADA is welcome. Latino people are the likeliest of any racial group to report having Long Covid, according to Census data; many also participate in SSDI, and her Univision non-answer on wait times was eyebrow-raising.

But a Long Covid–friendly ADA doesn’t mean any change in Social Security practices, which are separate. Securing disability income is a much more complex, demanding process than securing ADA accommodations (which can be hard enough). Separate action is needed on both—and within Harris’ grasp, should she land in the White House.

this is a very emotional town hall. Harris takes a question from a homeless woman whose life was wrecked by long covid about what she'll do for people like her pic.twitter.com/O65A3GJIX3

— Aaron Rupar (@atrupar) October 11, 2024

That’s not to say that Democrats have made no moves to address challenges around Long Covid and Social Security disability delays. In August, a Senate group including Sen. Tim Kaine (D-Vir.), Sen. Ed Markey (D-Mass.), Sen Tammy Duckworth (D-Ill.), and Sen. Bernie Sanders (I-Ver.) sent O’Malley a letter asking a similar question: what was the Social Security Administration doing to address the barriers that applicants with Long Covid face? They have yet to receive a response—at least publicly.

Three years ago, after developing Long Covid, 62-year-old Martha applied for Social Security Disability Insurance, which provides a modest monthly benefit to aging and disabled adults. Martha has no health insurance, which prevents her from getting the medical treatment she needs, and is homeless.

On Thursday, when she asked Vice President Kamala Harris about the issue at a town hall hosted by the Spanish-language news network Univision, she still hadn’t received a decision.

In the twelve-month stretch from October 2022 through September 2023, 30,000 people died while waiting for federal disability determinations, according to Social Security Commissioner Martin O’Malley. Martha asked Harris what she would do as president for people, like herself, who are waiting for disability decisions while in desperate need of health insurance.

Delays in those decisions, driven in part by understaffing and a Covid-related rise in disability rates, have driven the typical wait time from four months in 2019 to seven months today, often coupled with the need to appeal an initial rejection, which can take years. The processing times represent a mounting crisis for the more than 1 million Americans who apply for disability in a given year.

Harris, starting off on track, highlighted her recent push for Long Covid to be recognized under the Americans with Disabilities Act. But the vice president didn’t acknowledge the issue of wait times for federal disability benefit determinations, talking instead about how medical debt impacted credit scores.

Harris’ push to incorporate Long Covid into the ADA is welcome. Latino people are the likeliest of any racial group to report having Long Covid, according to Census data; many also participate in SSDI, and her Univision non-answer on wait times was eyebrow-raising.

But a Long Covid–friendly ADA doesn’t mean any change in Social Security practices, which are separate. Securing disability income is a much more complex, demanding process than securing ADA accommodations (which can be hard enough). Separate action is needed on both—and within Harris’ grasp, should she land in the White House.

this is a very emotional town hall. Harris takes a question from a homeless woman whose life was wrecked by long covid about what she'll do for people like her pic.twitter.com/O65A3GJIX3

— Aaron Rupar (@atrupar) October 11, 2024

That’s not to say that Democrats have made no moves to address challenges around Long Covid and Social Security disability delays. In August, a Senate group including Sen. Tim Kaine (D-Vir.), Sen. Ed Markey (D-Mass.), Sen Tammy Duckworth (D-Ill.), and Sen. Bernie Sanders (I-Ver.) sent O’Malley a letter asking a similar question: what was the Social Security Administration doing to address the barriers that applicants with Long Covid face? They have yet to receive a response—at least publicly.

For some chronically ill and disabled people, the revolution will start from their rooms—or even from bed.

Since the fall of Roe v. Wade, the fight to protect abortion access has become even more urgent, with 13 states having banned procedural abortion outright. Maternal deaths rose by 56 percent in Texas after an abortion ban was enacted, and an August report by House Democrats on the Energy and Commerce Committee found that, since the Dobbs decision, more pregnant people have delayed seeking care for complications. And more people are being forced to carry pregnancies to term who don’t want to—which isn’t exactly harmless to a person’s body. Every year, at least 40 million people worldwide (out of around 140 million who give birth annually) develop a long-term health problem linked to childbirth.

Yet the end of Roe has had a unique impact on disabled people. Research has shown that disabled people die from pregnancy and birth complications at rates 11 times higher than non-disabled people. Women with disabilities, especially those with intellectual and developmental disabilities, are more likely to be sexually assaulted than non-disabled women, leading to more unwanted pregnancies.

“You don’t have to be a full-time activist in front of a camera at a rally in order to make a huge difference for someone.”

But the spate of bans has also led to new waves of abortion rights activism, including by disabled people. For those who experience chronic illnesses or a range of other disabilities, in-person activism isn’t always an option, especially with an ongoing pandemic—but there’s a powerful precedent for reproductive rights activism by disabled people.

Laurie Bertram Roberts, the executive director of the Mississippi Reproductive Freedom Fund, cares deeply about accessibility in part because they are disabled; from bed, they write grants and follow up with people who need assistance in abortion care to make sure their needs are met.

