Presidential Candidates and disability policy

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Most of the top contenders for the U.S. Democratic presidential nomination have released comprehensive plans for disability policies. To a one, the policies call greater attention than in past elections to problems that affect people with disabilities — including those with autism.

As of 3 March, former New York City mayor Michael Bloomberg is the only Democratic candidate who has not released a policy. For a comparison of the various plans, click on each candidate’s photo — to the left on your desktop, or at the bottom of the article if you’re reading this on your mobile device — to see where they stand on the issues.

Compared with the Trump administration, most of the Democratic primary hopefuls’ platforms are also more favorable for autistic people and autism researchers, promising to provide more money for research and public-health funding.

Presidential hopefuls have never paid this much attention to disability policies or to autism research, disability advocates say, but it is politically savvy given that more than one in four people in the United States have a disability. The most promising policies come from candidates who have consulted with autistic self-advocates and others with disabilities.

“This is the first time where I’ve seen multiple candidates actively courting the disability community as an important constituency, an important voice,” says Kristie Patten Koenig, associate professor of occupational therapy at New York University. “With that central advisement and involvement, we’re seeing some of the best plans.”

For example, Senators Bernie Sanders and Elizabeth Warren have both consulted with Ari Ne’eman, co-founder and former president of the Autistic Self-Advocacy Network. Ne’eman served on the disability advisory committees for Barack Obama and Hillary Clinton in 2008 and 2016, respectively, and was appointed to President Obama’s National Council on Disability.

“In this [election] cycle, I think we’ve probably come further than we have ever before,” Ne’eman says.

Many experts say candidates Joe Biden and Bloomberg’s platforms are poorly thought out and worrisome, whereas Sanders and Warren have the broadest, most impactful policies.

“The thing that stood out to me was the thoroughness of Sanders’ and Warren’s plans,” says Finn Gardiner, communications specialist at the Lurie Institute for Disability Policy at Brandeis University in Waltham, Massachusetts.

Both senators address classroom inclusion, interactions with law enforcement, employment and sub-minimum wages more thoroughly than other candidates have, he says.

Sanders and Warren also both have plans for student loan forgiveness, which could benefit adults with disabilities, Gardiner says.

Almost all of the Democratic candidates have proposed increasing federal funding for the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH). For example, Warren has proposed $100 billion in guaranteed, mandatory spending for new NIH research over the next 10 years. And Sanders has proposed increasing funding for research on lifespan issues, such as community support and housing, for people with disabilities.

By contrast, President Donald Trump’s 2021 budget request proposes to cut funding for the NIH by 7 percent, or more than $2.9 billion.

The Trump administration has requested to eliminate funding for Leadership Education in Neurodevelopmental and Related Disabilities training, which teaches professionals how to provide better care for children with autism or related conditions. The administration has also proposed cutting 30 percent of the funding from the CDC’s National Center on Birth Defects and Developmental Disabilities, which compiles data and provides community services to Americans with disabilities.

Because the candidates have relied heavily on input from disability policy experts and advocates, most are not prepared to give articulate responses to probing questions, says Reyma McCoy McDeid, executive director of the Central Iowa Center for Independent Living in Des Moines. In a video posted in 2019 by the Disability Rights Center New Hampshire, for instance, former candidate Pete Buttigieg spoke about the need to include people with disabilities in crafting policy but was light on details.

“I appreciate that that feedback has been sought out, but I do wish that the candidates themselves were more well versed on the material that their plans contain,” McDeid says. Biden’s platform in particular seems poorly cobbled together, she says.

“That just signals a whole bunch of red flags for me and tells me that this is a candidate that, one, does not take this constituency seriously,” she says.

Buttigieg dropped out of the race on 1 March, and Amy Klobuchar dropped out the following day. As the field narrows, disability policies could help voters make up their minds about which candidate to support.

But campaign promises do not always become a reality, McDeid says.

“Within the disability community, we can celebrate that we are front and center as far as plans are, but we should also prepare for the inevitable letdown as well.”

BY JOE BIDEN / 3 MARCH 2020
General research funding
N/A

Secondary education and jobs
N/A

Early intervention and primary education
Fully fund the Individuals with Disabilities Education Act within 10 years.
Double the number of psychologists, guidance counselors, nurses, social workers and other health professionals employed in U.S. schools.
Partner with colleges to expand the pipeline of these professionals.

Housing policy
N/A

Criminal justice
Train police officers to interact with autistic individuals, deaf individuals and others.

Healthcare
Preserve the Affordable Care Act.
Protect Medicaid.
Double investment in community health centers.

For caregivers
Provide a $5,000 tax credit to caregivers who are providing long-term care.

Drug pricing
Establish an independent review board to assess and recommend prices for novel drugs.

Miscellaneous
N/A



BY MIKE BLOOMBERG / 3 MARCH 2020
General research funding
Require royalty payments to the government for intellectual property (drug research) that the NIH sells to private companies.

Secondary education and jobs
N/A

Early intervention and primary education
Issue grants to encourage states to enact universal preschool.
Housing policy
Provide housing vouchers to all Americans at or below 30 percent of the local median income.

