Seven Trends Threatening People With Disabilities
Updated from my earlier post, “Six Trends” to include a seventh and provide updates to the previous six.
When I published “Six Trends” in May 2025, many of you rightly pointed out a seventh: the growing push for MAID legislation in the U.S., similar to developments in Canada.
This updated version incorporates that seventh trend, revisits recent developments on the original six, and offers fresh reflections on how we can respond.
Introduction
Various scattered developments have continued to converge into deeper trends that threaten the lives of people with disabilities. It’s hard to discern the real threats, let alone know what to do about them, so here’s my effort to help make sense of it.
Each of the seven sections offers personal and communal responses and assumes you know at least one person who may be affected.
These response lists aren’t prescriptions but prompts to help you consider what you might do with and for that one person. And while the news is constantly shifting and impossible to summarize perfectly, the underlying insights remain applicable at all times.
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NOTES:
Updates are as of December 1st 2025. News may change beyond this point. Corrections are welcome in the comments.
1. Erosion of Disability Rights Guidance and Enforcement
In March 2025, the DOJ rescinded 11 guidance documents that had long helped institutions understand how to comply with the Americans with Disabilities Act (ADA).
On July 29, 2025, the DOJ released new guidance defining what it labels “illegal DEI” practices. Federal programs may grow hesitant to offer initiatives that specifically support people with disabilities, for fear such efforts appear to provide “preferential treatment.”
While the document affirms nondiscrimination, it may discourage proactive inclusion unless it is framed as universally open to all. The problem, of course, is that disability-specific supports are precisely what make meaningful and equal access possible in the first place.
The ADA remains law, but enforcing rights and navigating the culture wars surrounding them will become harder.
How we can respond:
Practice wisdom that is grounded in the whole person. Protection and support should reflect a person’s strengths, preferences, and aspirations and not just their needs for accommodations.
Strengthen valued roles. This increases opportunities for others to see the person’s competencies and contributions beyond the disability label.
Emphasize strong relational ties which possess the inherent ability to lift a person’s social status. Families, voluntary advocates, and loyal friends provide a level of protection that systems alone cannot.
2. Autism Research
On September 22, 2025, RFK Jr. claimed that Tylenol causes autism.
Medical leaders, including Dr. Fleischman, president of the American College of Obstetricians and Gynecologists, warn RFK’s statements create harmful confusion for pregnant women.
A 2024 Swedish study published in JAMA found no association between prenatal acetaminophen use and autism or other neurodevelopmental disorders. A separate review in Environmental Health (the study RFK cited) suggested a possible link but clearly stated that pregnant women should not avoid acetaminophen when medically necessary.
Meanwhile, despite limited evidence, demand for Leucovorin has grown following policy announcements that support its use in autism-related treatments. This reflects the desperation many families feel, underscoring the need for compassionate, well-informed guidance.
How we can respond:
Understand that the dangers lie not simply in misinformation, but a renewed slide toward stigmatizing and dehumanizing views of disability. A purely data-driven or medicalized approach to autism, without personal and relational understanding, risks reducing people to symptoms and statistics instead of listening to them, their families and honoring their full stories.
Acknowledge families’ pain and longing for help, while also promoting a broader frame for their children’s needs. Recognize the difference between addressing physiological concerns and nurturing social, emotional, and spiritual well-being.
3. Special Education Oversight Shift
Fifty years ago, most children with disabilities were either excluded from public schools or sent to institutions. That began to change with what was called the 1975 Education for All Handicapped Children Act (now IDEA) which guaranteed (though never fully actualized) every child the right to a free and appropriate public education alongside their peers and created federal oversight to protect that right.
As of late 2025, the Department of Education is considering transferring IDEA programs to the Department of Health and Human Services. Brookings says that such a shift would significantly alter IDEA’s funding and accountability structures.
IDEA may remain law, but without meaningful funding and enforcement, its guarantees risk becoming hollow, leaving families to fight harder for a proper education and a true place in our schools.
How we can respond:
Be the watchdog and put more efforts on parent advocacy groups and other voluntary associations that are holding the IDEA intact and upholding its promises.
Support schools. When systems weaken, communities must adapt. Strengthen IEP teams, support educators, and leverage local networks to sustain learning and inclusion.
Invest in extracurricular activities, both as a safety net and as a vital part of a child’s development, consider seeking out or organizing artist collectives, athletic groups, social gatherings, and other grassroots spaces for connection and growth.
