National Council on Independent Living
July 13, 2011
Good morning, everyone. Thank you, Kelly, for that gracious introduction.
And I want to thank all of you at the National Council on Independent Living for your decades of work fighting for a world in which people with disabilities “are valued equally and participate fully.”
I also want to acknowledge the Director of the Office on Disability at the Department of Health and Human Services Henry Claypool. Henry has built a record of developing and implementing disability policy at the local, state, and federal level, and he actually got his start at a Center for Independent Living in Colorado. Today, he’s in our nation’s most critical health policy meetings holding true to the adage “Nothing about us, without us.”
This is a fitting time of year for today’s gathering. In June, we observed the anniversary of the Olmstead decision. We’ll mark the anniversary of the Americans with Disabilities Act in a few weeks.
And last week, we celebrated the Fourth of July, a holiday which not only commemorates America’s declaration of independence from Great Britain, but also the American idea that each of us is entitled to our own independence, to “life, liberty, and the pursuit of happiness.”
For decades, disability rights advocates have worked to bring the reality of America closer to this ideal. And today, I am proud to reiterate this Administration’s support for the Convention on the Rights of Persons with Disabilities. No person, anywhere, should face discrimination because of their disability, and when the President submits the ratification package to Congress, we expect their swift advice and consent.
But being able to pursue your life’s true happiness means more than just the absence of discrimination. It also means the freedom to live as you wish, which includes the freedom to live in your own home, surrounded by those whom you love.
And for too long, too many Americans with disabilities haven’t had this option. The choice has been either moving to an institution or living at home with no support at all – which is often no choice at all.
For years, NCIL has fought to give Americans better choices, and today, I can tell you that this Administration shares that commitment.
And there’s nowhere that commitment is more evident than in last year’s health care law, the Affordable Care Act.
Many of you are familiar with the success of the Money Follows the Person program. It helps nursing facility residents use their Medicaid funds to locate and secure affordable housing or arrange for home modifications or assistive equipment to make their new home safe and functional. And over the past several years, it has helped more than 12,500 people on Medicaid transition out of an institutional setting into their community.
Under the Affordable Care Act, we’re extending the life of this successful program for another five years with an additional $2.25 billion investment. This will bring the program to 13 new states and will help an additional 55,000 people move from an institution to a home of their own by 2016.
The law is also helping make sure that when people move into their communities, they have access to high quality, person-centered services and supports. Beginning in the fall, we will provide extra money through the law’s Community First Choice program to help state Medicaid programs pay for services and supports at home. And I encourage all of you to work closely with your state to take advantage of this opportunity to make community living services the first choice of people who rely on Medicaid for long term services and supports.
There’s room for improvement for every state in these areas, but there are some states that have lagged further behind in meeting their Olmstead obligations. That’s why the law also includes the Balancing Incentives Payment Program, which provides financial support to the states that rely most heavily on nursing homes.
But these funds come with conditions attached. In return for increased Medicaid payments, these states will need to establish a “no wrong door” system and make other important changes, which make it easier for people to find the long-term services and supports they need to live in their communities. Whether you have the chance to live in your own home shouldn’t depend on whether you live in a certain state, and we’re working to make sure that doesn’t happen.
Finally, the health care law also calls for the creation of a Community Living Assistance Services and Supports program to address Americans' long-term care needs and help them remain as independent as possible, for as long as possible. And we are doing everything in our power to ensure that Americans have the choice of a financially sustainable CLASS program.
In addition, the health care law contains sweeping insurance reforms that will benefit Americans with disabilities.
Under the law, the days of insurance companies deciding who gets coverage and who doesn’t are coming to an end. It is now illegal for insurance companies to deny coverage to children based on their medical condition or disability. In 2014, this protection will apply to people of all ages. And until then, we have created new Pre-Existing Condition Insurance plans that are helping people who were previously locked out of the insurance market get coverage.
At the same time, the law’s new Patient’s Bill of Rights is ensuring that insurance companies can no longer put a lifetime limit on your coverage. We are establishing new standards for medical diagnostic equipment and data collection that will make our health care system more responsive to people with disabilities. Also starting in 2014, you will no longer face a limit to certain health care services that you need. And we’re expanding Medicaid, which will provide a new coverage option for many Americans with disabilities who may not meet the standards in the Social Security Act.
Together, these reforms means that for the first time in our history we’ll be able to say that all Americans, including those with disabilities, have access to affordable health insurance.
When you add these reforms together, the health care law is the most comprehensive civil rights law for people with disabilities since the Americans with Disabilities Act. But this commitment to making sure every American has the opportunity to live as independently as possible is one that stretches across the Administration and is part of everything we do.
The Department of Justice’s Olmstead enforcement efforts, for example, are keeping states focused on respecting people’s civil rights by serving people who rely on Medicaid in community-based settings.
And HHS and the Department of Housing and Urban Development have formed a historic partnership to make sure that there is a smooth transition from institution to a home in the community. Created under President Obama’s Year of Community Living, this partnership brings together local housing and health agencies to ensure that housing resources can be coordinated with Medicaid services. And HUD has already awarded 1,000 housing vouchers to be coordinated with programs like Money Follows the Person.
These are just some of the actions that the Obama Administration has taken to move our country forward and give Americans with disabilities more choices about where to live. But unfortunately, there are some who want to take those choices away.
The recent budget passed by the House Republicans proposes turning Medicaid into a block grant program, and would slash its budget by $770 billion. The fact is that two-thirds of the Medicaid spending goes to two populations: people with disabilities and older Americans. There’s simply no way to cut Medicaid spending in half without also significantly cutting benefits for all the Americans with disabilities who depend on Medicaid.
House Republicans have also voted to repeal the Affordable Care Act. According to the independent Congressional Budget Office, that would take away health coverage for 34 million Americans – along with every single long-term services and supports reform that I just mentioned.
If we want to give the reforms in the health care law a chance to succeed and build on the progress we’ve made in the last two years, we will need your voices in the debate to push back against these proposals. And you have the best chance of being heard if you find allies to make the case with you.
That’s why I’m urging you today to continue your efforts to partner with organizations that serve older Americans. The country is growing older. As we do, more and more seniors will require additional support to live comfortably. And the overwhelming majority of them will prefer to remain in their homes and community for as long as possible.
We need to get rid of the arbitrary distinction of over-65 and under-65 and focus on our common interest in improving access to the supports and services that allow people to live in their communities. America’s seniors want to age in place just as Americans with disabilities do, and if you work together, you can be a powerful force for change.
Here is just one example of an area where greater cooperation could have a huge impact. We know that the disability community has often felt like it was not an equal partner in Aging and Disability Resource Centers. But we’re working to change that.
We’ve updated the eligibility requirements for the centers to ensure that they demonstrate evidence of partnership with their local disability community. The new requirements also promote a substantive advisory role for consumers and other stakeholders of the disability community.
And this is just a start. If you continue to work with us and give us your ideas about how to improve these centers, we will continue to reward those that fully include and partner with Centers for Independent Living and other disability organizations.
To share your thoughts, I encourage all of you to attend a workshop on Friday led by Elizabeth Leef, a former NCIL staffer now with the Administration on Aging, where you can let us know how we can make these centers hubs of collaboration across the country.
The health care law and the other steps we’ve taken over the last two years are giving countless Americans with disabilities the chance to live independently that all people deserve.
But this progress will continue only if we resist the efforts of those who want to undo these reforms just as they’ve finally been achieved. To do that, we need all those who support independent living to stand together. If that happens, I’m confident that we will continue to move forward towards the day when all our citizens have the fundamental freedom to pursue their happiness in communities of their choosing.