| By Kim Mettler & Karen Wheeldon Published in Association on American Indian Affairs, Indian Affairs Journal, Volume 198, Spring/Summer 2026 and has been updated since originally published. In 2024, a group of 17 Republican-led states sued the federal government attacking section 504 of the Rehabilitation Act and its implementing regulations that protect people with disabilities from discrimination. Driven by concerns that the regulations make gender dysphoria a protected disability and the commitment to dismantle the anti-discrimination protections in Section 504, the lawsuit claimed that Section 504 and its regulations were unlawful and unconstitutional. The initial lawsuit changed after actions by the current administration, and now only five states continue their attack against people with disabilities to be protected from discrimination.(1) While the parties in the lawsuit have agreed to a temporary pause in the litigation, it is important that disability justice advocates and allies are aware of the case and the potential negative impacts to Native Peoples with disabilities. This article provides background information regarding disability rights, disabilities in Native Country, a summary of legal protections at stake, and the lawsuit. It also includes what readers can do to be allies at a time when civil rights for people with disabilities are under threat. |  |
Background
State and federal governments have allowed people with disabilities to be discriminated against in employment, healthcare, and education. Medical care has been denied.(2) Children with disabilities have been explicitly excluded from school, often being segregated in large residential facilities, institutions, boarding schools, sheltered workshops or even in their own homes.(3) While many of these facilities provide legitimate services and support, too many others housed people with disabilities inhumanely, with staff inflicting abuse, neg lect, and maltreatment.(4) During the Civil Rights Movement, disability rights advocates challenged forced institutionalization and stood for their rights to exist in their communities like any other person. Their efforts led to significant changes in anti-discrimination protections, including the 1973 enactment of the Rehabilitation Act, Section 504 regulations in 1977, and the 1990 enactment of the Americans with Disabilities Act, which will be discussed in more detail below.(5)
Native Country is no stranger to institutionalization or to disabilities. Institutions—hospitals, boarding schools, even foster care and jails—have never been places of support, treatment or care. Instead, they have been weapons to facilitate United States’ assimilation and genocidal policies against Native Nations and Native Peoples. The Canton Asylum for Insane Indians was a psychiatric facility built exclusively for Native People.(6) Between 1902 and 1934, it operated on the windswept plains of South Dakota and confined nearly 400 Natives. While some residents did suffer from physical illness, disability, or mental illness,(7) the majority were there because they were considered by local and federal governments to be “inconvenient Indians:” Natives who continued to engage in cultural practices, speak their language or who had conflicts with U.S. officials, boarding school superintendents, or reservation agents.(8)
During the same era Canton operated, Native children were being stolen from their families and Nations and sent away to boarding schools.(9) Stripped of their names, languages, spiritual practices, and their family connections, thousands of children were subjected to abuse, neglect, and other maltreatment, the effects of which still ripple through Native families and Nations today. Neither the threat, nor the trauma have faded with time. Elders report that, whether disabled or not, one of their greatest fears as they age is that they will be taken from their home and forced into an institution.(10)
Today, thirty percent of Native adults have a disability, the highest rate of disability of any ethnicity(11) and are the third highest population without insurance.(12) According to a 2019 estimate by the U.S. Census Bureau, almost 6% of Native homes had a child with a disability, the highest of all ethnic or racial groups.(13) More than 17% of Native children lack health insurance.(14) Every type of disability is found in Native Country and many people have hidden or unseen disabilities.(15)
Braided together with the prevalence of disabilities is chronic illness, both of which comprise significant health disparities in Native Country. A bi-directional relationship exists between chronic illness and disabilities: disability can be a result of chronic illness, and often people with disabilities develop chronic health conditions.(16) Native Peoples suffer more from higher rates of heart disease, cancer, diabetes, alcohol-induced illness and liver disease than other populations.(17) The disabilities that most often occur in Native Country are diabetes, visual and hearing impairments, mobility disability, emotional or mental health issues, learning disabilities, and substance use disorder.(18) Inconsistent sources of care, language and communication barriers, lack of diversity in the healthcare workforce, high rates of poverty, underfunded healthcare from the Indian Health Service and a lack of insurance coverage all exacerbate Native health issues.(19)
Despite these statistics, Natives with disabilities are underrepresented in academic studies, and substantive data about disabilities in Native Country is sparce.(20) In 2024, the Inter-Tribal Disability Advocacy Council (IDAC) published its report, Personal Journeys towards Hozho (Holistic Wellness): The Lives of Indigenous Relatives with Disabilities (the “IDAC Report”), which, through an Indigenous lens, documents the primary issues facing Native Peoples with disabilities.(21) According to the IDAC Report, Natives with disabilities experience a number of barriers to meaningful inclusion and quality of life.
