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HOUSTON, TX-Texas is leading a group of conservative states, with the backing of outgoing President Donald Trump, in a legal battle to have the sprawling health care law struck down. Texas argued last month before the U.S. Supreme Court that when Congress in 2017 eliminated the individual mandate, a tax for people who do not obtain health insurance, the rest of the law became unconstitutional.
A ruling is expected to come next year, and for Halvorson and 3 million other disabled Texans, the stakes feel impossibly high.
Without the Affordable Care Act, disabled Texans stand to lose programs that have allowed more people to stay in their homes, rather than state-run institutions. And like many Americans, they fear they could again face insurance companies that would deny them coverage because they have preexisting conditions.
“The ACA was a huge deal in terms of fairness for insurance for all Americans, but certainly for people with disabilities,” said Brian Shannon, a law professor at Texas Tech University who has served on the Governor’s Committee on People with Disabilities.
Texas is one of eight states that opted into the Community First Choice Option program, made possible by the ACA. The Medicaid program gives states funding to help keep disabled people in their homes who might otherwise end up in nursing facilities or other institutionalized care.
“It can provide personal assistance services to [have] someone in your home to help you with cooking and cleaning, to help you with personal tasks like toileting or grooming,” said Silvia Yee, senior attorney at Disability Rights Education. “It can help with support systems that a person with a disability might need to stay in the community.”
Before CFC, the state primarily relied on home- and community-based services, a Medicaid waiver, to provide at-home care for people with disabilities.
But there are more than 100,000 Texans on a waiting list to receive those services, and some people will wait more than 15 years before their number is called.