Although former Vice President Joseph R. Biden Jr.’s disability proposal is not as comprehensive as the policies rolled out by primary competitors Bernie Sanders or Elizabeth Warren, it does detail countless gains. The Biden plan, released on May 28, covers health care, education, transportation, civil rights, criminal justice, home and community-based services, and long-term services and supports, among other topics.
For everything positive about his proposal, Biden’s promise to reinstate an Obama-era rule overturned by Congress in 2017 depriving mentally ill people with payees under the Social Security Administration of their gun rights — and potentially many other liberties — may make disabled people think twice about voting for him.
Despite this potentially fatal flaw, there are some gains proposed by Biden that disabled people will achieve under his administration.
Here’s what you should know:
According to an article in The Atlantic by Sarah Katz, more than 1,200 employers pay over 300,000 workers with disabilities less than the federal minimum wage of $7.25 an hour. This completely legal status quo is known as subminimum wage, and it disproportionately impacts people with intellectual disabilities.
A 2001 report of the U.S. Government Accountability Office elucidated that only 5% of those employed in a sheltered workshop, where they are often paid pennies on the dollar to perform menial, repetitive tasks, will ever find employment outside one. Biden’s disability plan would phase out such exemptions and guarantee a living wage to all disabled workers.
Furthermore, too often, disabled people are trapped in the throes of guardianship or conservatorship. They may have next to no say in any of their own affairs, and there is often little oversight over the power of courts and family members to make these decisions. Tasks that most people take for granted, such as control over their own finances, where to live or even how they spend their time, are not under their own purview. Depending upon a judge’s decision, they also may not be able to vote.
Under Biden’s plan, however, he would direct the U.S. Department of Justice to review these laws and ensure that disabled people are the stewards of their own destiny and receive their civil rights protections under the Americans With Disabilities Act. Where assistance is needed, the former vice president proposes supported decision-making as an alternative to guardianship.
Social Security Benefits
Although disabled people may receive an income under the Social Security Administration (SSA), they are more than twice as likely to live in poverty as non-disabled individuals. To remedy the systemic issues for those unable to work, the Biden plan advocates for a number of proposals.
For starters, it sets a benefit rate for Supplemental Security Income (SSI) of at least 100% of the federal poverty level. In addition, it will eliminate the so-called benefit cliff for Social Security Disability Insurance, which often forces disabled people to choose between their benefits and gainful employment.
Equally important, the Biden plan will ensure that under SSI, beneficiaries have the “freedom to marry, save or live where they choose.” Under the current system, many individuals on disability cannot marry without losing their benefits, and SSI recipients are forced into poverty because of arcane asset limits. Moreover, Biden will ensure that those who need disability benefits can access them by fully staffing field offices and teleservice centers.
While Biden stops short of advocating a Sanders or Warren-style Medicare for All single-payer program, the former vice president will still ensure that the days of health care being tied to employment are over. This practice otherwise disadvantages disabled people — only 19.3% of people with disabilities are in the workforce. Through a Medicaid buy-in or a new Medicare public option, Biden will work toward universal health care coverage. Furthermore, the Biden plan promises co-pay free primary care.
In a boon to those who take prescription medication, Biden will allow Medicare to negotiate lower drug prices and end the “fail first” insurance company practice that erects barriers to needed medications. Biden’s plan would cease this time-consuming practice of physicians needing to fill out prior authorizations. He also promises to “improve the supply of quality generics.”
Under a Biden administration, steps would be taken to pass a federal mental health parity act. Additionally, home and community-based services will be prioritized and placed on an equal footing with institutions, which represents substantial progress for the disability community.
In a political milieu where it is often more difficult for people with disabilities to secure housing than the general population, Biden promises to invest in building new affordable housing and repairing older developments, as well as expanding community living models. Furthermore, Biden will ensure that everyone who meets the eligibility requirements for Section 8 housing is able to access it. He will also fully enforce housing protections like the Fair Housing Act and will invest in ensuring that older buildings are accessible.
Contrary to the Trump administration, Biden, like his predecessor Barack Obama, would take a “housing-first” approach to homelessness. A housing-first approach would see to it that being sheltered is the number one priority, after which one can meaningfully address any addiction or mental health issues. The former vice president will also ensure that all housing, including new units, are accessible, and that disabled people are given priority for such domiciles.
Health Care Shortcomings
While Biden’s disability plan sounds prima facie promising, the health care proposal he outlines for people with disabilities is murky, at best. Although the former Vice President highlights his mental health advocacy, a Medicare/Medicaid buy-in without a plan to raise the reimbursement rate could mean that people with disabilities are left with substandard health care.
If Biden is able to pass universal healthcare, it may culminate in two tiers of coverage. People working in jobs with good benefits get great health care with access to quality mental health services. In contrast, people with disabilities may face substandard access to mental health care, especially those who are un- or under-employed or need access to home and community-based services and long-term services and supports.
Such is the downfall of Biden’s hodgepodge universal health care plan; it may never aid mentally ill people in achieving the true parity that he promotes in other parts of the proposal.
Gun Rights and Mental Illness
With all the civil rights protections in the Biden plan, conspicuously absent is any guarantor of the right to gun ownership, especially in the context of mental illness. According to Bethany Lilly, director of income policy at The ARC, it was Biden’s office that was behind the Obama-era Social Security payee rule, which was overturned by Trump and Congressional Republicans.
— Bethany Lilly (@bethanylilly) March 4, 2020
Contrary to the reality that mentally ill people are far more likely to be the victims of gun violence than the perpetrators, the policy deprived people with mental health disabilities who had payees of their second amendment right to gun ownership. Even worse, these people would have been flagged in NICS, the national instant criminal background check system. Most jobs require a criminal background check, so listing in this system would make future job prospects bleak.
That Biden makes no mention of the NICS rule on his disability policy page, but advocates for its reinstatement in his gun safety proposal, betrays his lack of commitment to certain fundamental rights for mentally ill people. Ari Ne’eman, co-founder of the Autistic Self Advocacy Network, and other disability advocates fear that rules such as the one Biden hopes to reinstate will set a precedent of incapacity on issues such as parenting and voting rights, among other civil liberties. Biden’s gun policy has consequences for people with mental illness far beyond the ability to own a firearm.
For many people with disabilities, the choice between voting for Biden Jr. and President Donald Trump comes down to which civil rights they wish to preserve. If Biden is not forthcoming about his wish to abrogate the civil liberties of mentally ill people with payees under the SSA, how else will he not be transparent with the disability community?
With all the gains that Biden proposes in his disability policy, it is disheartening for him to so wantonly disregard disabled people’s civil rights because of the mistaken notion that there is any link between mental illness and gun violence. As a result of these pitfalls, the disability community should remain skeptical of a Biden presidency and pressure him to fundamentally change course on the NICS rule.