Barriers include:
These are only a few of the barriers identified in the IDAC Report.(22)
The Rehabilitation Act Section 504, and the Americans with Disabilities Act
Signed into law by President Richard Nixon after he twice vetoed it, the Rehabilitation Act of 1973 (hereafter the “Act”) prohibits discrimination on the basis of disability by programs receiving federal money, by programs conducted by federal agencies, in federal employment and in employment practices of federal contractors.(23) It is the first civil rights legislation protecting people with disabilities and is in direct response to protests by powerful anti-discrimination advocacy groups.(24)
The Act includes authorization for formula grants to states and Native Nations to operate vocational rehabilitation programs for people with disabilities to support them in preparing for and engaging in gainful employment.(25) The Act prohibits discrimination in the hiring of qualified persons with disabilities for federal employment(26) and requires accessibility of information and communication technology and maintaining websites with accessibility features for blind users.(27)
Section 504 of the Act is the anti-discrimination provision. It prohibits discrimination on the basis of disability in programs receiving federal financial assistance or any program or activity of any federal agency, including those of federal contractors.(28) Section 504 is far reaching, as it applies to all employers receiving federal financial assistance, as well as federal funding tied to education, housing, social services, recreation, and healthcare.(29) It covers, for example, all programs funded by the U.S. Department of Health and Human Services (HHS), which includes the Indian Health Service, from healthcare providers accepting Medicaid or Medicare to state child welfare programs.(30) But Section 504 does not just prohibit exclusion of people with disabilities, it also re quires their inclusion.(31)
The Americans with Disabilities Act (the “ADA”) became law in 1990. The ADA prohibits discrimination against individuals with disabilities in employment, education, transportation and in public and private places that are open to the public.
The ADA offers civil rights protections to people with disabilities similar to those protections provided based on race, color, gender, national origin, age and religion.(32)
In 1999, the U.S. Supreme Court decided Olmstead v. L.C., which established that unjustified segregation of people with disabilities is a form of disability discrimination under the ADA.(33) The Court held that public entities must provide community-based services to people with disabilities when such services are appropriate, the affected person does not oppose community-based treatment, and when community-based treatments can be reasonably accommodated.(34)
This has become known as the integration mandate and it not only has been applied to settings where people live, but also to where they receive services, go to school and where they work.(35) Integration into the community ensures access to the full spectrum of opportunities that allow a person to live a fulfilled, independent life.(36)
From Olmstead also came the “at-risk” doctrine. This extends anti-discrimination protections to people with disabilities who are at serious risk of institutionalization or segregation.(37) This risk may arise, for example, when in-home services are eliminated or reduced, when an agency fails to provide accessible, affordable housing options, or in any circumstance where a person is at risk of being separated from their community and maintained in the least restrictive settings. Under the at-risk doctrine, a person with disabilities does not need to wait until they are segregated or institutionalized to enforce their rights under the law.
Section 504 Regulations
No implementing regulations were issued for Section 504 of the Act until four years after its enactment, and after disability rights activists coordinated sit-ins across the United States, including a 26-day occupation of a federal building in San Francisco.(38) The 1977 regulations, issued by the Department of Health, Education and Welfare (the predecessor to the HHS), stated what federally funded entities had to do in order to ensure non-discrimination, including ensuring physical access, modifications to programs and effective communication.(39) The regulations themselves have rarely been amended, but legislative and judicial developments since then have changed the scope and strength of the nondiscrimination protections.(40) The developments that changed the nondiscrimination protections include amendments to the Rehabilitation Act, the enactment and amendment of the ADA, enactment of the Affordable Care Act and growing discrimination in accessibility of information and communications technology.(41) Regulations implemented in May 2024 were intended to ensure that implementation of Section 504 is consistent with those developments.