Former Mother Jones reporter Becca Andrews profiled Roberts and their fund’s work in 2019, when they faced down seemingly endless challenges even before the fall of Roe: “I don’t think [outsiders] understand that the structural barriers are at every turn of care,” Roberts said at the time. Now, as then, Roberts “spends much of her time bedbound due to painful fibromyalgia, but her phone and laptop are never far, basically operating as digital appendages.”

Roberts also hires workers who have their own experiences with chronic illnesses and disabilities—and encourages them to work in a way that is best for them, like taking flexible hours.

“A lot of us can get a whole lot done if people would just give us the opportunity to do it,” Roberts said.

The upside of taking reproductive rights activism online is that many people seeking abortions already turn to the internet for help. New York–based Ariella Messing, who lives with chronic migraines, saw how valuable that could be when she co-founded Online Abortion Resource Squad, which offers peer-based support. Messing and volunteers now run Reddit’s r/Abortion, where they answer questions for people seeking abortions around the world.

While running OARS is her full-time job as its executive director—and then some, with migraines interrupting some shifts—Messing has made volunteering for OARS accessible in multiple ways.

Helping someone learn how to safely get an abortion in their area can take just five minutes; as with OARS, it can be as simple as writing a comment on Reddit. “You don’t have to be a full-time activist in front of a camera at a rally in order to make a huge difference for someone,” Messing said.

But even among organizations that do put on events like rallies, there is still space for remote involvement, which Olivia Neal, a chronically ill communications staffer, does to help people have the information they need to get an abortion as part of her job at the ACLU of North Carolina.

Sustainable, accessible activism “takes a little extra people power.”

And the same challenges non-disabled activists face show up in force—like exhaustion and financial insecurity. Many people involved in the fight for reproductive rights don’t make a lot of money: Messing can’t afford good health insurance, and needs expensive medications. Lack of employer benefits, Messing said, was “the one thing holding me back at first from doing this full time—and that still is causing me trouble every single day.”

Avoiding overwork can be very hard when people need support, as Messing, who is usually logged into r/Abortion seven days a week, also knows. “It’s also really tiring to never be on autopilot,” she said. And despite accommodations to work remotely, Neal said, “I do feel that sense of guilt about not being able to always show up in physical spaces.”

Neal sees her main contribution as making information available and easily understandable: she created an abortion guide for those seeking one in North Carolina, including guidance on transportation and financial assistance. “We all bring different skills to the movement,” she said.

Ableism can mean even seasoned advocates aren’t not taken seriously; Roberts was previously pushed to step aside due to her disabilities. “Aside from the obvious ableism, I think that they missed the point that we are an important bloc of supporters.” 

While the fight for abortion access is an important part of the battle for reproductive rights, it’s far from the only one. Even before the fall of Roe v. Wade, disabled people struggled to get accessible gynecological care: A 2018 study suggests that many gynecologists lack the training to give disabled people the equal treatment they need. 

Mary Fashik, who has advocated for reproductive rights online as part of #UpgradeAccessibility, a movement she founded, experienced that firsthand. Fashik had an ovarian cyst burst, and when she finally had an appointment some days later, Fashik said she “could not get on the exam table because the exam table was not accessible.” Then and in general, Fashik felt that her white doctor was not taking her concerns seriously due to her race and disability. (Soon, fewer disabled people will experience this kind of inaccessible care: In August, the Justice Department finalized a rule mandating that medical diagnostic equipment, including examination tables, be accessible for people with disabilities.)

Fashik’s troubles helped lead her to organize online panels and events after Roe was overturned—“Online advocacy is real advocacy,” Fashik said—where she talked about birth control access and the forced sterilization of disabled people.

Sustainable, accessible activism “takes a little extra people power and or money,” Roberts notes. But it’s absolutely necessary for work like theirs, and the benefits outweighs the costs. “When we talk about access to care,” Roberts says, “we definitely have to talk about access to care for the disabled community.”

On Tuesday, Vice President Kamala Harris announced on The View that she would pursue a new Medicare benefit to cover the costs of in-home care for qualifying disabled people and anyone 65 and up.

Disabled people have fought for more than half a century for the right to remain in their homes and communities, rather than being subject to institutionalization—which includes the support, such as home care workers, that they need to do so. A recent poll released by the University of Michigan found that around three in five people older than 50 with a caregiver also have a physical disability. Medicare already covers home care for some people—but in a highly limited way that’s much more challenging to get.

“If you don’t have those services, you might unnecessarily be institutionalized.”

I spoke with Nicole Jorwic, Caring Across Generations’ chief of advocacy and campaigns, about Harris’ new proposal—what it means the people who would qualify, and what it would take for the benefit to succeed, if Harris is elected.

Why does Harris’ plan to expand Medicare excite you?

The plan from the Harris administration to include coverage for home care and Medicare is really a game-changer for disabled people and for older people. This proposal is exciting, not only for the folks that would get the care that they need but also because of the people that would be impacted by not having to provide that care themselves.

