In a new twist in a long-running lawsuit, a coalition of states is challenging the right of people with disabilities to live and receive services in the community as opposed to institutions.
Nine states are arguing that a 2024 update to U.S. Department of Health and Human Services regulations related to Section 504 of the Rehabilitation Act is unconstitutional. In particular, the states are taking issue with what’s known as the “integration mandate.”
The rule in question says that state and local governments and other entities receiving funding from HHS must serve people with disabilities in the most integrated setting appropriate. Further, the rule indicates that it can be a violation of Section 504 if people with disabilities are put at serious risk of unnecessary institutionalization. Running afoul of the rule could mean states lose out on federal funds.
Advertisement – Continue Reading Below
“The Final Rule exceeds the legitimate scope of Section 504 of the Rehabilitation Act and the Americans with Disabilities Act,” Texas and eight other states said in an amended complaint filed with the U.S. District Court for the Northern District of Texas in late January. “The Final Rule’s unlawful provisions regulating institutionalization should be set aside for exceeding the scope of HHS’s authority under Section 504 and the ADA. Neither statute empowers HHS to mandate community-based care or to regard as discriminatory care that involves the mere prospect of institutional care.”
The filing is the latest in a lawsuit known as Texas v. Kennedy that was originally brought by 17 states in 2024 over the Biden administration’s update to rules under Section 504. Initially the suit focused on a mention of gender dysphoria in the rule’s preamble, but HHS is currently working to tweak the regulation to specify that gender dysphoria does not qualify as a disability under the rule.
As a result, eight states dropped out of the suit, but Texas, Alaska, Florida, Indiana, Kansas, Louisiana, Missouri, Montana and South Dakota are pressing forward with their new argument and asking the court to toss out the HHS rule.
“This new lawsuit is a serious attack on one of the most important and hard-fought rights for people with disabilities — the right to live and participate in their own communities,” said Alison Barkoff, a professor at George Washington University who led HHS’ Administration on Community Living under the Biden administration. “These states are attempting in this litigation to narrow the longstanding interpretations of (the Supreme Court’s Olmstead v. L.C. decision) by the courts, the Department of Justice and HHS’ Office for Civil Rights.”
Even if the states are successful in getting the HHS regulations overturned, Section 504 and the ADA remain the law, advocates said, but it could be harder to enforce the rights of people with disabilities to access community-based services. They’re urging residents of the nine states involved in the lawsuit to contact their governors and attorneys general to ask that they drop the case.
“These states are suggesting that they’re not going to take the steps they need to spend these Medicaid dollars in the community,” said Claudia Center, legal director at the Disability Rights Education & Defense Fund. “What’s the deal with these nine states? Why can’t they do it? It seems they don’t care.”
