Disability Positions of the 2020 Presidential Candidates

This year’s election is pivotal, especially in regards to health care, as the United States continues to struggle with containing the COVID-19 pandemic. In order to assist families in choosing which candidate to vote for, this article compiles the policies for each candidate related to disability, health care, and other issues that directly affect people who are medically complex or have disabilities. This article does not contain an endorsement or tell you who to vote for; it simply lists and links the policies of each candidate to help you make your decision.

This year there are only two candidates polling consistently above 3% of the electorate: Joe Biden and Donald Trump. Since there are no seemingly viable third-party candidates, this article will focus exclusively on the two top contenders. Candidates will be listed in alphabetical order throughout the article.

The sources we have used include candidate websites, candidate submissions to disability questionnaires or disability voting events, and other written statements on disability. In some cases, candidates have not included the relevant information on their websites or completed disability questionnaires. In those instances, we have included other verbal/written statements or recorded policy decisions to attempt to provide the most accurate information.

This article will cover five main issues that are particularly relevant to people with disabilities or complex medical conditions:

• Disability Rights
• Health Care and Medicaid
• Home and Community Based Services
• Special Education
• Caregiver Provisions

We recognize there are many other important disability issues, particularly for adults with disabilities. Because we are a child-centered magazine, we have focused most on issues that affect children directly; however, the links to candidate plans and positions in the sections below will yield considerably more information about other important disability-related issues that cannot be included in detail here.

Disability Rights

To evaluate candidate positions on disability rights, we will first begin with how each candidate has discussed disability rights.

For those unable to view the table, candidate Joe Biden has a disability section on his website, completed all three disability surveys, submitted a video to the AAPD POWER Election event, and submitted a video via surrogate to the Respectability Disability Summit. Candidate Donald Trump does not have a disability section on his website, did not complete any surveys, but did submit videos via surrogate to both the AAPD POWER Election event and the Respectability Disability Summit. As of October 2, 2020, Biden mentions disability 132 times on his website, while Trump mentions disability 19 times.

Let’s take a closer look at what information each candidate includes on his website about disability.

Joe Biden’s Disability Platform

Biden includes a section on his website entitled The Biden Plan for Full Participation and Equality for People with Disabilities. This plan has seven main sections:

1. Ensure full inclusion of people with disabilities in policy development and aggressively enforce the civil rights of people with disabilities.
2. Guarantee access to high-quality, affordable health care, including mental health care, and expand access to home and community-based services and long-term services and supports in the most integrated setting appropriate to each person’s needs and based on self-determination.
3. Expand competitive, integrated employment opportunities for people with disabilities.
4. Protect and strengthen economic security for people with disabilities.
5. Ensure that students with disabilities have access to educational programs and support they need to succeed, from early interventions to post-secondary education.
6. Expand access to accessible, integrated, and affordable housing, transportation, and assistive technologies and protect people with disabilities in emergencies.
7. Advance global disability rights.

Detailed plans are presented for each of the seven sections listed above.

Specific to the topic of disability rights, Biden plans to appoint a director of disability policy in his administration, as well as a special envoy for international disability rights. He would also defend current civil rights legislation, including the Americans with Disabilities Act (ADA), Individuals with Disabilities Education Act (IDEA), and the Rehabilitation Act. He would revoke the public charge rule, which limits the abilities of immigrants with disabilities to obtain citizenship. He would work to ratify the United Nations Convention on the Rights of Persons with Disabilities.

Donald Trump’s Disability Platform

Trump does not include a disability section or plan on his website. However, disability is discussed in a news update from July 26, 2020. This update is primarily a list of instances of Trump meeting with people with disabilities, though a few disability-related policies that were enacted during his administration are mentioned as well.

Videos and Surveys

As part of the AAPD POWER Election event, Biden released a video in which he summarizes his full disability rights plan. His completion of various disability surveys reiterate this information, as well as the policies on his website, and are linked above in the table.

Trump has not completed any surveys, but he did submit two videos featuring Lara Trump on disability. The AAPD POWER and Respectability videos include information related to disability and COVID, and discuss previous disability-related accomplishments from the past four years.

Health Care and Medicaid

Health care, and especially Medicaid, is critical for most children with complex medical conditions and disabilities. As we all know, there are current gaps in the system that make it very difficult for some children and their families to access affordable health care. In this section we will outline the proposals by both major candidates for health care and Medicaid.

Biden’s Health Care Plan

Biden’s comprehensive health care plan continues and builds on the Affordable Care Act (ACA or Obamacare). He plans to create a public insurance option similar to Medicare that families can choose to purchase. In addition, his plan makes purchasing health care more affordable by increasing tax credits for insurance purchase. Finally, he closes the loophole for families in the states that refused to expand Medicaid, making these families eligible for the public option at no cost. Under his plan, Medicaid would remain intact.

Additional plans include stopping surprise billing, lowering prescription drug costs, and expanding access to mental and behavioral health. Biden also has a comprehensive health care plan for dealing with the COVID-19 pandemic.

Specific to people with disabilities, Biden’s disability health plan would review and make changes to aspects of Medicaid and Medicare, including improvements in home health, therapies, vision rehabilitation, medial equipment, and assistive technology.