The most exciting thing about it for me is that something that I hear when I’m out and about, meeting with folks in the in the care advocacy community—is so many people think Medicare already does this. It’s creating a a benefit in a government funded system that people already think that they’re going to get—fixing a problem that many people don’t even know that they’re going to have until they’re in a crisis.

How could it help disabled people remain at home, rather than in institutions like nursing homes or group homes?

95 percent of disabled people want to live in their homes and in their communities. But the reality is, because Medicaid has traditionally been the main funder for these services, you have to remain in poverty in order to access these services. Also because states can limit how many people they serve, there’s waiting lists.

Adding home care into Medicare would mean that more of the 7 million disabled people who are currently eligible for Medicare— 12 percent of Medicare beneficiaries—then maybe [do] not need to go on waiting lists for services. If you don’t have those services, you might unnecessarily be institutionalized. This proposal to add home care to Medicare would also take some pressure off of the Medicaid system. We could hopefully continue to pull people off of the waiting list and remove the institutional bias that currently exists today.

Why is it also crucial to address the care-worker shortage for a plan like this to be successful?

Anybody who needs home care, those services are going to be provided by a direct care worker, and we are in a direct care worker crisis. Not because there’s not enough people, but because there’s not enough good direct care jobs. What this proposal does also include is ensuring that the folks that are providing these Medicare services are being paid a good wage.

Disability advocates and aging advocates, when we have the opportunity to implement a policy like this [which] would have to move through Congress, we would also ensure that it rides alongside investments that would ensure that every direct care worker, whether they’re paid by Medicaid or Medicare, are paid a family sustaining wage. We have to also address the direct care workforce, that’s the human infrastructure, the people that are actually providing the services, for this program to be successful.

Right now we think about those direct support professionals or home care workers, those folks when they age, don’t have access to home care right away, unless they qualify for Medicaid, which we know can have waiting lists. Vice President Harris’s proposal to add home care to Medicare also would guarantee that those direct care workers who have been historically low-paid would also have peace of mind if they need home care.

Have there been examples of programs at a state level similar to what Harris is proposing?

There isn’t necessarily an example of a state adding to a federal program, but there are some examples of where states have invested in folks that just need a little bit of extra support at home. Under the Affordable Care Act, there was a program that was passed called the Community First Choice Option. It requires states who take up this option, like Oregon and Texas, to provide home and community based care for eligible folks, mostly through personal care assistance, in the same way that that Vice President Harris’s proposal does.

For folks that are on a waiting list, it provides a narrow benefit. We know that if we provide some benefit to people right when they need it, it actually can prevent them, maybe, from needing longer-term care further down the road.

Are there any lessons to learn from the state-level implementation of the Community First Choice Option?

When you look at implementing programs like the Community First Choice Option at the state level, something that’s important to think about is that you want to create as much flexibility as possible. You want to make sure that the services that are being provided are going to meet the unique needs of the senior or the disabled person who needs that care—also making sure that the definition of a workforce is broad enough. There might be somebody who might want it to be their family member, or a disabled person who might want it to be their spouse. You can’t just throw more people into the system without also addressing the workforce.

This interview has been edited for length and clarity.

On Tuesday, Vice President Kamala Harris announced on The View that she would pursue a new Medicare benefit to cover the costs of in-home care for qualifying disabled people and anyone 65 and up.

Disabled people have fought for more than half a century for the right to remain in their homes and communities, rather than being subject to institutionalization—which includes the support, such as home care workers, that they need to do so. A recent poll released by the University of Michigan found that around three in five people older than 50 with a caregiver also have a physical disability. Medicare already covers home care for some people—but in a highly limited way that’s much more challenging to get.

“If you don’t have those services, you might unnecessarily be institutionalized.”

I spoke with Nicole Jorwic, Caring Across Generations’ chief of advocacy and campaigns, about Harris’ new proposal—what it means the people who would qualify, and what it would take for the benefit to succeed, if Harris is elected.

Why does Harris’ plan to expand Medicare excite you?

The plan from the Harris administration to include coverage for home care and Medicare is really a game-changer for disabled people and for older people. This proposal is exciting, not only for the folks that would get the care that they need but also because of the people that would be impacted by not having to provide that care themselves.

The most exciting thing about it for me is that something that I hear when I’m out and about, meeting with folks in the in the care advocacy community—is so many people think Medicare already does this. It’s creating a a benefit in a government funded system that people already think that they’re going to get—fixing a problem that many people don’t even know that they’re going to have until they’re in a crisis.

How could it help disabled people remain at home, rather than in institutions like nursing homes or group homes?

95 percent of disabled people want to live in their homes and in their communities. But the reality is, because Medicaid has traditionally been the main funder for these services, you have to remain in poverty in order to access these services. Also because states can limit how many people they serve, there’s waiting lists.

Adding home care into Medicare would mean that more of the 7 million disabled people who are currently eligible for Medicare— 12 percent of Medicare beneficiaries—then maybe [do] not need to go on waiting lists for services. If you don’t have those services, you might unnecessarily be institutionalized. This proposal to add home care to Medicare would also take some pressure off of the Medicaid system. We could hopefully continue to pull people off of the waiting list and remove the institutional bias that currently exists today.

