Lawsuit raises concerns over disability rights for millions of Americans

By Pooja Mamnoor

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    3/17/25 (LAPost.com) — Jennifer Kucera, a 55-year-old Ohio resident with muscular dystrophy, relies on daily caregivers to help her get out of bed, bathe and dress. Without these services, she would likely be forced into institutional care.

“I am basically fighting for my life,” Kucera said to The Washington Post. “It is frightening because this lawsuit could affect everything.”

The lawsuit Kucera refers to, Texas v. Becerra, was filed last year by Texas Attorney General Ken Paxton in response to updated regulations in Section 504 of the Rehabilitation Act of 1973, a landmark federal law prohibiting disability discrimination.

The case has triggered alarm among millions of disabled Americans who depend on Medicaid for legally mandated services that allow them to remain integrated in society.

Section 504 specifically prohibits any entity receiving federal funds from discriminating against people with disabilities. The updated regulations focus on ensuring equal access to medical treatments and websites, providing accessible communications, and integrating disabled people into society to the fullest extent possible.

The lawsuit asks the court to prevent the new regulations from being enforced and to “Declare Section 504, 29 U.S.C. § 794, unconstitutional.” This language has sparked concerns among disability advocates and legal experts who believe the law is being targeted.

Many of the 17 attorneys general participating in the lawsuit have stated they want to prevent the inclusion of gender dysphoria in the definition of disability, not overturn Section 504 entirely. The preamble to the updated regulations includes an acknowledgment that gender dysphoria may, in some cases, be considered a disability under Section 504, based on a 2022 ruling from the U.S. Court of Appeals for the 4th Circuit.

“Despite the considerable misinformation about this lawsuit, the intent of this lawsuit was never to ask the Court to declare all of Section 504 unconstitutional or to in any way reduce funding for disabled children and their families,” South Dakota Attorney General Marty Jackley wrote in an emailed statement.

However, disability advocates and legal experts point to the lawsuit’s text, including a subsequent joint report filed in February, as evidence that Section 504 itself is at risk. The lawsuit characterizes the Rehabilitation Act as “coercive spending legislation” that forces states to choose between complying and losing federal funding.

“They are using these mealymouthed, tricky phrasings to try and confuse people and mislead people to think that this is a narrow challenge, and it absolutely is not,” said Claudia Center, legal director for the Disability Rights Education & Defense Fund, a nonprofit law and policy organization.

The joint filing states the lawsuit challenges “any purported application of [the law] to funds that are not authorized by the Rehabilitation Act.” According to Alison Barkoff, a disability law expert and professor at George Washington University who worked on the updated regulations, this challenges nearly every area where the law is applied, such as schools, hospitals, and public transportation.

“They did not change anything about the complaint. They did not drop the unconstitutional claim. They doubled down,” Barkoff explained. “This would be a complete change from how Section 504 has been applied for 50 years.”

Louisiana Attorney General Liz Murril stated she did not support continuing with “that particular part of the lawsuit” and believes the claim would be dropped. Georgia Attorney General Chris Carr denied assertions the lawsuit targeted Section 504, writing it was only about combating “radical, progressive transgender ideology.”

Disabled people and advocates worry the lawsuit will weaken Medicaid funding requirements that support home and community-based services. States are required to provide Medicaid services in the most integrated setting appropriate, based on the 1999 Supreme Court Olmstead decision, which ruled that unnecessarily segregating people with disabilities into institutions was discrimination.

The lawsuit challenges these requirements based on a U.S. Court of Appeals for the 5th Circuit decision which rejected the idea that risk for institutionalization constituted discrimination, marking a split from most circuit court rulings. The lawsuit characterizes integration requirements as “regulatory burdens” that “impose substantial costs” to states.

Before Section 504 was enacted, hundreds of thousands of people with disabilities were institutionalized without opportunities for education or employment. Veronica Ayala, 54, of Galveston, Texas, was placed in an institution at age two to receive treatments for her cerebral palsy.

“Most little kids are tucked into bed every night by their parents. I was not,” she recalled. “It kind of severed something as far as bonding with my mother.”

Ayala later received Medicaid-funded physical therapy at home, thanks to Section 504. She fears without federal mandates, states will institutionalize more people. “If you do not say they have to do something, they will not,” said Ayala, now a disability rights advocate. “Even with the mandate now, they do not do a good job.”

Many states have long wait lists for home and community-based Medicaid services, forcing some disabled people into institutions. Beverley LaVia, 70, described her son’s poor treatment during a year in an institution following a brain injury in 2016. At times, her 39-year-old son was left in soiled diapers for hours, she said.

The family eventually received Medicaid funding to install equipment and hire personal care aides who help her son with daily activities. “Without that type of help, I do not think we could do this, as much as we would want to, because we both also have our own medical issues,” said LaVia of Harrisburg.

Shira Wakschlag, senior director of legal advocacy for the Arc, a national disability advocacy organization, rejected the idea these services are too costly, citing data that shows community-based services are cheaper than institutionalization. She sees the lawsuit as part of a larger attack on Medicaid, especially as Republicans consider potential cuts to meet goals of reducing the federal budget.

Legal experts believe a ruling in the states’ favor could set a precedent affecting other civil rights laws that operate similarly to Section 504, such as Title VI (barring racial discrimination) and Title IX (barring sex-based discrimination).

“It is about fighting the history of using federal funding to protect civil rights. I think states would say they want the money without the rules,” said Nicole Huberfeld, a health law professor at Boston University. “But there is a long history of states using federal funding for the wrong purposes, so they need to put conditions on the funding.”

The lawsuit is currently paused, and the parties have been ordered to file another joint status report by April 21.

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