4. Federal Budget Cuts
A 2025 federal budget law includes the largest Medicaid cuts since the program was created, projecting that 10 million more people will be uninsured by 2034. The goal, in part, is to roll back a portion of the more than 40 million Americans who gained Medicaid coverage after its expansion began in 2012.
Medicaid Work Requirements
A new Medicaid work requirement, scheduled to take effect in 2027, will require millions of low-income adults to regularly verify that they are working, volunteering, in school, or otherwise exempt in order to keep their health coverage.
The policy applies to poor, childless adults ages 18–64 who are considered “able-bodied,” as well as parents of older teenagers.
The two primary issues disability advocates have raised are, first, that those considered “truly vulnerable” are being too narrowly defined. For example, people with disabilities who are difficult to diagnose or lacking clear medical records may technically qualify for exemptions but still be unable to prove it.
Second, when work requirements were tried in other states such as Arkansas in 2018, a judge stopped the provision nine months later, saying it was contrary to the purpose of the Medicaid program and did not increase employment or community engagement.
Housing
The administration plans to sharply cut funding for HUD housing programs and redirect the remaining money to programs that require people to work or enter treatment in order to keep their housing. This shift would significantly reduce support for permanent supportive housing, which primarily serves people with disabilities, and could put many formerly homeless tenants at risk of losing their homes.
In short: it moves away from a Housing First approach and toward a “treatment-first,” compliance-based system.
A Lesson From SNAP Benefits
The recent government shutdown and the game of chicken played over cutting SNAP benefits illustrate how this level of dysfunction disproportionately impacts the poor.
Some of the people with disabilities we support through Do For One have worked hard to establish grocery routines, yet these sudden, unannounced changes create challenges.
One woman in our community who is blind can’t easily adjust when her usual food source changes, and another who cannot read or use the internet struggles to locate local pantries or community meals.
Yet, this also illustrates what communities can do when they invest in one another.
Because relationships were already in place, we witnessed:
Advocates who were already planning to go grocery shopping with their Partners.
Partners who found calm simply because they had someone they could call.
And in one case, an Advocate who had just lost their job worked with their Partner to find support for them both.
We call this a practice of abundance, where not only needs are met, but it creates moments of shared joy. Just the other day, one Advocate shared that her Partner “baked her own cake!” and sent a group photo with a note explaining, “The rest of the people in the picture are from the café where she spends time. This is another story for the DFO wave!”
Do For One is a relationship-building program that brings isolated people into greater community life. We selectively match one person with disabilities (‘Partner’) with another person who enjoys a more socially included life (‘Advocate’).
How we can respond:
Check in with people who may be affected. Ask what they are worried about right now and whether they need help navigating the uncertainty. Follow up in the months and years to come as policies continue to shift.
Be present when important decisions need to be made. Sit with someone as they make phone calls, go with them to appointments, and assist them in completing applications or renewals.
5. Social Security and Access Barriers
People with disabilities are asked again and again to prove their eligibility, while states rush to build new systems that are underfunded and hard to navigate.
Many who should still qualify lose coverage—not because they are ineligible, but because they cannot keep up with the complex requirements. This burden falls heaviest on people with cognitive, psychiatric, or less visible disabilities, who may technically qualify for exemptions but struggle to prove it, or even to learn about and access the new processes.
It’s a bit like that SNL airline sketch where the customer asks for a refund and the agent admits, “We are trained to say no and see if people just accept it. But I see you won’t, so I’ll transfer you to someone who can assist.”
How we can respond:
Sit with your loved ones during important calls, accompany them to appointments, and help with applications so they don’t slip through the cracks or lose benefits they’re entitled to.
Be persistent. Don’t give up until you’ve exhausted all options, and seek second and even third opinions when needed.
6. Public Attitudes
Efforts toward inclusion are increasingly dismissed as merely part of a culture war or political correctness—leaving people with disabilities caught between outdated medical models and politicized debates about identity.
One may say, “Just ignore the haters. It’s what is written in the law that counts.” However, public attitudes often shift before policies do. For example, when there is an assumption that most people receiving assistance could work if they wanted to, certain lives are treated as burdensome and costly, and exclusion (even unto death) becomes easier to justify.
