On March 25, the Department of Justice (DOJ) filed a letter to the U.S. Court of Appeals for the Fifth Circuit stating it agreed with the ruling of the Federal District Court for the Northern District of Texas in United States v. Texas invalidating the entire Affordable Care Act (ACA). In this case, the lower court ruled that as a result of Tax Cuts and Jobs Act provision reducing the individual mandate penalty to $0, the mandate was unconstitutional. Furthermore, the lower court ruled that the entire ACA was invalid as a result. The DOJ had previously argued in District Court that only the individual mandate and pre-existing condition protections should be invalidated, while the rest of the law should remain intact. The Arc strongly supports fully overturning the District Court ruling and has signed onto an amicus brief.
On March 27, a judge in the Federal District Court for the District of Columbia issued two rulings striking down Medicaid work requirements in Arkansas and Kentucky. The opinions direct the Department of Health and Human Services (HHS) to reconsider the states’ waiver applications with consideration given to possible loss of coverage. The same judge invalidated Kentucky’s waiver last year, and HHS re-approved it without changes after another notice and comment period. Arkansas’s waiver had already gone into effect, and 16,000 had already lost coverage as a result. Read The Arc’s statement on the rulings.
On March 7, a Federal District Court judge overturned the Education Department’s (ED) decision to delay implementation of the 2016 significant disproportionality rule because it was “arbitrary and capricious” and the department “failed to provide a reasoned explanation” for its decision. The requirement for states and school districts to collect and report data on significant disproportionality, and take certain action if it is found, was added to the Individuals with Disabilities Education Act (IDEA) in 2004. However, since that time, few states and school districts have reported any such significant disproportionality. In response to this problem, documented in a 2013 study by the Government Accountability Office (GAO), the Department of Education issued regulations in 2016 to require a standard methodology to calculate significant disproportionality on the basis of race in identification, placement, and discipline. In 2018, the ED announced it would delay implementation of the rule. The Arc is pleased with the court ruling, which will ensure states and school districts move forward with implementation.
On December 14, a federal judge ruled that the Affordable Care Act (ACA) is unconstitutional as a result of the provisions in the Tax Cuts and Jobs Act that removed the penalty for individuals who do not purchase health insurance. The ruling further argued that the entire law was invalid because the provision requiring people to purchase health insurance was unconstitutional. The decision is likely to be appealed and the law remains in place as the case makes its way through the judicial process. The decision came the day before open enrollment ended in most states. It is estimated that, if the decision stands, more than 17 million people would lose health insurance. Many of the law’s most popular provisions would end, including the protections for people with pre-existing conditions, allowing parents to cover their children until age 26, eliminating annual and lifetime limits on coverage, and other provisions. The ACA provides many critical protections for people with disabilities and The Arc will continue to support the law.
On June 29, a federal judge ruled that Kentucky’s proposed waiver, which included work requirements, monthly premiums, lockouts for non-payment, limits on retroactive eligibility and non-emergency medical transportation, and penalties for non-emergency use of emergency rooms was arbitrary and capricious. The judge ruled that the waiver was invalid because the Department of Health and Human Services did not take into account the primary objective of the Medicaid statute: “to furnish medical assistance.” However, the ruling did leave open the possibility that a waiver including work requirements might pass legal muster if its impact is more carefully considered. The Arc is very concerned about potential barriers to health care created by work requirements and other policies.
On June 7, the Department of Justice announced that it will not defend key provisions of the Affordable Care Act (ACA) in a lawsuit challenging the law’s constitutionality. The lawsuit filed by Texas and 19 other states, argues that since the Tax Cuts and Jobs Act reduced the penalty for not purchasing insurance to $0, it no longer raises revenue, and is therefore no longer constitutional under the tax powers of Congress. Furthermore, they argue that if the court strikes down the individual mandate, the rest of the ACA must also be struck down. The Department of Justice response argues that the individual mandate is unconstitutional but other provisions of the ACA should remain intact. The Administration further asserts that two critical protections for people with pre-existing conditions, guaranteed issue and community rating provisions, are unenforceable. Guaranteed issue is the provision that prevents denial of coverage based on health status and community rating helps keep insurance affordable for people with health conditions. California and sixteen other states have filed a motion to intervene, which would allow them to defend the law. Peter Berns, CEO of The Arc submitted a declaration in support of California’s motion to intervene. Read The Arc’s statement here.
In a packed courtroom, at a hearing last week, US District Court Judge John Gibney announced that he would approve the settlement agreement negotiated between the Department of Justice (DOJ) and the Commonwealth of Virginia contingent on the parties agreeing to certain changes. If approved, the settlement will mark a significant development in Virginia’s transition to a community-based system of services and supports for individuals with disabilities. As part of the agreement, Virginia plans to close four of its five training centers (intermediate care facilities for individuals with intellectual and developmental disabilities).
In addition to DOJ and the Commonwealth, the Judge allowed a third party to participate in last week’s hearing. Parents of individuals who live in the training centers and who oppose parts of the settlement agreement were permitted to offer witness testimony and arguments during the hearing. Virginia and DOJ asked the judge to approve the settlement which would provide services to thousands of individuals who are on waiting lists and build in appropriate safeguards.
The proposed changes sought by Judge Gibney would consist of the following: (1) a requirement that a death of any individual who has left a Training Center be immediately reported to the Independent Reviewer, (2) a clarification about who has the ability to provide consent for discharge from a Training Center and a requirement that consent must be provided prior to discharge (3) a provision that residents of training centers can insist on remaining in state-run facilities and that state officials cannot remove residents without the consent of their authorized representatives.
On technical grounds, the US Court of Appeals for the Second Circuit overturned a lower federal court ruling that New York’s practice of segregating individuals with mental illness in large, congregate settings called adult homes was discrimination. The lower court had ordered the state to provide smaller community-based settings for over 4,000 individuals who live in the adult homes. The reason the appeals court overturned the decision was its finding that Disability Advocates, Inc. (DAI), a private non-profit agency that contracts with the state’s protection and advocacy system to provide legal services to individuals with mental illness, did not have standing to file the lawsuit.
The United States Supreme Court remanded the California Medicaid challenge, Douglas v. Independent Living Center of Southern California et al., to the Ninth Circuit Court of Appeals, delaying a decision on whether Medicaid providers and beneficiaries can bring lawsuits against state Medicaid officials. The Douglas case arose when California severely reduced Medicaid provider rates. Medicaid providers and beneficiaries sued, arguing that the rate reduction violated federal law. Since the Supreme Court agreed to hear the case, the Centers for Medicare and Medicaid Services (CMS) determined that California’s rate reductions did not violate federal law. The Ninth Circuit will rehear the case to determine if Medicaid providers and beneficiaries can maintain their cause of action in light of the decision by CMS.
A class action lawsuit, filed in U.S. District Court, charges Oregon state officials with violating the Americans with Disabilities Act and the Rehabilitation Act by failing to provide supported employment services to more than 2,300 state residents with disabilities who currently work in segregated sheltered workshops. The lawsuit, Lane v. Kitzhaber, seeks an injunction requiring the state to provide “an adequate array of integrated employment and supported employment services, as to avoid unnecessary segregation” and to provide supported employment services in integrated settings for all state residents currently employed in sheltered workshops. Review the complaint.