In May 2024, the Biden Administration published final regulations implementing Section 504.(42) The purpose of these final regulations was to address developments in the statutory and judicial landscape since the first regulations were issued in 1977 and to help service providers and service recipients better understand their rights and responsibilities.(43) The 2024 regulations were the culmination of decades of civil rights advocacy by people with disabilities, and represents a giant step forward in the disability rights movement, and contains a number of important provisions.(44)
Among other things, these regulations addressed discrimination in medical care, ensuring that treatment decisions are not based on bias, stereotypes or judgments about whether a person will be a burden on others or beliefs about the value of a disabled person’s life. It adopted standards for medical equipment to address barriers to care, such as mammogram machines that require a patient to stand to use them. The regulations prohibit the use of assessments, tools or measures that discount the value of life extension of a person based on disability. It also includes the integration mandate, clarifying obligations to provide services in the most integrated setting appropriate to the needs of a person with disabilities, consistent with the 1999 Olmstead decision discussed above.(45)
The publication of these regulations was cause for celebration. However, the regulations have not been without controversy, which has ultimately led to the lawsuit that currently threatens disability rights.
In the notice of proposed rulemaking for the Section 504 regulations, issued in May 2023 prior to the final regulations, Section 84.4(g) included a list of conditions taken directly from the Act that were consistent with exclusions in the ADA definition of “disability.”(46) The exclusions included “gender identity disorders not resulting from physical impairments.”(47) The proposed rulemaking also included a discussion of gender dysphoria in the context of a disability from a Fourth Circuit lawsuit brought under both section 504 and the ADA.(48)
HHS stated in the proposed rulemaking that restrictions interfering with a qualified individual’s access to care because of gender dysphoria may violate section 504.(49) In the 2024 final regulations, HHS again explicitly noted that gender identity disorders not resulting from physical impairment were excluded from the definition of disability. It also reiterated its prior statement that interfering with an individual who is disabled and has gender dysphoria may be a violation of Section 504. It did not state that gender dysphoria was a disability.(50)
Nonetheless, opponents of transgender and diversity, equity and inclusion laws saw an opportunity to further their attacks on transgender rights.
The Lawsuit: Texas v. Kennedy (formerly Texas v. Becerra)
In September 2024, 17 Republican-led states filed a lawsuit challenging the 2024 regulations on a number of grounds.(51) The primary allegation of the lawsuit was that the regulations upended established federal disability law by adding the term “gender dysphoria” to the definition of “disability,” unlawfully changing Section 504 and the ADA.(52) It also alleged, among other things, that both Section 504 of the Act and its regulations are unconstitutional. In January 2025, HHS notified the district court that the President had issued an Executive Order reflecting the current administration’s position that agencies shall not promote gender ideology and requested a stay in the litigation while it evaluated its position regarding the case.(53)
In April 2025, HHS published a notice of proposed rulemaking in the Federal Register stating—again—that the regulatory language in the 2024 regulations does not state that gender dysphoria is a disability and that the regulatory text incorporates and is consistent with language in the Rehabilitation Act that expressly excludes gender identity disorders as a disability.(54) This notice appears to be in response, in part, to the January 2025 Executive Order.55 That same month, the 17 Republican-led states and HHS filed a joint status report with the court and in it, HHS requested a continuing stay on litigation. The states informed the court they were no longer challenging the constitutionality of Section 504 of the Act. Eight of the 17 states dropped their challenge of the 2024 regulations altogether.
In January 2026, Texas, Alaska, Florida, Indiana, Kansas, Louisiana, Missouri, Montana, and South Dakota filed an amended complaint, renewing their attack on the 2024 regulations.(56) They argued that the regulations exceed HHS’s statutory authority under both Section 504 and the ADA because neither statute empowers HHS to mandate services be delivered in a community-based setting, or to authorize a discrimination claim where there is a serious risk of institutionalization without actual institutionalization.(57) Additionally, the states claim that the regulations are unconstitutional, because they redefine Section 504 to include the integration mandate and the at-risk theory of discrimination without Congressional approval.(58) On March 31, 2026, at the request of the plaintiffs, the judge lifted the stay on litigation. Indiana and South Dakota subsequently dismissed their claims, followed by Kansas and Missouri, leaving five states—Texas, Alaska, Florida, Louisiana, and Montana—as plaintiffs. On July 13, 2026, the court extended the deadline until September 22, 2026, for the remaining parties to respond to each other’s motions.(59)
If the Court Finds in Favor of the Trump administration
According to disability advocates, the Trump administration has engaged in an “all-out war” against people with disabilities.(60) An executive order signed in April 2025 ended the federal government’s practice of recognizing disparate-impact discrimination under civil rights laws.(61) Disparate-impact discrimination means that discrimination can occur even when it is not intended. It can occur when a policy or practice that applies to everyone causes a disproportionate and unjustified negative harm to a group.(62) The executive order directs federal agency leadership to stop enforcing policies, regulations and agreements that rely on theories of dispar ate impact liability, making it difficult to enforce civil rights laws such as the Rehabilitation Act and the ADA.(63) Texas v. Kennedy appears to be not just another weapon in the war against people with disabilities, but also a tool in broader efforts to dismantle everything that supports diverse and unique human beings that are not fully abled, not white, not Christian, not economically secure, and not cisgendered.
