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20th Anniversary of Americans with Disabilities Act

Washington, DC
July 14, 2010

Thank you, Melody. And thank you all for being with us today.

The Americans with Disabilities Act was not just a historic victory for equal rights and a milestone in American history, as Melody described. It was also, as many of you who fought for it remember, a great legislative achievement.

It took the whole disability community banding together, legislators from each party showing unusual courage, and years of hard work – and the final bill was more than many had thought was possible.

It broke down barriers in housing and the workplace, schools and shopping malls, telecommunications and public transportation. But there was one key form of discrimination that it left standing: discrimination in the health insurance market.

This wasn’t an oversight. There were many activists at the time who argued that access to affordable health care was just as important if not more important than access to jobs or public spaces. But ultimately, ending health insurance discrimination was seen as too difficult and was removed from the bill.

So this March, when our country enacted the Affordable Care Act, another historic law, we not only achieved a health care goal we had been seeking for years, we also helped fulfill the promise of the Americans with Disabilities Act twenty years after it was passed.

We took the values of the ADA – promoting fairness, empowering consumers, giving people new choices – and applied them to an area where they were badly needed.

Every American will benefit from these reforms. But because over the last few decades, Americans with disabilities have been more likely to be mistreated by insurance companies or to fall into our health insurance system’s coverage gaps, no one will gain more from ending that mistreatment and closing those gaps.

In fact, the Affordable Care Act will do more to give Americans with disabilities control over their lives than any legislation since the ADA.

For one thing, the new law is going to restore some fairness to our health insurance markets.

For years, insurance companies have been allowed to pick and choose who they gave coverage to. The result for many Americans with disabilities was being shut out of the insurance market altogether.

If you were offered insurance, you often had two choices: one plan that cost too much and another plan that didn’t offer the benefits you needed.

Under this status quo, the people who needed health insurance most were often the people who couldn’t get it.

With the Affordable Care Act, that’s changing. Starting this year, it will be illegal for insurance companies to deny coverage to children based on their medical condition or disability.

In 2014, adults get the same protection.

And until then, as a temporary measure, we’ve worked with states to create a state-based Pre-existing Condition Insurance Plan. Many of those state plans are already accepting applicants. By the end of August, they’ll all be taking applications.

To help learn whether you or people in your community are eligible for these plans, we’re encouraging all Americans to use a new website our department developed called healthcare.gov. For the first time ever, this site gives you the ability to see all your insurance options – public and private – in one place.

You go on, answer some questions about your health status and where you live, and with a few clicks, you can see all the health plans available to you and compare their benefits packages. Starting in October, we’ll have price information too.

You can also choose one of six profiles that give detailed information about how health care is changing under the new law for different groups. One of those profiles – right there with seniors and young adults – is people with disabilities. This may seems like a small detail, but it reflects the fact that Americans with disabilities have been at the front of our minds as we developed and have now begun to implement this law.

Healthcare.gov is a powerful new tool for Americans with disabilities, creating a more transparent, competitive market and putting all their health care options at their fingertips.

But we also want to make sure those health care options are good options.

So last month as part of the Affordable Care Act, we announced a new Patient’s Bill of Rights that will take effect this fall. Thanks to these new protections, insurance companies will no longer be able to put a lifetime limit on your benefits so that they disappear when you need them most. And they’ll no longer be able to cancel your coverage when you get sick just because they found an error in your paperwork.

For any of you who have ever fought with an insurance company, this establishes a basic principle: if you do the right thing and pay your insurance bill every month, then your insurance company has to do right by you too.

These protections will apply to nearly all plans this fall. But there were some gaps in our health insurance system that needed to be addressed separately.

So we’re giving young adults more security by allowing them to stay on their parents’ insurance plans until age 26 – a step that will help many young people with disabilities as they transition from school to work and adulthood.

We’re helping Medicare beneficiaries afford their medicines by mailing $250 rebate checks to people who have fallen into the Medicare prescription drug donut hole this year – the first step towards closing the donut hole completely.

We’ll eventually Medicaid, which will provide a new insurance option for many Americans with disabilities who may not meet the standards in the Social Security Act.

And not only are we eliminating co-pays for key preventive services like certain cancer screenings, the Food and Drug Administration is also working with the U.S. Access Board on new accessibility standards for these services.