Why is it also crucial to address the care-worker shortage for a plan like this to be successful?

Anybody who needs home care, those services are going to be provided by a direct care worker, and we are in a direct care worker crisis. Not because there’s not enough people, but because there’s not enough good direct care jobs. What this proposal does also include is ensuring that the folks that are providing these Medicare services are being paid a good wage.

Disability advocates and aging advocates, when we have the opportunity to implement a policy like this [which] would have to move through Congress, we would also ensure that it rides alongside investments that would ensure that every direct care worker, whether they’re paid by Medicaid or Medicare, are paid a family sustaining wage. We have to also address the direct care workforce, that’s the human infrastructure, the people that are actually providing the services, for this program to be successful.

Right now we think about those direct support professionals or home care workers, those folks when they age, don’t have access to home care right away, unless they qualify for Medicaid, which we know can have waiting lists. Vice President Harris’s proposal to add home care to Medicare also would guarantee that those direct care workers who have been historically low-paid would also have peace of mind if they need home care.

Have there been examples of programs at a state level similar to what Harris is proposing?

There isn’t necessarily an example of a state adding to a federal program, but there are some examples of where states have invested in folks that just need a little bit of extra support at home. Under the Affordable Care Act, there was a program that was passed called the Community First Choice Option. It requires states who take up this option, like Oregon and Texas, to provide home and community based care for eligible folks, mostly through personal care assistance, in the same way that that Vice President Harris’s proposal does.

For folks that are on a waiting list, it provides a narrow benefit. We know that if we provide some benefit to people right when they need it, it actually can prevent them, maybe, from needing longer-term care further down the road.

Are there any lessons to learn from the state-level implementation of the Community First Choice Option?

When you look at implementing programs like the Community First Choice Option at the state level, something that’s important to think about is that you want to create as much flexibility as possible. You want to make sure that the services that are being provided are going to meet the unique needs of the senior or the disabled person who needs that care—also making sure that the definition of a workforce is broad enough. There might be somebody who might want it to be their family member, or a disabled person who might want it to be their spouse. You can’t just throw more people into the system without also addressing the workforce.

This interview has been edited for length and clarity.

Daniel Inouye wanted to serve the United States from a young age. Growing up in Hawaii, he was rattled by the attack on Pearl Harbor; in 1944, at the age of 19, Inouye deployed to Italy, then France, to fight the Nazis. War changes most soldiers’ lives, but Inouye, fighting in an all–Japanese American combat unit, also had to get his right arm amputated: A Nazi soldier struck him with a grenade launcher, partly destroying the arm and forcing him to pry the undetonated grenade out with his left hand. He threw it back at the Nazi—this time, it detonated.

After being rehabilitated, Inouye continued to serve the United States, first as one of Hawaii’s earliest delegates to the House of Representatives, then, in 1963, in the Senate, where he remained for nearly 50 years. Inouye supported civil rights, but he was not at the forefront of the disability rights movement; in fact, Inouye did not see himself as a disabled person, likely due to stigma at the time. By 2010, Inouye was president pro tempore of the Senate, making him the highest-ranking person of color with a disability in the presidential line of succession, ever.

“When he started in politics, to have a disability would have been a weakness.”

Inouye’s story is the subject of a new documentary, out October 8, in PBS’ Renegades series of five short films telling the stories of underrecognized disabled figures in US history, like Inouye and Black Panther Party member Brad Lomax.

Mother Jones spoke with Renegades series creator Day Al-Mohamed, who has worked on disability policy in the Biden-Harris administration, and Tammy Botkin, who directed the short on the late senator, on Inouye’s relationship to his disability and more.

As someone who worked in politics, Day, why was it important for you that a politician with a disability was featured?

Al-Mohamed: If you think about it, very much that shapes the the way the country operates, right? It actually, in some way, shapes the very look and feel of a country—that is, the politics and the policies and the laws. It would be remiss to not include a politician, and we specifically wanted Sen. Inouye to be a part of this because of his perspective on disability.

In your work in disability policy, even decades later, do you see similarities in how many veterans may not view themselves as part of the disability community—like Daniel Inouye didn’t?

Al-Mohamed: I still remember, as one veteran explained it to me, “I don’t have a disability. I’m just busted out.” It’s very much a way of thinking about that. Veterans are a community in and of themselves and [had] a job, in many ways, that is based on your your body, abilities and capacity.

We all have different perceptions of what it means to be disabled, and we can even see that within the non-veteran community as well. There’s this general mainstream perception that disability is a wheelchair user, or it’s somebody who is blinded. I think that that has done a disservice to many folks who don’t see the opportunity to take advantage of the policies and politics that protect them, which is also, in some ways, at the heart of the episode.

It does seem there’s a generational shift, where younger people are embracing that identity more than in the days when more people were being institutionalized.