A worse-case scenario result from this lawsuit would be set back disability rights more than 50 years. Programs and services would no longer be required to be provided in community-based settings, if at all. This means that either people with disabilities would have access to fewer services, or they would have to seek them in more segregated, institutional settings—like nursing homes, residential facilities or psychiatric facilities, for example. And rather than having a cause of action against programs and services (or lack thereof) posing serious risk of institutionalization, people would have to wait for institutionalization and harm to occur before bringing a civil rights claim. Weakening the integration mandate and erasing the at-risk doctrine would clear the way for people with disabilities to again be segregated from their communities, increasing the possibility of a return to forced institutionalization and the discrimination that previously existed.
For Native Country, it is difficult to imagine how a win for plaintiffs in Texas v. Kennedy could make things worse for Natives with disabilities. One of the Association’s concerns is the threat of losing the integration mandate. The IDAC Report documents the absence of resources altogether in some cases and having to leave the reservation to access resources.(64) Without the integration mandate, it appears there would be nothing to protect Natives with disabilities from having to choose between services, resources, or even independence and their culture, family, and Native Nation. The threat of forced separation from family, Nation and culture carries a particular weight for Native Peoples, and it re opens a wound that has never fully healed.
Native Peoples already experience some of the most severe health disparities in the United States, including disproportionately high rates of diabetes, traumatic brain injury, behavioral health conditions, and chronic illness — meaning disability is not an abstract concern but a lived reality for a significant portion of the population. Without Section 504 and its regulations, health and disability disparities will only be exacerbated, and, as the IDAC Report reveals, there is not much more ground that can be lost for Natives with disabilities.(65)
Arguably nearly every barrier meant to be removed by Section 504 and the 2024 regulations exists because these dis ability discrimination protections are already underenforced. Indian Health Service facilities already lack specialized knowledge for disabilities and cultural responsiveness, leading to misdiagnoses and poor outcomes.(66) Indian Health Service funding limitations, staffing shortages and high provider turnover mean long wait times for appointments, and un affordable healthcare.(67) Physical accessibility to education and ensuring Individual Education Plans are enforced are already the most common challenge in education.(68) Affordable, accessible housing is scarce both on and off reservation; reliable, accessible transportation for even routine tasks like grocery shopping, attending community events or going to work is not available consistently and is expensive; the list is long.(69) Texas v. Kennedy and other attacks on the civil rights of Natives with disabilities is a direct threat to the resources that many depend upon to live independently, participate in community life, or in some instances, just to survive.
Conclusion
The health disparities Native Peoples experience and the barriers faced by Natives with disabilities did not emerge overnight. They are the product of generations of colonial violence, including forced assimilation, separation from culture, lack of education, housing, healthcare, and nutrition owed to Native Nations and Peoples through treaties and other federal laws, and outright neglect. They persist in the waiting rooms of understaffed IHS facilities, in IEP meetings where caregivers are confused and outnumbered, in in accessible and unaffordable housing, and in the silence of responses to requests for assistance or accommodation. While Section 504 and the implementing regulations are not a fail-safe or complete solution to these issues, they do represent a significant legal framework available to ensure inclusion, dignity and care for Natives with disabilities. Losing these basic civil rights protections would be a long fall for some and would embolden those who want to strip other marginalized people of their rights, too.
Though it seems grim, there is still a light on. Texas v. Kennedy seems to be a slow-moving case and Kansas and Missouri have now joined Indiana and South Dakota in dismissing their claims. The litigation is being monitored by disability rights champions, civil rights activists, and other allies. A win for the plaintiffs would be tempered with likely years of litigation on appeal. There could be an intervening regime change. And it remains true that we are not powerless—there are things we can do.
Contact the attorneys general of the five remaining plaintiff states: Texas, Alaska, Florida, Louisiana, and Montana. Demand they withdraw from the lawsuit and remind them that their attack does not protect the citizens of their respective states, it abandons the most vulnerable of them.
