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The Center for Disability Rights (CDR) works all year long to support seniors and people with disabilities living in the community. What follows is a GOTV message from CDR with a clear focus on three major issues that deserve our careful and continued attention, now and after the election: Medicaid, Olmstead enforcement and the Community First Choice Option.

Please take a moment to review and share with people you know who may also be interested.


The Center for Disability Rights works all year long to support seniors and people with disabilities living in the community.  As Election Day arrives, we think it’s important for everyone to know the facts about how both of the two major Presidential candidates would likely affect the right of people with disabilities to live in the most integrated setting.

Here are three major issues we need to consider: Medicaid, Olmstead enforcement and the Community First Choice Option.


Medicaid pays for long term services and supports, and when it comes to Medicaid, the difference between the candidates is dramatic.

The Romney-Ryan plan for Medicaid would block grant Medicaid and cut $810 billion out of the program over 10 years.  That means a Romney administration would cut one-third of Medicaid!  States are already dealing with their own budget issues by cutting vital Medicaid home and community based services, so with one-third less federal funding, home and community-based services would be devastated.

Although President Obama has proposed some cuts to Medicaid, we know that he is committed to the program.  President Obama has largely shielded Medicaid from cuts in budget negotiations with Congress.  His administration wants to combine spending cuts and tax increases on upper-income households to close the fiscal hole without fundamentally changing the government guarantees at the heart of Medicaid.

Civil Rights: Enforcing Olmstead

The Supreme Court’s Olmstead decision underpins much of our advocacy to support people with disabilities living in the community.  The Department of Justice, under the leadership of Attorney General Eric Holder, has done incredible and unprecedented work enforcing the Olmstead decision and assuring that states provide services and supports in the most integrated setting.  In the last few weeks DOJ demonstrated that addressing fiscal issues in the states does not necessarily conflict with Olmstead compliance.  In conjunction with the Department of Health and Human Services, DOJ brokered a deal where Washington State agreed to add an exception process to their personal care cuts that would prevent people from being forced into institutional settings.  Had DOJ not brokered this deal, Washington State would have appealed MR v Dreyfus to the Supreme Court and potentially undermined the entire Olmstead decision.    

Mitt Romney hasn’t said much on what the Department of Justice would look like if he wins the election, but he has criticized Obama’s DOJ, especially Attorney General Holder. During a New Hampshire campaign event late in 2011, Romney said, “There’s not very much that Eric Holder does that I agree with.”  

Community First Choice Option

The Community First Choice (CFC) Option is a community-based Medicaid state plan service which includes hands on assistance, safety monitoring, and cueing for assistance with activities of daily living, instrumental activities of daily living and health related functions based on functional need, not diagnosis or age.  It was the result of over twenty years of work by the disability rights community which has advocated ending the institutional bias that forces people into unwanted and unnecessary institutionalization.  

The Community First Choice Option was established as part of the Affordable Care Act, also known as “Obamacare”.  It is well-established that President Obama supports the Affordable Care Act and his administration supports implementation of the Community First Choice Option.

Mitt Romney has been clear that he would the repeal the Affordable Care Act which includes the Community First Choice Option.  His plan for block granting Medicaid would also eliminate the CFC option and the incentives it created for states to rebalance their systems for providing long term services and supports.

The Center for Disability Rights

The Center for Disability Rights is a non-partisan advocacy organization working for the full integration, independence and civil rights of people with disabilities.  We believe that as advocates, our first and most important job is to get informed and vote.

We’ve provided you with some information, but the rest is up to you.

So vote!

Bruce Darling

Center for Disability Rights

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