Botkin: It’s definitely related to generational views of disability. It is also related to the Senator’s identity as a war veteran, who has seen many other friends who died and were maimed far worse than he. It also has to do with his identity as a Japanese American. Then, his need as a politician to show himself as strong—and when he started in politics, to have a disability would have been a weakness.

Why was it important to explore multiple aspects of Inouye’s identity—including how anti-Japanese sentiment made it difficult for Inouye to enlist, and led to his being called a communist?

Botkin: First off, the senator being smushed into 12 minutes feels like an aberration. How do you do that? He [had] such a massive, massive life, and he himself was such a prolific storyteller and framer of his experience and our collective experience.

There were so many facets to him that to really even begin to understand him as an individual, to leave any of those out is to not be able to really grasp who he is—that he belonged to many communities. He’s Japanese American, yes, but also Hawaiian. Yes, he’s military. He’s a politician. He’s a man from a certain generation of Americanism. He would fight for people with disabilities, but for him to take the lead on it would be self-serving. He wouldn’t do that, and that leans a lot into his Japanese American heritage. We worked with Japanese American consultants to nail this in.

When you’re telling somebody’s story, it’s terrifying because I personally feel like I have to get it right. Luckily, in this case, the Senator’s best friend, who’s in the film, Jeff Watanabe, was incredibly pleased with the representation, so I can breathe.

Al-Mohamed: If you watch the film, you can see [Tammy’s] pulling strands of different labels. As you even highlighted, the discussion around communism, discussion about being Japanese American, discussion about disability, discussion about veteran, those are all labels. At the heart, it’s about the ones you choose to embrace, the ones you don’t, the ones society puts on you, and the ones that you choose for yourself.

What does Inouye’s story reveal about about how people’s lived experiences can help them push for justice?

Botkin: As a person who was never diagnosed as a child with neurodivergence, it started dawning on me in my 30s. I’m like, “Huh, you might have this thing.” I’m terrified of the label, to be honest. That’s the kind of the stance that I feel like that the senator was taking, which was, I’m not going to claim it for me, but I’m going to fight for everybody else.

What is that inability within ourselves to accept it? I don’t know. That’s something that I actually felt like I had in common with the senator, and I think maybe it’s just the old programming that we haven’t been able to take care of.

Al-Mohamed: In many ways, your own lived experiences are what are going to shape your own policies, your views and your actions. It was very clear from the senator’s early life and the things that happened to him, there was very much a clear recognition of some of the inequities that existed. He was somebody who basically committed five decades of his life to addressing those inequities across a variety of arenas.

From a political standpoint, he didn’t have a box, [like] it’s just going to be veteran stuff. He actually ended up taking that way of looking at what is fair and what is right and putting it into a variety of arenas. Some stronger than others, but the fact is that they were there. I think that’s where you see Inouye using that personal experience and using it to push for positive change.

This interview has been edited for length and clarity.

Former President Donald Trump has disdain for disabled people. As Fred Trump III, his nephew, revealed this year, the former President said in 2020 that people with complex disabilities “should just die.” Even before that, Trump hatefully mocked a disabled reporter at a rally in 2015, and called the Paralympics “tough to watch” in 2018.

Now, Trump has referred to his opponent in the 2024 presidential race, Vice President Kamala Harris, as “mentally disabled” at a Saturday rally—where he also called President Joe Biden “mentally impaired.”

Trump: Joe Biden became mentally impaired. Kamala was born that way. She was born that way. And if you think about it, only a mentally disabled person could have allowed this to happen to our country. pic.twitter.com/v6Yo6uINp5

— Acyn (@Acyn) September 28, 2024

As Maria Town, president of the American Association of People with Disabilities, pointed out in a statement, Trump’s use of disability as an insult is indicative of his ableism.

“To be clear, the insult of Donald Trump’s comment is not the suggestion that Vice President Harris is disabled, but rather, the insinuation that having a disability is synonymous with poor performance as a prospective president,” Town said.

Ableism is also questionable political strategy, given that, as Town notes: “there are more than 38 million eligible voters with disabilities in the United States, who possess a wide variety of beliefs.”

Some allies have tried to come to Trump’s defense, or offer damage control. South Carolina Republican Sen. Lindsey Graham said on CNN’s State of the Union that while Harris “is not crazy…her policies are.” Graham didn’t repudiate Trump’s comments, nor did he acknowledge their bigotry—and he ignored that disabled people have asked people to not use the word “crazy,” a derogatory reference to mental disability, in such contexts.

In a Face the Nation interview, former Maryland Gov. Larry Hogan, who is running for Senate as a Republican, said that Trump’s comments about Harris were “insulting not only to the to the vice president, but to people that actually do have mental disabilities.”

Katy Neas, CEO of The Arc, an organization which supports people with intellectual and developmental disabilities, agrees. “When public figures mock disability, they’re not just attacking political opponents,” Neas said in a statement Sunday. “Millions of people with disabilities and their families are hearing that they and their loved ones are devalued.”

