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Home»Healthcare Innovation»Trump administration targets disability integration mandate in DOJ memo
Healthcare Innovation

Trump administration targets disability integration mandate in DOJ memo

primereportsBy primereportsJune 23, 2026No Comments5 Mins Read
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Trump administration targets disability integration mandate in DOJ memo
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The Trump administration released a memo last week that seeks to upend landmark disability laws and court rulings that prioritize people with disabilities receiving care while living in their community instead of at institutions like nursing homes.

The memo — written by the Department of Justice Office of Legal Counsel in response to an inquiry from White House officials — breaks with decades of disability law and practice and argues that the “integration mandate” is not actually a mandate, especially for people with “severe mental illness or disabilities.”

“This is potentially devastating for the rights of people with disabilities,” said Jennifer Mathis, deputy director for the Bazelon Center for Mental Health Law and a former deputy assistant attorney general in the DOJ’s civil rights division.

The memo does not change existing laws or decisions that have laid the groundwork for the integration mandate, including Section 504 of the Rehabilitation Act of 1973, the Americans with Disabilities Act, or the Supreme Court’s 1999 Olmstead v. L.C. decision. Courts still must abide by their precedents and these three legal pillars if a lawsuit hits their dockets. 

However, the memo publicly signals the Trump administration’s stance on the rights of people with disabilities, especially their right to be not segregated in institutions to receive necessary care, several legal experts say. They expect the Justice Department to pull back from its longstanding role as the federal enforcer of the so-called Olmstead claims that place institutionalized people with disabilities back into their communities, and they also worry that the memo tees up an attempt to dismantle the Olmstead decision.

“You can’t change the law through fiat. But I do think [this memo] signals a frontal attack on basic tenets of the disability rights movement,” said Jennifer Lav, director of the Disability Practice Area at the National Health Law Program.

Disability

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The memo arrives a year after the Republican administration significantly slashed state Medicaid allocations, one of the key funding sources of home and community-based services. States have already started cutting their own home care budgets in response. Ohio and Maryland are proposing wage cuts for disabled caregivers, while Idaho considered discontinuing all community care. 

Community living and disability rights go hand in hand, and people have been fighting to live in their communities since the mid-20th century, like when National Federation for the Blind founder Jacobus tenBroek pushed for “The Right to Live in the World” in 1966. The Rehabilitation Act first enshrined integration into U.S. law in 1973 before the ADA and Olmstead decision embedded it into the bedrock of the American legal system.

The DOJ memo acknowledged its unusual position, especially given that community care is cheaper than institutional care and that the federal government already has a long-standing position of favorability towards integration. The author writes, “we recognize that this view of Olmstead’s import is out of step with the common understanding of that decision within the federal courts.”

Memos from the DOJ’s Office of Legal Counsel do not have the force of law, said Samuel Bagenstos, a law professor at the University of Michigan who was formerly the general counsel of the Department of Health and Human Services. But they do help the executive branch make decisions about how it will interpret the law, and the memo’s text suggests that it was prompted by questions from White House officials. The memo proceeds to provide three examples for why it believes the integration mandate is not a mandate.

Disability law experts were generally unimpressed with legal arguments laid out by Lanora Pettit, the principal deputy assistant attorney general in the Office of Legal Counsel, who wrote the memo. Pettit came to the position in 2025 after spending several years in Texas Attorney General Ken Paxton’s office. A few months after Pettit left for the federal DOJ, Texas filed a lawsuit against the federal government challenging the federal integration mandate. A final decision is still to come, but it is one of several lawsuits that the Supreme Court could take up, should the DOJ decide to try and target the integration mandate through the court system.

A Justice Department spokesperson did not respond to a request for comment about the memo, but some advocates believe a motivation behind the memo could be providing the federal government with more flexibility in how it tackles rising rates of homelessness, which has already been the subject of a sweeping executive order. The memo seems to suggest that an increase in chronic homelessness in the last decade is due to de-institutionalization, even though the statistic cited does not mention de-institutionalization as an inciting cause.

Experts say the biggest effect that this memo will have in the short term will be the federal government’s pull-back from enforcing Olmstead claims and the regulations and budgetary changes that the Trump administration can enact, since the ADA is pretty transparent in its approval of the integration mandate. 

“As states are facing the biggest cut in the Medicaid program’s history, and we are already starting to see states cutting home and community-based services, I’m incredibly worried that there is no guard rails if the federal government walks away from Olmstead enforcement,” said Alison Barkoff, a disability rights lawyer and the former head of the Administration for Community Living.

The timing of the memo particularly stung for advocates. Yesterday, the disability community celebrated 27 years since the Olmstead decision. Without Olmstead, said Barkhoff, her brother, Evan, never would have gotten a chance at a full life after his Down syndrome diagnosis. Now, he has a job, a girlfriend, and his own apartment with a roommate of his choice. 

“All of that is possible because he has a Medicaid home and community-based waiver that he waited more than a decade for, and that’s what’s at stake here,” she said.

STAT’s coverage of disability issues is supported by grants from Robert Wood Johnson Foundation and The Commonwealth Fund. Our financial supporters are not involved in any decisions about our journalism.

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