Contact your Representatives and Senators and demand they take a stand in defense of Section 504 and the regulations. Urge them to oppose any legislation that weakens disability and civil rights protections. Demand that they approve full, sustained funding for Indian Health Service and for Bureau of Indian Education services and programs to Native Country.
Support Native advocacy organizations, such as the Native American Disability Law Center whose work centers the voices and lived experiences of Native Peoples with disabilities. Make donations, share their social media, volunteer.
Disability rights, civil rights and Native rights movements progressed and survived because people refused to accept that their lives were less valuable, their inclusion unimportant or that their People deserved less. Natives and non-Natives with disabilities and their allies continue this forward movement, despite the history that has tried to break them. Now is the time to be a good Relative and join them.
Sources
1 Texas v. Becerra, No. 5:24-cv-00225 (N.D. Tx. filed Sept. 26, 2024), sub nom. Texas v. Kennedy, No. 5:24-cv-00225-C (filed Feb. 19, 2025). See Free Law Project. Court Listener. State of Texas v. Becerra, 5:24-cv-00225, (N.D. Tex.). Courtlistener.com/docket/69200578/state-of-texas-v-becerra/, accessed May 26, 2026.
2 Education Rights Counsel. Protect 504 Public Means Everyone Educationrightscounsel.org/pdfs/Section504-WhitePaper.pdf, accessed March 11, 2026.
3 Disability Justice. Dehumanization, Discrimination, and Segregation. Disabilityjustice.org/justice-denied/dehumanization-discrimination-andsegregation/, accessed March 10, 2026.
4 Bhattar, Kala. “The American Education System and the Treatment of Disabilities in America.: A History.” University of Alabama Institute for Human Rights Blog. February 2023. Sites.uab.edu/humanrights/2023/02/20/ the-american-education-system-and-the-treatment-of-disabilities-inamerica-a-history/, accessed March 10, 2026.
5 Id.
6 Yellow Bird, Pemina. Wild Indians: Native Perspectives on the Hiawatha Asylum for Insane Indians. Power2u.org/wp-content/uploads/2017/01/ NativePerspectivesPeminaYellowBird.pdf, accessed March 10, 2026.
7 Richards, Richie. “The nation’s only insane asylum for Indians was in South Dakota.” Indianz.com September 2018. Indianz.com/News/2018/09/28/thenations-only-insane-asylum-for-india.asp, accessed March 10, 2026.
8 Whitt, S., (2022) “‘Care and Maintenance’: Indigeneity, Disability and Settler
*Kim Mettler is a citizen of the Mandan, Hidatsa and Arikara Nation and serves as the Next Generations Director for the Association on American Indian Affairs.
*Karen Wheeldon is a Ph.D. student in special education at Texas Tech University. Having had the opportunity to serve students with disabilities, their families, and communities for about thirty years, Karen is serving while learning as an intern through the Association on American Indian Affairs.
Disability rights, civil rights and Native rights movements progressed and survived because people refused to accept that their lives were less
valuable, their inclusion unimportant or that their
People deserved less.
Colonialism at the Canton Asylum for Insane Indians, 1902-1934”, Disability Studies Quarterly 41(4). Dsq-sds.org/article/id/753/, accessed on March 10, 2026.
9 Id.
10 Dr. Kimberly Yellow Robe. Personal conversation. February DATE, 2026.
11 National Council on Disability. Understanding Disabilities in American
Indian and Alaska Native Communities Toolkit Guide. February 2023 at page 10. Nicoa.org/wp-content/uploads/2023/03/NCD_Understanding_ Disabilities_in_American_Indian_508.pdf, accessed March 7, 2025.
12 Singh, Gopal K, and Sue C Lin. “Marked ethnic, nativity, and socioeconomic
disparities in disability and health insurance among US children and adults: the 2008-2010 American community survey.” BioMed research international vol. 2013 (2013). Article ID 627412. Pmc.ncbi.nlm.nih.gov/articles/ PMC3819828, accessed March 16, 2026.
