The September 23 decision in Texas v. Kennedy is a serious step backward for people with disabilities.
The federal court vacated the community-integration provisions in HHS’s 2024 Section 504 regulations, including the definition of the “most integrated setting.” Importantly, the decision did not repeal Section 504, change the Americans with Disabilities Act, or overturn the Supreme Court’s Olmstead decision. But removing these regulatory protections weakens the federal government’s commitment to ensuring that people with disabilities receive services in the most integrated setting appropriate to their needs.
And it raises a basic question: What happens next?
If the answer is more institutionalization, we should understand what that means.
Institutions cost money. People who live in them surrender much of the autonomy and control the rest of us take for granted—when to get up, when to eat, what to wear, where to go, what to do, and with whom to spend their time.
Communities may become less invested in inclusion. Community-based day programs and supported employment may shrink. Families who want a family member with a disability to remain at home may face an impossible choice: Who quits a job to provide support during the day?
And families with the resources to move may migrate to states that maintain stronger protections for community living.
If the federal government believes states will simply absorb the direct and indirect costs of this policy shift, think again.
If elected officials believe families will quietly accept fewer community options, think again.
Disability is not Republican or Democratic. People who need community-based services live in Republican households, Democratic households, independent households, and households that couldn’t care less about politics.
The answer is not to retreat from community living. The answer is to make community living work better.
We need creative planning to expand community-based services. We need honest research about what is working, what is failing, what services cost, and what families actually need. We need better housing, a stronger direct-support workforce, meaningful day programs, supported employment, transportation, and reliable assistance for families.
And we need to understand what institutionalization actually does.
Institutions concentrate control in the hands of administrators and staff. The people living there learn to survive within somebody else’s rules and schedules. Families worry from the outside. Communities lose the presence and contributions of people who should be their neighbors, coworkers, customers, friends, and citizens.
I wrote about this earlier this year because I know something about institutionalization personally. At 13, I spent six months in Shriners Hospital undergoing orthopedic surgeries. Even in a good institution providing excellent medical care, somebody else controlled virtually every hour of my day.
That experience stayed with me.
In 2026, we should be smarter than this.
The question for policymakers now should not be how to make it easier to segregate people with disabilities. It should be how to build community services strong enough that institutionalization is unnecessary.
Congress and state legislatures can also examine whether the community-integration protections contained in the 2024 Section 504 regulation should be written more explicitly into law, rather than leaving such important protections dependent upon changing regulations and administrations.
This should be a question for candidates as well. Ask them where they stand. Ask whether they support the right of people with disabilities to receive services in the most integrated setting appropriate. Then make your own decision at the ballot box.
There is a smart way to address the challenges facing people with disabilities and their families.
Going backward is not it.
Thank you.
Common Grounder