How we can respond:
Keep sight of human dignity. Don’t let fear of sounding too progressive or too conservative (depending on the issue and your surroundings) distract you from the truth that every person has value and deserves a fair chance at life.
Commit to relationships and belonging. Show through consistent love that no one is a burden to be managed, and that when people with disabilities are brought into community life, everyone benefits .
Honor disability on its own terms. While solidarity with other marginalized groups can certainly be appropriate and meaningful, disability is its own broad, diverse, and complex reality that deserves to be understood as such. Some assume people with disabilities must all have the same political views, they do not. People with disabilities are able to hold their own views individually—just like everyone else.
7. The Normalization of Medical Assistance in Dying (MAID)
As of June 2025, Medical Aid in Dying (MAID) is legal in 11 states and the District of Columbia, with Delaware the most recent to adopt it.
MAID is said to be available to mentally competent adults with a terminal illness and a life expectancy of six months or less, verified by two healthcare providers.
If Canada gives us any indication of where this is heading, we will likely see not only an increase in deaths but also an expansion of who is eligible for such assistance. Canada legalized MAID in 2016 and it is now the 5th leading cause of death in Canada.
As debate grows over whether psychological suffering, disability, or chronic pain should qualify someone for assisted death, death itself risks becoming normalized as a “treatment” especially for those already seen as burdensome.
Disability advocates say that expanding MAID under conditions of economic and social abandonment effectively offers death as the cheapest form of care. U.S. nursing homes will become the frontline of pressure toward assisted suicide, especially for residents without any visitors who are perceived as difficult or costly to care for.
How we can respond:
Be clear with your language. Medical language shapes how we understand death. When we speak about Medical Aid in Dying, we need to recover the moral clarity that our detoxified language obscures. We are not describing a neutral clinical procedure but the intentional ending of human life.
Be clear about who is responsible. Increasingly, physicians are guided less by the Hippocratic Oath and its duty to preserve life, while the shift from “physician-assisted dying” to “medical aid in dying” moves moral agency away from the physician and places it squarely on the person who is suffering. This reframes the act so that it is understood less as an act performed by professionals and more as a personal, autonomous choice by the patient. As Dr. Jack Kevorkian, famously known as “Dr. Death,” once said, “This is the ultimate self-determination, when you determine how and when you’re going to die, when you’re suffering.”
Expand options toward living and eliminate the demand. This means addressing the loneliness, abandonment, and sense of being a burden that often lead individuals to consider suicide. The heart of the solution is a ministry of presence, offering freely-given friendship with the elderly and disabled people living alone in nursing homes and other neglected places.
This third point, of course, is at the heart of Do For One.
Do For One in 2024: a community practicing presence and resistance through committed, freely-given friendships across differences.
Conclusion
Taken together, these seven trends revive certain elements of the logic that once justified institutionalizing children and adults, even if the context today is different. To understand what is required of us today, it may reinvigorate us to revisit how and why institutionalization came to be justified and what parents and other advocates did to resist dehumanization and accomplish reform.
How and Why Institutionalization Came to be Justified
First, society claimed it needed protection from people with disabilities, and that people with disabilities needed protection from society.
Second was a growing scientific and intellectual elitism that pushed aside Judeo-Christian and moral-philosophical traditions in favor of materialistic science. This mainstreamed Social Darwinism and broad fears about genetics.
Third was a strong pull toward efficiency, cost-saving, and institutional convenience. Budgets and administrative order were valued above human life and personal dignity.
Finally, through all of this were “noble” disguises and detoxified language. Death reframed as mercy, and human oppression and control boasted as state-of-the-art care.
What Parents and Other Advocates Did
Parents and allies contributed to change through three stages that outline the historical pattern, even if they didn’t always unfold sequentially.
First came the stage of addressing urgent needs and stopping abuse wherever it was happening.
Second was advocating for better policies, stronger oversight, and systems that could prevent harm from happening again.
Finally came the stage of rebuilding, which involved creating grassroots, faith-based, and community-driven efforts that offered lasting protection and real belonging beyond what any formal system could provide.
NOTE: Dr. Wolf Wolfensberger studied the patterns that led to institutionalization as well as strategies that led to the de-institutionalization movement. These last two paragraphs were drawn from two of his works: A Multi-Component Advocacy–Protection Schema and Voluntary Associations on Behalf of Societally Devalued People.
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So thankful for your work and articulation, Andrew. Looking forward to continued conversation and collaboration in the new year.