Trump’s views on disability may also be linked to his views on eugenics: “The family subscribes to a racehorse theory of human development,” Trump biographer Michael D’Antonio said in a 2016 Frontline documentary, according to HuffPost. “They believe that there are superior people and that if you put together the genes of a superior woman and a superior man, you get a superior offspring.”

Disabled people, generally, are viewed to have “weaker” genes—making them a target of eugenicist policies, both horrifically in the Holocaust, whose architects shared Trump’s views that disabled people should “just die,” and through laws that allow disabled people to continue to be sterilized without their consent to this day.

In an August interview I conducted with, Fred Trump III, the younger Trump said that his uncle demeans “people that he thinks are lesser than him”; notably, many members of the Trump family have never met his disabled son.

Trump has seemingly not yet addressed the backlash: his recent posts on Truth Social are about immigration and attending a football game.

While she did not use the term, VP Harris did laugh and reply “well said” in response to someone calling Trump “mentally retarded” in 2019. She did, however—unlike Trump—apologize.

When my staff played the video from my town hall yesterday, it was upsetting. I didn’t hear the words the man used in that moment, but if I had I would’ve stopped and corrected him. I’m sorry. That word and others like it aren’t acceptable. Ever. https://t.co/mNmo1hyNpW

— Kamala Harris (@KamalaHarris) September 7, 2019

In the final weeks before Election Day on November 5, Town said that she hopes “all candidates will treat our community with dignity and respect, instead of using us as a punchline to score cheap political points.”

Former President Donald Trump has disdain for disabled people. As Fred Trump III, his nephew, revealed this year, the former President said in 2020 that people with complex disabilities “should just die.” Even before that, Trump hatefully mocked a disabled reporter at a rally in 2015, and called the Paralympics “tough to watch” in 2018.

Now, Trump has referred to his opponent in the 2024 presidential race, Vice President Kamala Harris, as “mentally disabled” at a Saturday rally—where he also called President Joe Biden “mentally impaired.”

Trump: Joe Biden became mentally impaired. Kamala was born that way. She was born that way. And if you think about it, only a mentally disabled person could have allowed this to happen to our country. pic.twitter.com/v6Yo6uINp5

— Acyn (@Acyn) September 28, 2024

As Maria Town, president of the American Association of People with Disabilities, pointed out in a statement, Trump’s use of disability as an insult is indicative of his ableism.

“To be clear, the insult of Donald Trump’s comment is not the suggestion that Vice President Harris is disabled, but rather, the insinuation that having a disability is synonymous with poor performance as a prospective president,” Town said.

Ableism is also questionable political strategy, given that, as Town notes: “there are more than 38 million eligible voters with disabilities in the United States, who possess a wide variety of beliefs.”

Some allies have tried to come to Trump’s defense, or offer damage control. South Carolina Republican Sen. Lindsey Graham said on CNN’s State of the Union that while Harris “is not crazy…her policies are.” Graham didn’t repudiate Trump’s comments, nor did he acknowledge their bigotry—and he ignored that disabled people have asked people to not use the word “crazy,” a derogatory reference to mental disability, in such contexts.

In a Face the Nation interview, former Maryland Gov. Larry Hogan, who is running for Senate as a Republican, said that Trump’s comments about Harris were “insulting not only to the to the vice president, but to people that actually do have mental disabilities.”

Katy Neas, CEO of The Arc, an organization which supports people with intellectual and developmental disabilities, agrees. “When public figures mock disability, they’re not just attacking political opponents,” Neas said in a statement Sunday. “Millions of people with disabilities and their families are hearing that they and their loved ones are devalued.”

Trump’s views on disability may also be linked to his views on eugenics: “The family subscribes to a racehorse theory of human development,” Trump biographer Michael D’Antonio said in a 2016 Frontline documentary, according to HuffPost. “They believe that there are superior people and that if you put together the genes of a superior woman and a superior man, you get a superior offspring.”

Disabled people, generally, are viewed to have “weaker” genes—making them a target of eugenicist policies, both horrifically in the Holocaust, whose architects shared Trump’s views that disabled people should “just die,” and through laws that allow disabled people to continue to be sterilized without their consent to this day.

In an August interview I conducted with, Fred Trump III, the younger Trump said that his uncle demeans “people that he thinks are lesser than him”; notably, many members of the Trump family have never met his disabled son.

Trump has seemingly not yet addressed the backlash: his recent posts on Truth Social are about immigration and attending a football game.

While she did not use the term, VP Harris did laugh and reply “well said” in response to someone calling Trump “mentally retarded” in 2019. She did, however—unlike Trump—apologize.

When my staff played the video from my town hall yesterday, it was upsetting. I didn’t hear the words the man used in that moment, but if I had I would’ve stopped and corrected him. I’m sorry. That word and others like it aren’t acceptable. Ever. https://t.co/mNmo1hyNpW

— Kamala Harris (@KamalaHarris) September 7, 2019

In the final weeks before Election Day on November 5, Town said that she hopes “all candidates will treat our community with dignity and respect, instead of using us as a punchline to score cheap political points.”