Trump’s Health Care Plan

Trump released a partial health care plan recently. He is actively working to repeal the Affordable Care Act by bringing a challenge against the law to the Supreme Court this fall, after also repealing the individual mandate. A repeal of the ACA would eliminate the following: coverage for those with pre-existing conditions, annual and lifetime caps, Medicaid coverage for low income adults, youth coverage until age 26, coverage for preventative care, essential benefit coverage, and the ability to purchase insurance through ACA marketplaces. It is unclear how Trump would handle most of these changes if the ACA is repealed, as his plan does not discuss them, with the exception of continuing coverage for those with pre-existing conditions. His health plan includes the following additional elements: bringing down drug prices, ending surprise billing, ending HIV/AIDS, and encouraging the use of short-term and association health plans. His plan does not include any information on Medicaid, but he has historically supported block-granting Medicaid, which means giving a fixed number of dollars to states to use for Medicaid.

Home and Community Based Services

Most families want their children with disabilities or complex medical conditions to live at home and fully participate in community life. In order to do so, many children require home and community based services ranging from home nursing and personal assistant services to respite, home modifications, and vehicle modifications. This section contains each candidate’s plan for these services.

Biden’s Home and Community Based Services Plan

Biden’s disability plan contains extensive information on home and community based services. First of all, Biden strongly believes in the Supreme Court Olmstead decision that mandates inclusive living, working, and education in the community for people with disabilities, and Biden states he plans to vigorously enforce it. His plan further states that he will completely end the institutional bias of Medicaid that has historically paid for care only in institutions. He would expand community services to eliminate waiting lists that exist in many states by investing further in Medicaid and increasing the federal portion of the funding for home and community based services.

Biden’s plan supports the right for individuals and families to self direct home and community based services, and would maintain both the Money Follows the Person program, which helps people move from institutions into the community, and the HCBS Rule, which mandates true community settings for those receiving home or community based services. He would also strengthen Medicaid Buy-in programs for adult workers with disabilities so they can both work and receive Medicaid coverage. Finally, his plan invests in direct care workers and makes sure they will be paid a living wage, as well as builds the nursing workforce.

Trump’s Home and Community Based Services Plan

Trump has no published plan for home and community based services and has not passed any legislation related to this topic. Recently, the Centers for Medicare and Medicaid Services under his leadership announced that supplemental funding would be available for the Money Follows the Person program, which aims to move people from institutions into the community. Trump’s plan to repeal the ACA would affect some in-home personal care services by eliminating the Community First Choice Option.

Special Education

Many children with complex medical conditions or disabilities receive some sort of special education services. In this section, we outline how each candidate would address special education for children and young adults. Up to 40% of special education costs are supposed to be paid by the federal government; however, this amount has never been allotted by budgets of previous administrations.

Biden’s Special Education Plan

Biden’s special education plan begins at birth, with investments in home visiting services to monitor infant development, and child development specialists added to community health centers. The plan also would fully fund early intervention (birth to age 3) services for children with disabilities or delays, and would also maintain EPSDT services, which help to screen and treat children with disabilities or medical conditions. His education plan also calls for universal preschool.

Biden’s plan would fully fund special education at the 40% maximum amount and would also triple funding to Title I low-income schools. In addition, the plan would fund sign language interpreters, computer-assisted devices, augmentative and alternative communication, braille materials and increase funding for Parent Training and Information Centers. His education plan asks for the doubling of social workers, nurses, psychologists, and guidance counselors in schools.

Biden’s plan also supports teens transitioning into work and secondary school programs, including an increase in vocational and college programs. He would invest in programs that support students with disabilities to receive an inclusive education at colleges.

Trump’s Special Education Plan

Trump has no published special education plan. His education recommendations have historically included school choice, or using vouchers, scholarships, and tax credits to allow families to choose a school of their choice.

Caregiver Provisions

As parents who care for children with disabilities and complex medical conditions, we need to be very concerned for our own health and financial stability. As such, we have evaluated candidate plans for caregiving and caregivers.

Biden’s Caregiving Plan

Biden has a robust plan for caregiving in general, with additional details related to caregiving for individuals with a disability. This plan includes a general increase in child care and universal preschool, tax credits for parents who are informal caregivers, tax credits to pay caregivers, and Social Security credits for informal caregiving.

His plan invests in Medicaid to eliminate waiting lists for home and community based services, allowing children with disabilities to receive needed home care services, and thereby returning informal caregivers to work, if desired. His plan also allows for families to self-direct services and be paid to provide caregiving services. Lastly, he would also pass legislation to create 12 weeks of paid family leave.

Trump’s Caregiving Plan

Trump currently has no published caregiving plan. As president, he did sign both the Recognize, Assist, Include, Support, and Engage (RAISE) Family Caregivers Act, which charges the government with creating a strategy to address caregiving, and a bill granting paid maternity/paternity leave to federal government workers.

Voting in Your Family’s Interest

It is imperative to take into account how candidates will address disability, home and community based services, special education, health care, and caregiving when voting. We hope this information is helpful in determining which candidate’s plan will best meet the needs of individuals with medically complex conditions and disabilities. We strongly encourage voters to become educated on the plans of both candidates and support candidates who will further the concerns of people with disabilities.