DOJ Reverses Decades of Policy, Undermining Right of Disabled Americans to Community-Based Care
The Department of Justice has withdrawn its long-standing enforcement of the ADA's integration mandate, declaring that states are not legally required to provide community-based care for disabled Americans. Advocates warn the shift could lead to a return to forced institutionalization.
By Hailey Scott
- Disability Rights Advocates
- Argues that the integration mandate is a fundamental civil right and that removing federal enforcement will lead to the forced institutionalization of disabled Americans.
- Department of Justice
- Maintains that while the ADA prohibits discrimination, it does not legally compel states to prioritize or fund community-based care over institutional settings.
- State Medicaid Administrators
- Focuses on the financial and administrative flexibility needed to manage state healthcare budgets without rigid federal mandates.
Why this matters
This policy reversal removes the federal government's primary mechanism for forcing states to provide in-home care for disabled Americans. Without federal enforcement, cash-strapped states could slash community-based services, potentially forcing millions of people with physical, intellectual, and mental disabilities into nursing homes or psychiatric institutions to receive care.
The U.S. Department of Justice has officially reversed a 25-year-old civil rights policy, declaring that federal law does not require states to provide community-based care for disabled Americans. The shift, formalized in a June 2026 Office of Legal Counsel (OLC) memorandum and executed through recent withdrawals from ongoing federal lawsuits, upends decades of civil rights enforcement.[1][2]
At the center of the reversal is the DOJ's new interpretation of the landmark 1999 Supreme Court decision Olmstead v. L.C. For over a quarter-century, the federal government interpreted Olmstead as establishing an "integration mandate" under the Americans with Disabilities Act (ADA), requiring states to prioritize home and community-based services (HCBS) over institutionalization whenever medically appropriate.[3][4]
The June 18 memo, authored by Principal Deputy Assistant Attorney General Lanora Pettit, argues that this mandate was a fundamental misinterpretation. Pettit wrote that while the ADA prohibits discrimination, it does not impose a blanket requirement on states to fund community care over institutional care, nor does it guarantee a right to community integration.[2]
The DOJ is already acting on the new guidance. In recent weeks, federal officials have pulled out of or altered their arguments in multiple disability rights cases, including a major lawsuit in Florida involving children with complex medical needs.
The DOJ had previously secured an order requiring Florida to improve community-based care to keep children out of nursing homes. Now, federal officials have asked an appeals court to reconsider, arguing against federal protections for children at risk of institutionalization.
The DOJ had previously secured an order requiring Florida to improve community-based care to keep children out of nursing homes.
Disability rights advocates are warning of catastrophic consequences. Without federal pressure, cash-strapped states facing Medicaid budget constraints could slash funding for in-home aides, personal care attendants, and community programs.[1][5]
"It is now the position of the United States government that people with disabilities don't have a right to be part of their communities," said Alison Barkoff, a health law and policy professor who led disability policy efforts in previous administrations. She warned that the reversal could lead to the de facto segregation of disabled Americans in nursing homes and psychiatric facilities.[1]
The American Bar Association and advocacy groups like The Arc argue the DOJ's new stance ignores the explicit legislative history of the ADA, which identified segregation and unnecessary institutionalization as forms of discrimination. They note that Olmstead was built on the understanding that institutional placement severely restricts everyday life activities, including family relations, work, and social contacts.[3][4]
However, the DOJ's position mirrors arguments made by several Republican-led states, which have long contended that federal integration mandates represent an unconstitutional overreach. These states argue that rigid federal requirements strip them of the flexibility to manage their own Medicaid budgets and healthcare systems efficiently.[5]
The practical impact is expected to be immediate. Currently, over 8 million Americans receive home and community-based services through Medicaid. With the federal government stepping back from its enforcement role, the burden of protecting community-based care will shift entirely to individual families and underfunded state-level advocacy groups, leaving the future of millions of disabled Americans dependent on state legislatures.[1]
Key points
- The DOJ issued a memo declaring the ADA does not require states to provide community-based care for disabled Americans.
- The decision reverses 25 years of federal enforcement based on the 1999 Olmstead Supreme Court ruling.
- Federal officials have already begun withdrawing from ongoing disability rights lawsuits, including a major case in Florida.
- Advocates warn the shift will allow states to cut Medicaid funding for in-home care and return to forced institutionalization.
Sources
[1]NPRDisability Rights AdvocatesDOJ memo stokes fear among disability advocates of a return to institutionalization
Read on NPR →
[2]CBS NewsDepartment of JusticeStates aren't required to provide community-based care for people with disabilities, new DOJ opinion claims
Read on CBS News →
[3]American Bar AssociationDisability Rights AdvocatesNarrowing Olmstead: A Response to the OLC's June 2026 Memorandum
Read on American Bar Association →
[4]The ArcDisability Rights AdvocatesDOJ Opinion on Olmstead Threatens the Right of People with Disabilities to Live in the Community
Read on The Arc →
[5]Bipartisan Policy CenterState Medicaid AdministratorsHow Policy Changes Are Reshaping Aging in America
Read on Bipartisan Policy Center →
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