On Tuesday, US District Judge R. David Proctor ruled in an injunction that part of Alabama’s voter suppression law SB1—state legislation that made it a felony to assist disabled people in requesting and filling absentee ballots—was an unenforceable violation of the federal Voting Rights Act. The rest of SB1, which nominally targets the practice of “ballot harvesting,” will remain intact for the time being.

SB1, which was enacted in March, prohibited “any person from ordering, requesting, collecting, prefilling, obtaining, or delivering an absentee ballot application or absentee ballot of a voter.” The law also established criminal penalties for people who assisted others with absentee voting.

In April, the Alabama NAACP, the state chapter of the League of Women Voters , Greater Birmingham Ministries, and the Alabama Disabilities Advocacy Program sued Alabama Attorney General Steve Marshall and other state government officials, asking for an injunction.

As their lawsuit points out, the US Code explicitly protects people’s rights to receive assistance while voting:

Any voter who requires assistance to vote by reason of blindness, disability, or inability to read or write may be given assistance by a person of the voter’s choice, other than the voter’s employer or agent of that employer or officer or agent of the voter’s union.

In his opinion, Proctor acknowledged that SB1 disproportionately affected disabled and low literacy voters: “SB 1 unduly burdens the rights of Section 208 voters to make a choice about who may assist them in obtaining and returning an absentee ballot,” the judge wrote.

In a statement released after Proctor’s decision, the plaintiffs celebrated the injunction as a positive step in upholding democracy.

We’re glad that the district court has sided with the rights of the voters and is committed to promoting voting accessibility. Our democracy works best when everybody can participate in it, and this ruling prevents the enforcement of a cruel law that would have suppressed the voices of blind, disabled, and low literacy voters.

On Tuesday, US District Judge R. David Proctor ruled in an injunction that part of Alabama’s voter suppression law SB1—state legislation that made it a felony to assist disabled people in requesting and filling absentee ballots—was an unenforceable violation of the federal Voting Rights Act. The rest of SB1, which nominally targets the practice of “ballot harvesting,” will remain intact for the time being.

SB1, which was enacted in March, prohibited “any person from ordering, requesting, collecting, prefilling, obtaining, or delivering an absentee ballot application or absentee ballot of a voter.” The law also established criminal penalties for people who assisted others with absentee voting.

In April, the Alabama NAACP, the state chapter of the League of Women Voters , Greater Birmingham Ministries, and the Alabama Disabilities Advocacy Program sued Alabama Attorney General Steve Marshall and other state government officials, asking for an injunction.

As their lawsuit points out, the US Code explicitly protects people’s rights to receive assistance while voting:

Any voter who requires assistance to vote by reason of blindness, disability, or inability to read or write may be given assistance by a person of the voter’s choice, other than the voter’s employer or agent of that employer or officer or agent of the voter’s union.

In his opinion, Proctor acknowledged that SB1 disproportionately affected disabled and low literacy voters: “SB 1 unduly burdens the rights of Section 208 voters to make a choice about who may assist them in obtaining and returning an absentee ballot,” the judge wrote.

In a statement released after Proctor’s decision, the plaintiffs celebrated the injunction as a positive step in upholding democracy.

We’re glad that the district court has sided with the rights of the voters and is committed to promoting voting accessibility. Our democracy works best when everybody can participate in it, and this ruling prevents the enforcement of a cruel law that would have suppressed the voices of blind, disabled, and low literacy voters.

Disabled people are five times more likely to experience domestic violence than non-disabled people, and make up a third of its victims, according to a new report published today by the federal Government Accountability Office. People with cognitive disabilities, such as those who are autistic, are even more likely to be abused. Disabled women are also more likely to be the target of such violence than disabled men.

The rates of abuse, drawn from Justice Department data from 2017 to 2022 underscore the necessity for domestic violence centers and their services to be accessible to disabled people—which is required by both the Americans with Disabilities Act and Section 504 of the Rehabilitation Act, key items of federal civil rights legislation, but is not always the case. ADA enforcement, for instance, often requires disabled people to make complaints after the fact. Someone actively experiencing domestic violence may not have the capacity to do so, let alone wait for a center to make itself accessible—highlighting the importance of government enforcement of accessibility laws for disabled people’s safety.

“The GAO report highlights a critical gap in our domestic violence services for individuals with disabilities.”

“We must guarantee that our systems are not only adequately funded but also effectively implemented, so survivors, regardless of their abilities, receive the support they need,” said Rep. Bobby Scott (D-Vir.), who released the report with Rep. Suzanne Bonamici (D-Ore.), in a statement to Mother Jones.

The GAO report investigated whether domestic violence programs that receive funding from the Department of Health and Human Services are accessible to disabled people; most of the domestic violence centers interviewed for the report across Maryland, Mississippi and Washington said that they served relatively few disabled survivors, and officials at nine of 12 centers weren’t certain how to identify whether a survivor had a disability. Some disability groups, according to the report, say that local centers do not work with them to better reach disabled survivors.