13 National Council on Disability, note 11 at page 10.
14 Singh, Gopal K, and Sue C Lin at note 12. The Indian Health Service (IHS)
is an agency within the U.S. Department of Health and Human Services that delivers health care to Natives and funds Native Nation and urban Native health programs. The obligation for the U.S. to provide health care to Natives Peoples arises from the Constitution, treaties, laws, Supreme Court decisions and Executive Orders. The IHS plays a central role in Native healthcare access, especially in rural and reservation areas. However, IHS is not health insurance and does not ensure access to all medical care. Native Peoples still need health insurance. For one reason, IHS is chronically underfunded and not all needed services are available. For another reason, IHS may not provide specialists for health conditions requiring specialized treatment. Third, IHS facilities are not available everywhere and therefore it may be difficult for Natives to access care when they are away from an IHS facility. To learn more about IHS, see: Cms.gov/outreach-and-education/ american-indian-alaska-native/aian/downloads/10-importantfacts-about-ihs-and-health-care-.pdf; Ihs.gov/forpatients/faq/#; and Nativereach.com/native-american-healthcare-access/#elementortoc__heading-anchor-1 all accessed April 7, 2026.
15 National Council on Disability, note 11 at page 11.
16 Lyon, JoLynne. “USU Researchers: Nationwide, 80% of Adults with Disabilities
Report Chronic Illnesses.” April 10, 2025. Usu.edu/today/story/usuresearchers-nationwide-80-of-adults-with-disabilities-report-chronicillnesses# conditions, accessed on March 19, 2026.
17 Indian Health Service. Disparities. October 2019. Ihs.gov/newsroom/
factsheets/disparities/#, accessed March 19, 2026.
18 Lyon, JoLunne, note 16.
19 National Indian Council on Aging, Inc. American Indian Health Disparities.
Nicoa.org/elder-resources/health-disparities/, accessed on March 16, 2026.
20 National Council on Disability, note 11 at page 11.
21 The Inter-Tribal Disability Advocacy Council. Personal Journeys Towards
Hozho (Holistic Wellness): The Lives of Indigenous Relatives with Disabilities. July, 2024. Nativedisabilitylaw.org/about-us/latest-updates/351-intertribal-disability-advocacy-council, accessed March 16, 2026.
22 Id at pages 13-17.
23 Employer Assistance and Resource Network on Disability. “Rehabilitation Act
of 1973 (Rehab Act).” Askearn.org/page/the-rehabilitation-act-of-1973rehab-act, accessed March 11, 2026.
24 U.S. Department of Health and Human Services, Administration for
Community Living. Final Rule Implementing Section 504 of the Rehabilitation Act of 1973. Administration for Community Living. September 25, 2024. Acl. gov/504rule, accessed March 12, 2026.
25 29 U.S.C. §720 and §741.
26 29 U.S.C §791 and §793.
27 29 USC §794(d).
28 29 USC §794.
29 Id.
30 U.S. Department of Health and Human Services, Administration for
Community Living, note 19.
31 U.S. Department of Health and Human Services, Administration for
Community Living. 25th Anniversary of Olmstead Decision. June, 2024. Acl.gov/news-and-events/events-and-observances/25th-anniversaryolmstead-decision#, accessed March 19, 2026.
32 ADA National Network. “What is the Americans with Disabilities (ADA) Act?”
adata.org/learn-about-ada, accessed May 26, 2026.
33 Olmstead v. L. C., 527 U.S. 581 (1999).
34 U.S. Department of Health and Human Services, Civil Rights. Understanding
Olmstead and Community Integration. June 23, 2025. Hhs.gov/civil-rights/
for-individuals/special-topics/community-living-and-olmstead/servingpeople-disabilities-most-integrated-setting, accessed March 13, 2026.
35 Oded, Yair and Veliz, Jesus. “The Right to Community Integration.” Bazelon
Center for Mental Health Law. September 11, 2025. Bazelon.org/the-ada-at- 35-the-right-to-community-integration/, accessed March 9, 2026.
36 Dubé, Kate. “Community Integration: What It Is and Example Activities:
Foothold Technology. October 31, 2023. https://footholdtechnology.com/ news/community-integration, accessed March 10, 2026.
37 Center for Public Representation. The Right to Community Participation:
Olmstead v. L.C. Centerforpublicrep.org/the-right-to-communityparticipation-olmstead-v-l-c accessed March 14, 2026.
38 Education Rights Counsel, note 2, at page 5.
39 Id.
40 Nondiscrimination on the Basis of Disability in Programs or Activities
Receiving Federal Assistance. 89 FR 40066. May 9, 2024.
41 Id.
42 Id.
43 Discrimination on the Basis of Disability in Health and Human Service
Programs or Activities. 88 FR 63392. September 14, 2023.
44 U.S. Department of Health and Human Services, Administration for
Community Living, note 19.