Criminal justice
Expand access to alternative-to-incarceration programs.
Implement crisis-intervention teams with mental health professionals for 911 responses.

Healthcare
Expand Medicare to cover routine dental, hearing and vision checkups.
Put a $2,000 cap on Medicare beneficiary out-of-pocket spending.
Expand enrollment in the Affordable Care Act by restricting the sale of health plans that don’t meet the act’s standards.
Expand Medicare to include an optional policy covering dental, hearing and vision care, and Medicaid to require oral health services.

For caregivers
N/A

Drug pricing
Cap drug prices at 120 percent of the average price among other Western countries.
Ban drug company payments to pharmacy benefit managers.

Miscellaneous
Expand the National Health Service Corps.


BY BERNIE SANDERS / 3 MARCH 2020
General research funding
Expand funding within the Institute for Education Sciences for research on how early-childhood professionals can best support children with disabilities.
Double the budget of the National Institute for Disability, Independent Living and Rehabilitation Research.
Require the NIH grant-review processes to include people with disabilities as reviewers.
Require that at least half of each condition-specific advisory committee, such as the Interagency Autism Coordinating Committee, is composed of individuals with the relevant disability.
Expand pre- and postdoctoral training grants for researchers with disabilities.
Re-authorize the Autism CARES Act with provisions to increase the proportion of autism research funding allocated to the needs of autistic adults.
Grow the representation of autistic people and others with developmental disabilities in disability programs.
Permanently re-authorize the Patient Centered Outcomes Research Institute created by the Affordable Care Act.
Establish a Center for Clinical Research within the NIH to develop and test drugs for conditions with limited or expensive treatment options.
Create a prize model to spur innovation for drugs.

Secondary education and jobs
Abolish sub-minimum wage.
Devote $50 billion over the next decade to expand career and technical education opportunities to prepare students for well-paying community employment.
Require universities to have a minimum number of full-time University Disability Services personnel.
Create a federal jobs guarantee that would include workers with disabilities.
Increase the budget of the Employment Equal Opportunity Commission, and provide funding for employment ‘testers’ to address disability discrimination.

Early intervention and primary education
Fully fund the Individuals with Disabilities Education Act.
Establish universal childcare and preschool.
End restraint and seclusion in schools through the passage of the Keeping All Students Safe Act.
Invest in expanding access to augmentative and alternative communication for students who need communication assistance.
Lower the age at which schools must begin transition planning for students with disabilities from 16 to 14.

Housing policy
Build nearly 10 million permanently affordable, accessible homes to fully close the gap in affordable, accessible housing units.
Fully fund housing-choice programs.
Encourage zoning and development designed to maximize the number of housing units accessible to people with disabilities.

Criminal justice
Make discriminatory law enforcement interactions with people with disabilities a major enforcement priority of the Civil Rights Division.
Fund police training on bias and how to interact with people with disabilities.
Create a civilian corps of unarmed first responders for mental health crises, such as social workers, emergency medical technicians and trained mental health professionals.
End solitary confinement for people with disabilities.

Healthcare
Create a single-payer healthcare system, including long-term services and supports, dental and vision.
Instruct the Department of Justice and the Health and Human Services Office of Civil Rights to issue rules protecting people with disabilities against healthcare discrimination.
Issue an executive order instructing the secretary of Health and Human Services to incorporate people with disabilities into the agency’s definition of medically underserved populations.

For caregivers
Issue guidance through the Department of Education to require consideration of supported decision-making as part of post-secondary transition planning and to prevent schools from unnecessarily funneling students with disabilities into guardianship and conservatorship.

Drug pricing
Allow Medicare to negotiate with big drug companies to lower prescription drug prices.
Allow patients, pharmacists and wholesalers to buy low-cost prescription drugs from Canada and other industrialized countries.
Cut prescription drug prices in half by pegging prices to the median drug price in five major countries: Canada, the United Kingdom, France, Germany and Japan.

Miscellaneous
Create a National Office of Disability Coordination, run by a person with a disability, to protect the civil rights of people with disabilities.


BY ELIZABETH WARREN / 3 MARCH 2020
General research funding
Provide $100 billion in guaranteed, mandatory spending for new NIH research over the next 10 years to support people with disabilities.

Secondary education and jobs
Abolish sub-minimum wage.
Raise the number of people with disabilities in federal service to 14 percent of the overall workforce.
Fully fund the Office of Disability Employment Policy.
Early intervention and primary education
Fully fund the Individuals with Disabilities Education Act, plus $20 billion.
Increase funding for early intervention.
Establish universal childcare.
Implement Department of Education regulations to ensure that students of color with disabilities are treated fairly when it comes to identification, classroom placement, services and accommodations, and discipline.

Housing policy
Add more than 3 million new affordable housing units, and prioritize a portion of these units to people with disabilities.

Criminal justice
Pilot non-police mental health crisis response teams.

Healthcare
Create a healthcare system that will eventually be single payer and that covers dental, vision and long-term services and supports.

For caregivers
Create a Social Security credit for caregivers of family members.

Drug pricing
Cap drug prices at 110 percent of the average
international market price.
Remove the limit on the number of drugs for which Medicare can negotiate prices.

Miscellaneous
N/A