Sept. 25, 2020
Speaking at a campaign rally in Ohio on Tuesday, President Trump doubled down on previous comments he’s made downplaying the severity of COVID-19, arguing that the coronavirus “affects virtually nobody,” except the elderly and those with “other problems.” The president’s words categorically dismissed the importance of protecting people with preexisting health issues, including more than a quarter of the U.S. population who were born with or have acquired a disability.
Our nation has a shameful history of discriminating against people with disabilities. For centuries, people with disabilities in the United States endured abuse, segregation, stigmatization, and even forced sterilization. In 1922, for example, Harry Laughlin, a proponent of eugenics, crafted model legislation that would require sterilization of the “feeble-minded,” the “insane,” the “delinquent,” the “diseased,” the deaf, and the “crippled.” By 1938, 33 states had adopted sterilization laws based on this model, and between 1921 and 1964, 63,000 individuals were sterilized.
But over the past half-century, inspired by the civil rights movements, people with disabilities and their allies galvanized support for a remarkable wave of policy change. Section 504 of the 1973 Rehabilitation Act, for example, created and extended civil rights for children and adults with disabilities in education, employment, and other settings; the 1975 Education for All Handicapped Children’s Act—now known as the Individuals with Disabilities Education Act (IDEA)—mandated free and appropriate public education to all students with disabilities; and the Americans with Disabilities Act in 1990 (ADA) prohibited discrimination against individuals with disabilities in all areas of public life.
But the passage of these laws has not guaranteed equality. People with disabilities still face prejudice and bias in the media, segregation in schools, limited access to transportation and technology, and discrimination in housing and employment. One example of continued inequality is a provision in the Fair Labor Standards Act (“14c”), which allows employers to pay disabled employees less than the minimum wage set by Congress. While the initial intent behind the law was to integrate people with disabilities into mainstream workplaces, the result is a policy that allows people with disabilities to be classified as a substandard group for whom the “minimum” does not apply. As a result of systemic discrimination in policy and practice, people with disabilities are twice as likely to live under the poverty line, three times more likely to have difficulty paying required bills, and two and a half times more likely to experience unemployment, according to the 2017-18 American Community Survey. They are also more likely to need but less likely to receive adequate health care coverage and services.
The U.S. response to the COVID-19 pandemic exposed just how unprepared our nation’s public health infrastructure is to serve the needs of people with disabilities. Many are experiencing an interruption in services, therapies, supports, and critical health needs. Students with disabilities, for example, are facing long stretches without access to the essential in-person educational and related services, such as physical, occupational, behavioral, and other services, typically provided by schools. People with intellectual and developmental disabilities, disproportionately isolated prior to the pandemic, have seen intensified isolation and anxiety. Meanwhile, state-level datasets, used to track cases and plan responses, are almost entirely devoid of information on people with disabilities.
Further, although most people with disabilities are not inherently at higher risk of contracting the virus, many are at higher risk of infection or severe illness due to underlying medical conditions. Some people, having contracted the virus, have even been denied lifesaving treatment because of their disability. In violation of the ADA, the Rehabilitation Act, and the Affordable Care Act, in March, Kansas and Alabama began restricting access to ventilators, denying access to individuals the states defined as having “severe or profound mental retardation,” including children. After disability advocates filed lawsuits, Alabama withdrew its discriminatory guidelines and the U.S. Office of Civil Rights issued a bulletin affirming the civil rights of people with disabilities to lifesaving treatment.
Congress is not doing enough to address the needs of Americans with disabilities during this crisis.
Where people with disabilities live can also increase their risk of exposure to COVID-19. Many people with significant disabilities, including the elderly, live in congregate settings where it is nearly impossible to implement social distancing. As of September 17, there were more than 455,000 confirmed cases associated with long-term care facilities, nursing homes, skilled nursing facilities, and assisted living facilities, and nearly 79,000 deaths. COVID-19 is also deeply impacting people with disabilities in other congregate settings who are high risk for contracting the virus. The Bureau of Justice Statistics reports that people in prison, among those hardest hit by the virus, are four times more likely to report a cognitive disability—including autism, intellectual disability, or learning disability—than the general population.
When disability intersects with poverty, race, and other factors, the risk levels of contracting COVID-19 and other diseases and health conditions are compounded. American Indians and Alaska Native Americans, in particular, have the highest rates of disability across all Americans of all ages, and are among the racial and ethnic groups at highest risk for severe COVID-19 outcomes. The death rate for Black Americans, who have the second highest rate of disability among racial groups, is 2.4 times the rate of white Americans.
Congress is not doing enough to address the needs of Americans with disabilities during this crisis. While the pandemic aid bills passed to date total over $3 trillion, they authorize only $955 million to support nutrition programs, home and community-based services, family caregivers, and to expand oversight and protections for seniors and individuals with disabilities. The HEALS Act, the Senate’s fourth pandemic aid package, contains no funding specifically targeted to assist people with disabilities, and negotiations have stalled in the Senate.
But several provisions in the HEROES Act, passed by the House in May, as well as the Coronavirus Relief for Seniors and People with Disabilities legislation introduced by Sens. Bob Casey (D-Penn.) and Deborah Dingell (D-Mich.), point to policy reforms that support the disability community during and far beyond the pandemic. For example, ensuring access to home- and community-based services (HCBS), which gives people with disabilities and the elderly the option to receive supports in their homes rather than requiring them to be in institutions, would provide immediate protections from the virus and have broad, long-lasting implications for the health and independence of the disability community.
In 1990, President George H.W. Bush signed the Americans with Disabilities Act into law, calling it the beginning of “a bright new era of equality, independence, and freedom” for people with disabilities. On the thirtieth anniversary of this act, amidst a pandemic that has fueled a focus on healthcare access and protections, our nation’s leadership must do more to recognize and prioritize the needs of Americans with disabilities. The current president may want us to believe that people with “other problems” are an expendable sideshow but 61 million Americans with disabilities and their families feel otherwise and deserve better.