45 Id.
46 Discrimination on the Basis of Disability in Health and Human Service
Programs or Activities, note 40 at 63463.
47 Id.
48 Id. at 63464.
49 Id.
50 Nondiscrimination on the Basis of Disability in Programs or Activities
Receiving Federal Assistance, note 40.
51 Texas v. Becerra at note 1.
52 Id.
53 Texas v. Becerra, note 1. Unopposed motion for stay of all deadlines.
January 24, 2025. See also Executive Order 14168, 90 Fed. Reg. 8615.
54 Nondiscrimination on the Basis of Disability in Programs or Activities
Receiving Federal Financial Assistance; Clarification. 90 FR 15412.
55 Texas v. Kennedy, note 1. Joint Status Report January 9, 2026.
56 Texas v. Kennedy, No. 5:24-00225 (N.D. Tex. Jan. 23, 2026).
57 Id.
58 Id.
59 Id.
60 Ives-Rublee, Mia and Doherty, Casey. “The Trump Administration’s
War on Disability.” The Center for American Progress. July 28, 2025. Americanprogress.org/article/the-trump-administrations-war-ondisability/#, accessed March 7, 2026.
61 Executive Order 14281, 90 Fed. Reg. 17537. April 28, 2025.
62 Congress.gov What Is Disparate-Impact Discrimination? Congress.gov/crs-
product/IF13057, accessed March 14, 2026.
63 Ives-Rublee, Mia and Doherty, Casey, note 6.
64 The Inter-Tribal Disability Advisory Council, note 19 at page 21.
65 Id.
66 Id at page 16.
67 Id at page 14.
68 Id at page 17.
69 Id at page 14, 19.
State and federal governments have allowed people with disabilities to be discriminated against in employment, healthcare, and education. Medical care has been denied.(2) Children with disabilities have been explicitly excluded from school, often being segregated in large residential facilities, institutions, boarding schools, sheltered workshops or even in their own homes.(3) While many of these facilities provide legitimate services and support, too many others housed people with disabilities inhumanely, with staff inflicting abuse, neg lect, and maltreatment.(4) During the Civil Rights Movement, disability rights advocates challenged forced institutionalization and stood for their rights to exist in their communities like any other person. Their efforts led to significant changes in anti-discrimination protections, including the 1973 enactment of the Rehabilitation Act, Section 504 regulations in 1977, and the 1990 enactment of the Americans with Disabilities Act, which will be discussed in more detail below.(5)
Native Country is no stranger to institutionalization or to disabilities. Institutions—hospitals, boarding schools, even foster care and jails—have never been places of support, treatment or care. Instead, they have been weapons to facilitate United States’ assimilation and genocidal policies against Native Nations and Native Peoples. The Canton Asylum for Insane Indians was a psychiatric facility built exclusively for Native People.(6) Between 1902 and 1934, it operated on the windswept plains of South Dakota and confined nearly 400 Natives. While some residents did suffer from physical illness, disability, or mental illness,(7) the majority were there because they were considered by local and federal governments to be “inconvenient Indians:” Natives who continued to engage in cultural practices, speak their language or who had conflicts with U.S. officials, boarding school superintendents, or reservation agents.(8)
During the same era Canton operated, Native children were being stolen from their families and Nations and sent away to boarding schools.(9) Stripped of their names, languages, spiritual practices, and their family connections, thousands of children were subjected to abuse, neglect, and other maltreatment, the effects of which still ripple through Native families and Nations today. Neither the threat, nor the trauma have faded with time. Elders report that, whether disabled or not, one of their greatest fears as they age is that they will be taken from their home and forced into an institution.(10)
Today, thirty percent of Native adults have a disability, the highest rate of disability of any ethnicity(11) and are the third highest population without insurance.(12) According to a 2019 estimate by the U.S. Census Bureau, almost 6% of Native homes had a child with a disability, the highest of all ethnic or racial groups.(13) More than 17% of Native children lack health insurance.(14) Every type of disability is found in Native Country and many people have hidden or unseen disabilities.(15)
Braided together with the prevalence of disabilities is chronic illness, both of which comprise significant health disparities in Native Country. A bi-directional relationship exists between chronic illness and disabilities: disability can be a result of chronic illness, and often people with disabilities develop chronic health conditions.(16) Native Peoples suffer more from higher rates of heart disease, cancer, diabetes, alcohol-induced illness and liver disease than other populations.(17) The disabilities that most often occur in Native Country are diabetes, visual and hearing impairments, mobility disability, emotional or mental health issues, learning disabilities, and substance use disorder.(18) Inconsistent sources of care, language and communication barriers, lack of diversity in the healthcare workforce, high rates of poverty, underfunded healthcare from the Indian Health Service and a lack of insurance coverage all exacerbate Native health issues.(19)
Despite these statistics, Natives with disabilities are underrepresented in academic studies, and substantive data about disabilities in Native Country is sparce.(20) In 2024, the Inter-Tribal Disability Advocacy Council (IDAC) published its report, Personal Journeys towards Hozho (Holistic Wellness): The Lives of Indigenous Relatives with Disabilities (the “IDAC Report”), which, through an Indigenous lens, documents the primary issues facing Native Peoples with disabilities.(21) According to the IDAC Report, Natives with disabilities experience a number of barriers to meaningful inclusion and quality of life.
