7 Ways the Biden Administration Can Support People With Disabilities
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On January 20, 2021, we witnessed a historic day when Joe Biden and Kamala Harris were inaugurated as President and Vice President of the United States. The new president’s level-headed compassion and commitment to unity represent an opportunity to come together and address the unprecedented challenges we face in these times. Addressing these “cascading crises” as the president described them includes securing the rights and meeting the needs of people with disabilities, many of which have been magnified by the COVID-19 pandemic.
Here are seven ways the Biden administration can support people with disabilities in the short and long term, including policies they have already supported and suggestions for how to improve them.
1. Get the COVID-19 vaccine into more arms.
The COVID-19 pandemic has had a devastating effect on the disability community. The virus has disproportionately killed seniors and people with disabilities, especially those living in congregate care settings such as nursing homes and group homes. The vaccine is a great source of hope in our community, but so far the rollout has been largely botched. In addition to the lack of doses, there have been issues with prioritization. Some groups of high-risk people with disabilities, such as those who receive in-home care, have been forgotten and left out of early tiers.
President Biden pledged to distribute 100 million doses of vaccine in 100 days, but subsequently discovered that the vaccine supply is far lower than expected. Hopefully, he can still achieve this goal, but if he can’t, it shouldn’t be held against him. Biden has pledged to follow the lead of doctors and scientists as we continue to battle this virus, has made the pandemic his top priority, and has demonstrated compassion for those who are suffering and dying. I am confident that his approach will help bring an end to this nightmare as soon as humanly possible.
2. End the subminimum wage.
Did you know it’s legal to pay people with disabilities less than minimum wage? Due to a little-known provision in the Fair Labor Standards Act of 1938, businesses can apply for special certificates allowing them to pay as little as pennies per hour to their disabled employees. We’ve come a long way since 1938, yet this terrible provision remains in place, incentivizing businesses and state agencies to exploit the cheap labor of people with intellectual disabilities rather than providing the job coaching and other support they need to transition to fair wage employment in the community.
Thankfully, President Biden has already pledged to end this policy as part of his proposed bill that would raise the federal minimum wage to $15 per hour. However, the bill would need to be approved by both houses of Congress.
3. Increase the federal minimum wage to $15 per hour.
President Biden has strongly supported increasing the minimum wage to $15 per hour. This would benefit people with disabilities in a number of ways.
People with disabilities are disproportionately represented in low wage jobs. Higher wages could be especially life-changing for people with chronic health conditions who can only work part-time and/or have extra medical expenses that aren’t covered by insurance.
Many people with disabilities rely on direct support workers such as personal care attendants for tasks such as bathing, dressing, cooking and housecleaning. These services are funded by state Medicaid programs, which tend to pay extremely low wages — the national average is only $11.76 per hour. This makes it difficult for people with disabilities to hire good caregivers and for dedicated caregivers to stay afloat financially. A higher minimum wage would reduce turnover and improve the lives of these workers who are essential to our community.
4. Create a Medicare public option with home and community-based services included.
President Biden has stated that he supports a public option where anyone can choose to buy into Medicare or a Medicare-like healthcare plan. I truly can’t understand the objections to this idea. Why would you want to take away someone else’s choice of healthcare plan? And this plan, unlike some versions of Medicare for All, retains private insurance companies and allows people to choose private plans if that’s what they prefer.
In addition to seniors, many younger people with disabilities already have Medicare through Social Security Disability (SSDI). However, people on Supplemental Security Income (SSI) who became disabled before accumulating work credits can currently only qualify for Medicaid. And some people with disabilities (including me) have both. Medicare and Medicaid are extremely important resources for the disability community, and expanding access to them would improve our lives.
With that said, it’s important to note that simply granting public enrollment into Medicare as it currently stands would be of limited benefit for many people with disabilities. Its requirements to qualify for mobility aids currently exclude ambulatory people who need a wheelchair to leave their home, and it does not cover personal care attendants and other home and community-based services. These and other issues would need to be addressed to make public-option Medicare a truly viable healthcare plan for people with disabilities who don’t qualify for or are limited by Medicaid.
5. Expand access to home and community-based services.
I’ve written about the importance of home and community-based services over and over and over and over and over again. Like millions of people with disabilities, I rely on them — specifically, personal care attendants funded by a Medicaid waiver — to live independently in my own home. Medicaid waivers also fund other essential services, like in-home nursing care for medically fragile kids and job coaches to help people with intellectual disabilities succeed at work.
Because home and community-based services are funded by state Medicaid waivers, the types and amounts of services available vary from state to state. More than 800,000 people across the United States are currently on waiting lists for HCBS. Biden has committed to eliminating these waiting lists, and supports better wages and benefits for caregivers. He has also discussed expanding Medicaid buy-in programs, which could help people with disabilities access these critical services without being subject to the asset and income limits that often keep us unemployed and under-employed.
Biden has a plan to pay for this by cutting tax breaks for the richest real estate investors, but it’s also important to note that caring for people with disabilities in their own homes is less expensive overall than nursing home care, so his plan is economically sound as well as the right thing to do. And the need for home care rather than nursing homes has become even more critical during the pandemic. It could mean the difference between life and death.
6. Increase SSI payments and the asset limit.
Currently, people with disabilities who receive Supplemental Security Income (SSI) only get $792 per month — not even close to enough to live on. Biden would increase SSI benefits to 100% of the federal poverty level, or about $1091 per month, with yearly increases for cost of living. He would also eliminate the in-kind support and maintenance penalty, which causes that paltry $792 to be reduced by one-third if a beneficiary lives with a family member without paying for shelter and food.
People on SSI (as well as those on Medicaid, in many states) cannot have assets worth more than $2000, or $3000 for a couple, excluding a house and one car. This limit has not been updated since 1984. Biden would more than double the limit, to $4289, and allow twice the resources for a married couple. This partially addresses the marriage penalty that keeps many people with disabilities from getting married.
I hope Congress and the Biden administration will go further and fully eliminate the marriage penalty for all SSI and Medicaid recipients with disabilities. No one should lose their only source of income because they marry somebody who makes “too much” money.
7. Repeal Trump’s expansion of the public charge rule.
The public charge rule allows the federal government to deny green cards and some visas to immigrants it knows or believes will be “overly reliant” on public benefits. Although the law was passed in the 1880s, it was only used in limited cases until the Trump administration massively expanded it. Trump added Medicaid, Section 8 housing assistance and SNAP to the list of programs that could cause an immigrant to be denied a green card, disproportionately affecting people with disabilities who need healthcare and home and community-based services that can only be obtained through Medicaid. It has also led to some immigrants feeling afraid to seek critical medical care for COVID-19 and other urgent issues.
Biden has pledged to end this discrimination, and has nominated former California Attorney General Xavier Becerra, who previously filed lawsuits to overturn the public charge rule expansion, to be the new Secretary of Health and Human Services.
The Biden administration has already shown more interest in the disability community and our needs than many previous Presidential administrations. I believe President Biden, Vice President Harris, and the Democratic Congress will prioritize issues that affect people with disabilities and recognize our rights to life, liberty and the pursuit of happiness. However, we must not allow ourselves to become complacent. We face real challenges as a community and a country, and we must continue to make our needs known and our voices heard. I’m ready to move forward and do my part to make the USA and the world a better place with kindness and honesty. Are you?
Image via YouTube.