Myths & Facts

The bill doesn't address Medicaid's institutional bias.

Although the bill does not change the Medicaid program itself, it gives individuals who are institutionalized or at risk of institutionalization an enforceable civil right to live in freedom. It requires state Medicaid programs to ensure people not only have a right to live in the community, but to be fully integrated and lead an independent life. The bill goes beyond Medicaid, extending protection to non-Medicaid LTSS providers, including insurance providers. That's why we call this the fight for Disability Freedom.

The Supreme Court already affirmed this right in Olmstead, so we don't need another law.

The Olmstead decision affirmed that Title II of the ADA required states to provide LTSS in the most integrated setting, but it was not a full endorsement of Disability Freedom and is limited in real ways. LRFA clarifies and strengthens the integration mandate by:

• Creating a direct, clear statutory requirement for community integration regarding LTSS;
• Adding managed care organizations as directly covered entities;
• Establishing a new, stronger definition of "community-based";
• Reducing the threshold of protection from "at serious risk of institutionalization" to "at risk of institutionalization";
• Eliminating the treating professional's role in deciding whether community integration is appropriate;
• Establishing specific prohibitions addressing systemic discrimination that is currently permissible — and rampant;
• Requiring public entities to address affordable, accessible, integrated housing independent of service delivery;
• Eliminating the fundamental alteration defense;
• Requiring public entities and MCOs to complete a self-evaluation with substantial public participation;
• Requiring a transition plan with milestones and benchmarks; and
• Establishing the ability to secure legal representation and punitive damages.

By the same logic that says we don't need this bill because we have Olmstead, advocates could have argued we didn't need Title II of the ADA because we already had Section 504. That clearly wasn't true.

The Olmstead decision isn't at risk.

Only one member of the Court that decided Olmstead remains on the bench: Justice Clarence Thomas, who dissented and outlined how he would reverse the decision. Congress recognized a similar threat to same-sex marriage and took bipartisan action to enact the Respect for Marriage Act. Freedom is as fundamental as marriage — LRFA is bipartisan legislation that would protect and expand the right to community integration in statute, where it belongs.

Most Disabled people can't get a lawyer, so LRFA wouldn't change anything.

Access to legal services is a serious problem in enforcing civil rights law generally, and the situation is worse for Black and Indigenous People of Color (BIPOC) with disabilities. LRFA addresses this directly: Section 8(a)(3) authorizes courts to appoint an attorney for Disabled individuals who have experienced discrimination and to waive fees, costs, or security. The bill also allows individuals to collect actual and punitive damages — which both penalizes violators and makes it easier to secure legal representation, since punitive damages increase what an attorney may recover for the case.

LRFA doesn't help people with mental health disabilities.

LRFA is broader than Medicaid-based bills, so it addresses the needs of people institutionalized in facilities that Medicaid doesn't fund. Its broad definition of Instrumental Activities of Daily Living — crafted with the Bazelon Center for Mental Health Law and the National Coalition for Mental Health Recovery — includes support for communication, interpersonal relationships, goal-setting, and crisis transitions. The bill also requires assistance with "short-term, intermittent or emergent" LTSS needs, and hospitals are already defined as institutions under the law — so people at risk of psychiatric hospitalization because emergency support wasn't provided are protected.

People just put Latonya Reeves's name on the bill. She didn't do anything important and didn't even support it.

This is untrue and wildly offensive. Anyone who has been with ADAPT over the decades and fought for Disability Freedom alongside Latonya Reeves knows the truth. Rather than read her story, watch Latonya tell it herself.

LRFA doesn't do anything for 10 years.

This is unfounded. There is no delayed effective date in the bill — when it's signed into law, the definition of discrimination and the right to take legal action apply immediately. An individual at risk of institutionalization because of a state budget cut or a managed care reduction could take action right away. The 12-year transition window applies only to larger structural changes, like building out housing capacity, and even then the bill requires entities to act "as soon as practicable" — not to wait out the clock. The self-evaluation and transition plan process requires meaningful advocate participation, and entities must publicly report progress annually, giving advocates real accountability tools throughout.

This bill doesn't help Disabled people in BIPOC communities.

Disability Freedom depends on more than Medicaid LTSS — affordable, accessible, integrated housing and transportation are just as critical, and their absence disproportionately impacts BIPOC Disabled people, who research shows are more likely to be institutionalized because they have less access to home and community-based services, housing, and transportation. Legislation that expands Medicaid HCBS without addressing housing and transportation barriers would simply reinforce that structurally racist pattern. LRFA requires a comprehensive plan that includes transportation, and defines a failure to ensure affordable, accessible, integrated housing as a form of discrimination.

