Hundreds of disability rights advocates gathered in New York in 2025 to protest Medicaid cuts and demand enforcement of disability rights protections.
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For nearly 50 years, the federal government has said that people with disabilities should live, work and learn in the most integrated setting possible rather than being segregated in institutions like nursing homes.
The Trump administration has just taken the most concrete step yet to reverse this position.
Last week, a federal judge agreed to remove references to “integration” from federal regulations related to Section 504 of the Rehabilitation Act, a landmark civil rights law that prohibits discrimination on the basis of disability. The judge did so after the Justice Department declined to defend its own rules in a lawsuit filed by several states challenging the legality of those rules.
Part of what’s so striking Texas v. Kennedy is that the federal government was originally the defendant in this lawsuit, brought by states fighting what is known as the integration mandate. Then he switched sides and agreed with the states that this requirement should be rescinded.
Bruce Darling, president and CEO of the Center for Disability Rights, said hearing about the decision felt “like a stab in the chest. Because what we’re hearing, what people are hearing, is that the federal government has made a decision that (people with disabilities) don’t have the right to live in freedom, that they can be locked up against their will.”
The court’s decision removes Section 504 regulations that explicitly required federally funded programs to provide services within the “most integrated framework.”
“This lack of clarity will impact people’s rights. It will likely impact what states do and how they behave,” says Jennifer Mathis, a disability rights attorney who helps direct the Bazelon Center for Mental Health Law.
Mathis says it’s important to note that the court’s decision made not overturn integration protections related to the Americans with Disabilities Act (ADA) or those established by decades of case law, including the landmark Supreme Court decision known as the Olmstead.
“What concerns me is that at the moment people with disabilities have a right to integration on paper. It’s in the law, but whether this will be implemented in practice is a serious question,” says Darling. Her organization is focusing its energy on a bill that would strengthen protections around inclusion, while others are working with states to strengthen their disability laws.
The Justice Department did not respond to multiple requests from NPR asking why it is changing course after decades of legal and bipartisan support for community services.
After 50 years, the government changes its position
In 1973, Congress passed the first civil rights law for people with disabilities: Section 504 of the Rehabilitation Act. But it took advocates years of struggle – until 1977 – to get real regulations that would make this law enforceable.
The Department of Health and Human Services, under President Joe Biden, updated the regulations in 2024 so states were clearer about what they needed to do to enforce the law. “They thought it was important to do this to make those rights as clear as possible,” Mathis says.
In recent months, the federal government, under President Donald Trump, has begun to publicly change its position: First, in June, the Justice Department issued an advisory saying that it no longer interpreted the Disability Act to “require states to treat mentally disabled patients in the most integrated and appropriate setting for their needs.” The memo even indicates that its position is “out of step with the common understanding” of the Olmstead decision.
Then, in July, the Justice Department announced that it would stop relying on its own long-standing guidance explaining how it enforced the integration mandate.
These actions led the federal government to change sides Texas v. Kennedy. Finally, last week, a federal judge agreed to strike down the integration mandate rules under Section 504, including terms first introduced nearly 50 years ago.
Activists Kitty Cone, Judy Heumann, Eunice K. Fiorito, and sign language interpreter Jadine Murello at a 1977 rally of disabled Americans in Washington, D.C., demanding enforcement of Section 504 of the Rehabilitation Act. After a 28-day sit-in in a federal building in San Francisco, they obtained that the regulations help strengthen the integration of people with disabilities.
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Mathis believes this kind of about-face is very unusual. “It is quite significant and unprecedented to see the federal government ask a court to overturn its own rules.”
This could leave more of the work of defining and implementing the right to community living to people with disabilities, private litigants, advocacy organizations, and the courts.
All of this, Mathis says, comes at a time when states are already under immense pressure from the federal government to cut spending on Medicaid, which allows people with disabilities to access many of the services they need. “States are looking for things to cut,” she said. Mathis worries that the government’s shift in stance on integration will give states more freedom to cut spending on community living programs.
How law enforcement is already evolving
One of the clearest examples of the effects of the federal government’s shift in stance concerns children with complex medical needs in Florida.
In 2013, the Justice Department sued the state of Florida, arguing that it failed to provide adequate services to children requiring in-home care. As a result, some families have been forced to place their children in care facilities. Other children were at the same risk.
The federal government won their case in 2023 and the state of Florida had to provide these families with the services they needed to keep their children at home. But in August, the government asked the federal court to overturn its victory and allow Florida to rehear the case in district court, citing the Justice Department’s new opinion on the issue.
Mathis calls the reversal shocking. “To do this in a matter that involves ripping children away from their families, removing them from homes where they have families who want to care for them, and forcing these children to grow up in an institution, is truly unthinkable to me and is incredibly heartless.”
The Florida case suggests that future battles for community integration may increasingly be fought not through the federal government, but on a case-by-case basis, in the courts.
What disability advocates are doing now
The disability rights community is rallying around a number of actions to try to combat the federal government’s latest actions.
“There is nothing more valuable and hard-won than the right to live, work, participate and be included in one’s community,” says Alison Barkoff, who worked on disability rights enforcement during the Obama administration and is now a professor of health law and policy at George Washington University. She says the disability community works hard to try to protect these rights.
Through recent advocacy efforts, Barkoff says some members of Congress have reaffirmed their commitment to the rights of people with disabilities to get the services they need in their communities. Just this week, a group of bipartisan lawmakers introduced a resolution affirming the federal government’s long-standing interpretation of Olmstead. In July, 100 members of Congress signed a letter asking the Justice Department to rescind its June opinion.
There is also movement at the state level: Delaware has already passed a law incorporating Section 504 regulations that were removed from federal law. Barkoff says other states are moving in a similar direction: “I probably received calls last week from at least a dozen state leaders across the country about how to codify the integration mandate…into state law.” I see a lot of momentum,” she says.
Bruce Darling of the Center for Disability Rights helped author the Latonya Reeves Freedom Act, a bipartisan bill that would codify the inclusion of people with disabilities in federal law. He says his organization is working to convince lawmakers to sign on.
Although the bill has some bipartisan support, it has failed in the past and would have a difficult road ahead, facing an executive branch that now challenges integration. But Darling says he hopes members of Congress are now more aware of the challenges facing his community.
“I think the problem has really come to a head now and people can see it. Olmstead is seriously in danger, that we have to do something,” Darling said. “I don’t know, I’m optimistic.”
Edited by Nirvi Shah
Visual design and development by LA Johnson
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