Disability rights advocates rally at the Missouri State Capitol to protest the state’s participation in a lawsuit that began as an effort to block protections for transgender people but ended in a rollback of protections for people with disabilities. Missouri eventually withdrew from the suit, but five Republican-led states did not. (Photo by Annelise Hanshaw/Missouri Independent)
A court battle that began when conservative-led states sued to block protections for transgender people has ended in a rollback of protections for people with disabilities — a result disability advocates have feared for months.
At the end of August, the U.S. Department of Health and Human Services joined the handful of conservative-led states suing it, and asked a court to strike language from a federal disability-rights regulation that directed states to prioritize serving disabled people in their communities rather than in nursing homes or institutions.
Last week the judge did so, ending the case, Texas v. Kennedy, by removing all mentions of community integration from the regulation that implements a piece of landmark federal disability law known as Section 504.
The Trump administration’s move — along with a June memo from the Justice Department that argued federal law doesn’t require states to provide community-based services for disabled people — marks a sharp about-face for the federal government, which has long been the chief enforcer of such protections.
The change to the Section 504 rule, disability rights advocates fear, will make it harder for disabled people to receive services they need to live in their communities — and to stay out of institutions.
“This affects children, this affects adults, it affects your elderly parents. It affects everyone,” said Charlotte Cravins, a Baton Rouge, Louisiana, attorney whose toddler son Landry was born with Down syndrome and has impaired vision.
Landry receives publicly funded therapies that have helped him learn to crawl, pull himself up to stand, and to use American Sign Language, all while being able to live at home with his family.
But Cravins worries the ruling threatens those gains. Her husband, who was Landry’s main caregiver, recently had to return to work, and so Cravins is now caring for their son while also working. They’re hoping to get Landry assessed for nursing services and other aids that can help with daily living.
“But those services are at risk now of being unavailable,” she said.
A spokesperson for the U.S. Department of Health and Human Services told Stateline in an email that the department “remains firmly committed to protecting the civil rights of individuals with disabilities” and enforcing applicable disability rights law.
“Our commitment to ensuring that individuals with disabilities are treated with dignity, afforded equal opportunity, and are able to meaningfully access community services remains unchanged,” he said.
The U.S. Department of Justice, in an email to Stateline, said the court’s order “answered an ordinary-course request” about updated federal guidance and clarified the “proper scope” of Olmstead v. L.C., the landmark 1999 Supreme Court ruling that people with disabilities have a civil right to live and receive services in their communities rather than institutions.
Previous administrations have relied on Olmstead’s precedent to compel states to provide community-based services.
States that were plaintiffs in the lawsuit have told the court they don’t want federal interference: They said that Biden-era updates to Section 504 unfairly restricted how they’re able to spend money, and prevented them from deciding how best to care for their own residents. They said their budgets, strained by rising costs and workforce shortages, can’t always accommodate expensive services required by the law, and that with smaller Medicaid budgets they’re having to make hard choices. Removing the federal “integration mandate” would give them more flexibility.
“Florida joined this lawsuit to serve as a check on federal power, not to deny care,” Jae Williams, press secretary in the office of Florida Attorney General James Uthmeier, a Republican, told Stateline in a statement.
“Reclaiming state authority gives Florida the flexibility needed to address critical public safety and homelessness issues while ensuring proper care for individuals.”
The resolution of the case “achieves the right balance,” said Sam Curtis, information officer for the Alaska Department of Law, “by keeping historical Section 504 protections in place and vacating only the unlawful new provisions that threatened Alaska’s Medicaid program, home and community based services, and systems of care for Alaskans with complex needs.”
It’s part of this bigger effort from the federal government to walk away from their longstanding commitment to the right to community living.
– Alison Barkoff, director of the Hirsh Health Law and Policy Program at the Milken Institute School of Public Health at George Washington University
But the change to how the feds enforce Section 504 means states may no longer have a federal monitor ensuring they provide community services, disability advocates and experts told Stateline.
“It’s part of this bigger effort from the federal government to walk away from their longstanding commitment to the right to community living,” said Alison Barkoff, director of the Hirsh Health Law and Policy Program at the Milken Institute School of Public Health at George Washington University.
Disabled people still have a legal right to receive community-based services, she said, “but the right is only as good as the enforcement.”
The case began back in 2024, when 17 Republican-led states sued the Biden administration over its inclusion of gender dysphoria as a protected disability under Section 504.
But then the suit morphed into something different.
After Trump was reelected and his administration made clear it would not enforce the Biden rule, several states pulled out of the lawsuit. Their attorneys general scrambled to distance themselves from it, amid a swift backlash from the disability community that warned the suit imperiled federal protections for all people with disabilities.
But in a surprising move, a handful of states chose to stick with the lawsuit. In January, they amended their complaint to ask the court to strike down the Section 504 rule that directs states to provide disabled people services in their communities whenever possible, rather than in institutions such as nursing homes and state hospitals.
By September, more states had dropped out, leaving five — Alaska, Florida, Louisiana, Montana and Texas — when the Trump administration joined them in asking the court to strike the integration provisions.
In an email to Stateline, a spokesperson for Texas Attorney General Ken Paxton, a Republican, connected the lawsuit and its resolution to the original complaint about the inclusion of gender dysphoria, saying it defeated a “woke” rule that “would have endangered disability funding for the sake of promoting the radical trans agenda.” He did not address the removal of the integration mandate.
“This resolution ensures that Texans who rely on Section 504 and disability assistance are fully protected,” he said. “It supports family choice, ensures healthcare providers are able to provide the best possible care to Texans, and guarantees that all protections that existed prior to the 2024 Biden rule are upheld and permanently preserved.”
Barkoff emphasized that the ruling doesn’t change disability rights protections that are baked into other federal laws, such as the Americans with Disabilities Act, and precedent-setting cases such as Olmstead.
“These rights still exist, and people need to understand that,” Barkoff said.
M. Geron Gadd, a senior attorney at the National Health Law Program who focuses on disability rights cases, agreed that the ruling doesn’t eliminate states’ legal requirement to provide community-based services to disabled people.
However, she said, “it can make it much harder for people with disabilities and their families, who often are already struggling, to obtain needed services.”
One practical result of the judgment in this case — and the Department of Justice’s June memo that reinterpreted federal disability law and the Olmstead decision — is that disabled people may have to go to greater lengths, including suing states, to get services if they’re denied them.
The department has already retreated from disability rights cases against states including Florida and Texas, which have long pushed back against Olmstead’s scope in the hopes of persuading the feds to narrow their interpretation of disability law.
In 2023, a U.S. district court found that Florida had kept children with complex medical needs unnecessarily institutionalized in nursing facilities, violating federal disability rights law and the Olmstead integration mandate. The Justice Department filed the lawsuit during the Biden administration. The department shifted its stance this year and asked the court to vacate its decision.
The Justice Department also dropped out of a long-running case centered on claims Texas has been illegally placing thousands of disabled people in nursing homes for decades.
Disability rights groups and advocates have called for protection of federal integration requirements. Late last month, a bipartisan group of congressional representatives cosponsored a resolution to reaffirm Olmstead and the right of disabled people to receive services in their communities. A group of 100 Democratic members of Congress also signed a letter in July calling on the Justice Department to rescind its memo.
Stateline reporter Anna Claire Vollers can be reached at avollers@stateline.org.
This story was originally produced by Stateline, which is part of States Newsroom, a nonprofit news network which includes Louisiana Illuminator, and is supported by grants and a coalition of donors as a 501c(3) public charity.