Republicans won't support a civil rights bill for Disability rights and freedom.

There is a long history of bipartisan support for disability rights: President Nixon signed the Rehabilitation Act of 1973 (after vetoing two earlier versions), and President George H.W. Bush signed the ADA in 1990. This legislation itself was introduced by Republican Rep. Chris Gibson (R-NY) in the 114th Congress, then carried by Rep. Jim Sensenbrenner (R-WI) in the 115th and 116th Congresses, where 17 Republicans signed on as cosponsors — including strongly conservative members like Reps. Ken Buck (CO), Greg Gianforte (MT), Doug Lamborn (CO), Cathy McMorris Rodgers (WA), Elise Stefanik (NY), Scott Tipton (CO), and Don Young (AK).

Members of Congress just cosponsor to placate activists — it doesn't mean they support the bill.

Cosponsors make a bill more attractive and demonstrate support in Congress. Since only about 4% of bills ever become law, a strong cosponsor list is one of the clearest ways a bill stands out — and one of the only tools advocates have to gauge whether a member supports an issue. Cosponsor counts also unlock procedural tools: a bill that holds 290 or more cosponsors for 25 legislative days can be placed on the House's Consensus Calendar, which the Speaker must schedule from almost every week. Every cosponsor matters, mechanically as well as symbolically.

LRFA would force Disabled people out of institutions.

States are only required to ensure people have a choice to live in the community — the bill provides community-based LTSS only if the individual "selects such services and supports." At the request of advocates for community integration, a construction clause was added ensuring the bill cannot be interpreted as requiring anyone to live in a more integrated setting than they choose (Section 4(d)(1)(C)).

We have to choose between a civil right and reforming Medicaid and the LTSS system.

Not true — these efforts need to be coordinated. If the federal government took full responsibility for Medicaid and cut states out of the system, Olmstead's protections (an interpretation of ADA Title II) could be wiped out along with them. Other proposals that centralize control over which LTSS services are offered risk leaving people who need a specific service unprotected. A statutory civil right guards against both outcomes.

People with significant disabilities need to be in institutions.

Untrue. As Latonya demonstrated, you may not be able to get what you need where you are, but somewhere in the U.S. you can live in freedom. If our movement accepts that some Disabled people "must" be institutionalized, we're conceding it's permissible to deny some Disabled people their rights to Life, Liberty, and Freedom — the only question becomes who loses their rights, and where that line is drawn. Our movement needs to fight for every Disabled person, not just a privileged subset of our community.

This bill wasn't written by professionals, so it can't be good legislation.

You don't need a title to understand this issue — the people who understand it best often don't have one. This bill was crafted by Disabled activists directly impacted by the issue it addresses. That's a strength, not a weakness.

A programmatic solution is better than a civil right.

We tried that. States that implemented the Community First Choice Option were supposed to level the playing field between institutional and community-based care — some states used enhanced pandemic-era funds to shore up institutions or insurer margins instead. ADAPT worked for decades on program bills without gaining real traction: the Community Choice Act of 2009 topped out at 131 House cosponsors, while this bill drew 238 in the 116th Congress and 202 in the 117th. An enforceable civil right for all Disabled people will broaden support for programmatic solutions, not compete with them.

LRFA doesn't address attendant wages.

Section 4(b)(6) defines discrimination as "a failure to establish an adequate rate or other payment structure that is necessary to ensure the availability of a workforce sufficient to support an individual with an LTSS disability in living in the community and leading an independent life." If rates are too low to attract attendants, Disabled people affected by the shortage can sue.

LRFA doesn't address housing.

Failing to ensure sufficient affordable, accessible, and integrated housing is defined as discrimination under LRFA. The bill also recognizes that housing tied to services can limit autonomy even when the housing itself is otherwise adequate — so it requires that individuals have the option to live where LTSS is not tied to tenancy. LRFA doesn't eliminate assisted living or group homes where housing and services are bundled; it just guarantees the option to live somewhere else without losing housing when changing providers.

LRFA doesn't address emergencies.

Section 4(b)(7) requires services on an intermittent, short-term, or emergent basis — covering situations like an attendant not showing up, a sudden change in someone's condition, equipment breaking down, or a storm displacing people who rely on LTSS.