Disabled people may also be scared to report domestic violence if they are abused by people they rely on for caregiving, as the report notes:

One domestic violence group told us that some people with disabilities who require caregiving to live in their homes may not seek domestic violence services because they are reluctant to report the abuse they have suffered. Officials from that group said people with disabilities who require caregiving may be worried that if they seek domestic violence services from a local center, law enforcement or other authorities will be notified of the abuse and move them from their preferred living situations into institutions.

HHS is responsible for ensuring compliance with federal law at the institutions it makes grants to, but here it also falls short, investigators found. The GAO report notes that there were no accessibility-related findings from on-site visits by HHS from 2019 to 2022 across 17 states, which HHS says it’s addressing by updating its monitoring requirements “to include more specific accessibility compliance questions.”

Investigators also reached out to resource centers like the National Network to End Domestic Violence: 11 of the 16 that responded said they shared best practices for how to work with survivors with disabilities, but only two have developed technical assistance on making shelters accessible to disabled people. GAO’s site visits, the report says, “raise questions about whether the assistance provided by national resource centers and state coalitions” addresses local needs, made still more difficult by a lack of data on accessibility needs and efforts.

“The GAO report highlights a critical gap in our domestic violence services for individuals with disabilities,” Scott said. “We must invest in the collection of crucial data to understand the needs of survivors with disabilities, but also must ensure this information leads to meaningful improvements.”

The report, available in full on GAO’s website, recommends that HHS investigate how it can better support local centers in accessibility and support for disabled survivors, and implement those changes.

Earlier this month, Vice President Kamala Harris’ campaign dropped an issues page detailing the Democratic candidate’s priorities if elected. One brief but important point: Harris’ platform commits to ending the federal subminimum wage for disabled workers.

Since the establishment of a federal minimum wage in 1938, an exception has allowed employers, through a certificate system, to pay disabled workers much less than the national minimum of $7.25 an hour—sometimes as little as 25 cents. It’s a practice that 25 states, most recently Ohio, have introduced or enacted legislation to phase out. If Harris succeeds, at least 40,000 workers across the country will see a wage rise. But for most disabled workers earning below minimum wage, it won’t make a difference.

That’s because workers in prison—including disabled ones—are subject to another subminimum wage, which neither candidate aims to roll back. Imprisoned workers in all 50 states, including the 17 where prison work is enforced, can earn pennies an hour, or even nothing at all, as a 2022 American Civil Liberties Union report highlights. In Louisiana, people working in prisons can make as little as 2 cents an hour; if they worked 30 hours each week, they would earn just over $30 annually.

Federally, and in seventeen states, “incarcerated people under law are required to work, and they actually cannot opt out of that work.”

Kate Caldwell, director of research and policy at Northwestern University’s Center for Racial and Disability Justice, told me that more than half of incarcerated people in US prisons have a disability, including psychiatric disabilities. Given that Black and Latino people are disproportionately incarcerated, disabled people of color face the brunt of low prison wages.

“Most incarcerated individuals want to work,” Caldwell said, “but they want to earn a wage.”

Caldwell explained that getting rid of subminimum wage for disabled people in prison involves different legal frameworks: Ending the practice for disabled people in sheltered workshops, as workplaces allowed to engage in the practice are known, would mean amending the Fair Labor Standards Act—whereas ending subminimum wages for incarcerated people would mean requiring workers in prison to be recognized as employees under federal law, which they aren’t.

Federally, and in the seventeen states where it is mandatory, “incarcerated people under law are required to work, and they actually cannot opt out of that work,” Caldwell told me, “nor can they opt out of work when there are dangerous conditions in most states.” This includes fighting wildfires, a strikingly common form of prison labor. Work done while in prison also does not count toward work requirements for Social Security Disability Insurance, Caldwell noted.

On the other hand, as the ACLU report describes, some disabled people in prisons are denied the opportunity to work when they want to. The extent of the problem is hard to capture, Caldwell says, given the lack of data on disability and the criminal justice system—but regardless, it’s “in violation of the ADA and Section 504 of the Rehabilitation Act,” Caldwell said. “It’s either because of the stigma that disabled people can’t work, or the perceived cost of providing accommodations.”

Being incarcerated can also be incredibly expensive: health care is pricey, poor, and limited, not to mention financing your own incarceration, essentials from the commissary, paying restitution, continuing to pay child support, and affording costly phone calls with loved ones.

“There are typically medical co-pays involved in seeing a doctor,” Wanda Bertram, a communications strategist with the Prison Policy Initiative, told me. “For instance, in the Federal Bureau of Prisons, there’s a $2 co-pay every time you request a doctor visit.” That could represent 17 hours of work—and given the health issues that many disabled people experience, the cost can quickly add up.

Bertram raised another issue, one that also comes up in connection with sheltered workshops: whether or not some jobs typically given to prisoners, like making license plates, develop skills that will help them when they leave prison. Bertram and Caldwell both note that many jobs for incarcerated workers also involve essential administrative and maintenance work that keeps their prisons running.

“The largest beneficiary of prison labor is the prison system itself,” Caldwell said. “Those workers are providing over $9 billion of services a year to the prisons where they are incarcerated.”