Because there’s no reason a mom should have to go without a mammogram just because none of the machines in her community can reach a woman in a wheelchair.

These reforms are going to knock down many of the barriers preventing Americans with disabilities from getting the health care they need. They will shift the balance of power from insurance companies to you. They’ll give you better choices.

But there’s another area of the law that’s just as important for Americans with disabilities, though it’s gotten less attention: the expansion of long-term care services and supports.

Over the last few decades, advances in medicine have allowed Americans to live longer and more independently with conditions that might have been fatal or debilitating in the past.

But as you know, our health care system has sometimes been slow to adapt.

The Affordable Care Act accelerates the progress we’ve made to give Americans better long-term care choices.

For example, it extends the Money Follows the Person Rebalancing Demonstration program in Medicaid. Over the last few years, this program has allowed more than 6,000 people in 30 states transition from an institutional setting to their community where they typically have greater satisfaction and lower costs of care.

Under the new law, we’re extending that program through 2016 with $2.25 billion in new funding.

Beginning next fall, the Affordable Care Act creates a Community First Choice option which gives states an enhanced match so that they can offer community-based services alongside nursing home and institutional services.

The bias in Medicaid towards moving people out of their communities is left over from a time when it was harder for people to live independently and policies often failed to take into account the preferences of the people they aimed to serve.

Under the Affordable Care Act, we are committed to provide new incentives so that States can continue the rebalancing process to give Americans who need long-term care get a full range of options.

To that end, the new law also contains a new self-funded, voluntary insurance program for long-term care and supports – a policy that was championed for many years by one of the disability community’s greatest allies, Senator Kennedy, who sadly didn’t get to see it enacted.

Thanks to the CLASS Act, Americans with disabilities who have long been shut out of the private long-term care insurance market will soon have an opportunity to pay into a program that provides a long-term benefit. And the rest of the nation will now be able to get the peace of mind that comes with knowing they’ll have choice and control if they ever have to rely on long-term services.

We’ve structured this law so that these reforms kick in gradually. But across the country, Americans with disabilities are already seeing the benefits. Two of those people are here with us today.

Teresa Hammond’s son Quentin suffered a traumatic brain injury when he was four weeks old, and he spent his first six years in a Children’s Nursing Home. But like any mom, Teresa wanted her son to live at home, surrounded by family and friends who loved him.

So she worked through the Money Follows a Person program, which provided Quentin with an accessible home and ramp, bedding, clothes, furniture and more – everything he needed to get the same high level of care he got at his nursing home. Because of this program, last December, Quentin was able to come home. And you’re going to hear from Teresa in a few moments about how this change has helped Quentin thrive.

These are exactly the kinds of improved choices we’re trying to give Americans with the Affordable Care Act.

When the Americans with Disabilities Act passed, some people asked why employers on the sixth or seventh floor should have to have an elevator. After all, couldn’t employees who weren’t able to climb stairs just work on the first floor?

The answer is that in this country, we believe no one should be limited to the first floor or a nursing home – not when there are other options available. Everyone should have the freedom to make the best choices for themselves and their families, and the Affordable Care Act moves us in that direction.

In a few minutes, you’re also going to hear from Tina Westra from Grand Rapids, Michigan. Tina’s twenty-two and like a lot of young Americans including my two sons, her first thought after she was done celebrating her college graduation was: how am I going to get health insurance?

But for Tina, that question carried a little more weight because she also has epilepsy. She found a job in Virginia but couldn’t find any health insurance except a very limited policy.

Now, thanks to the Affordable Care Act, she can stay on her family’s plan, which not only provides great coverage but also covers the doctors who know her and she trusts.

This is the promise of the Affordable Care Act. In a way, it’s the same promise of the Americans with Disabilities Act. It’s the promise of giving Americans more control over their health care and lives, of knocking down barriers to give people new, improved choices.

That’s what we’ve tried to do over the last three months as we’ve worked to implement this law and that’s what we’ll continue to do in the coming years as new provisions take effect. At every step of the way, we’re counting on you to work with us to make sure these reforms take into account the needs and hopes of Americans with disabilities.

Your work didn’t end when the Americans with Disabilities Act passed twenty years ago and our work didn’t end this March.

We’ve still got a long way to go, but we’re headed in the right direction.

Thank you.