A legal battle targeting a pivotal disability law has been reignited as nine states challenge federal mandates that require individuals with disabilities to receive care in integrated community settings. Texas, Florida, and seven other states are contesting the Biden administration’s 2024 update to Section 504 of the Rehabilitation Act of 1973, specifically objecting to the provision that states must fund services in the “most integrated setting.”
Section 504 prohibits discrimination against individuals with disabilities in any setting that receives federal financial assistance, including healthcare facilities. Disability advocates argue that a rollback of this protection could potentially push individuals in need of long-term care back into facilities that isolate them from society, a regression from the progress made over decades.
Alison Barkoff, a disability rights lawyer and former head of the Administration for Community Living, emphasizes the significance of the right to live and participate in the community as a fundamental aspect of disability law. She expresses concern over any attempts to weaken the integration mandate, citing the landmark Olmstead decision in 1999 as a pivotal moment in securing this right for individuals with disabilities.
The recent filing in the ongoing lawsuit, submitted last week, builds upon a case initiated in 2024 by seventeen states challenging the constitutionality of Section 504. The lawsuit initially contested the entire statute, including the 2024 update that added gender dysphoria as a protected disability. Subsequent developments led to several states withdrawing from the litigation in 2025 following changes made by the Department of Health and Human Services regarding care for transgender individuals.
The updated lawsuit argues that the Biden administration’s rulings violate the spending clause and exceed HHS’s authority under Section 504 and the Americans with Disabilities Act, despite the Supreme Court’s validation of the integration mandate in the Olmstead v. L.C. decision. The outcome of this legal battle holds significant implications for millions of Americans, particularly in the wake of Congress’s decision to reduce state Medicaid funding in 2025, a crucial source of care for individuals with disabilities.
If successful, the lawsuit could have devastating consequences for people with disabilities, especially in light of the Trump administration’s efforts to undermine diversity, equity, inclusion, and accessibility initiatives. The fight over disability rights and the integration mandate remains a critical issue with far-reaching consequences for vulnerable populations.
STAT’s coverage of disability issues is made possible by grants from the Robert Wood Johnson Foundation and The Commonwealth Fund. The financial supporters do not influence editorial decisions.