Barriers include:
- Basic accommodations for disabled people, such as accessible pharmacy services for the blind, are routinely denied.
- Legally mandated educational services are routinely withheld, and Native students are stigmatized simply for needing special education services.
- Natives with disabilities face discrimination in hiring based on both their Native identity and their disability.
- Accessible housing is rare in Native Country and waiting times for housing assistance and home modifications can last from months to years, while overcrowded multigenerational housing makes accommodating medical equipment difficult.
- Historical and intergenerational trauma has created deep and justified distrust of systems and service providers. Natives with disabilities are routinely told that to access the services they are entitled to, they must leave the reservation, forcing them to abandon their family, community and cultural support systems.
These are only a few of the barriers identified in the IDAC Report.(22)
The Rehabilitation Act Section 504, and the Americans with Disabilities Act
Signed into law by President Richard Nixon after he twice vetoed it, the Rehabilitation Act of 1973 (hereafter the “Act”) prohibits discrimination on the basis of disability by programs receiving federal money, by programs conducted by federal agencies, in federal employment and in employment practices of federal contractors.(23) It is the first civil rights legislation protecting people with disabilities and is in direct response to protests by powerful anti-discrimination advocacy groups.(24)
The Act includes authorization for formula grants to states and Native Nations to operate vocational rehabilitation programs for people with disabilities to support them in preparing for and engaging in gainful employment.(25) The Act prohibits discrimination in the hiring of qualified persons with disabilities for federal employment(26) and requires accessibility of information and communication technology and maintaining websites with accessibility features for blind users.(27)
Section 504 of the Act is the anti-discrimination provision. It prohibits discrimination on the basis of disability in programs receiving federal financial assistance or any program or activity of any federal agency, including those of federal contractors.(28) Section 504 is far reaching, as it applies to all employers receiving federal financial assistance, as well as federal funding tied to education, housing, social services, recreation, and healthcare.(29) It covers, for example, all programs funded by the U.S. Department of Health and Human Services (HHS), which includes the Indian Health Service, from healthcare providers accepting Medicaid or Medicare to state child welfare programs.(30) But Section 504 does not just prohibit exclusion of people with disabilities, it also re quires their inclusion.(31)
The Americans with Disabilities Act (the “ADA”) became law in 1990. The ADA prohibits discrimination against individuals with disabilities in employment, education, transportation and in public and private places that are open to the public.
The ADA offers civil rights protections to people with disabilities similar to those protections provided based on race, color, gender, national origin, age and religion.(32)
In 1999, the U.S. Supreme Court decided Olmstead v. L.C., which established that unjustified segregation of people with disabilities is a form of disability discrimination under the ADA.(33) The Court held that public entities must provide community-based services to people with disabilities when such services are appropriate, the affected person does not oppose community-based treatment, and when community-based treatments can be reasonably accommodated.(34)
This has become known as the integration mandate and it not only has been applied to settings where people live, but also to where they receive services, go to school and where they work.(35) Integration into the community ensures access to the full spectrum of opportunities that allow a person to live a fulfilled, independent life.(36)
From Olmstead also came the “at-risk” doctrine. This extends anti-discrimination protections to people with disabilities who are at serious risk of institutionalization or segregation.(37) This risk may arise, for example, when in-home services are eliminated or reduced, when an agency fails to provide accessible, affordable housing options, or in any circumstance where a person is at risk of being separated from their community and maintained in the least restrictive settings. Under the at-risk doctrine, a person with disabilities does not need to wait until they are segregated or institutionalized to enforce their rights under the law.
Section 504 Regulations
No implementing regulations were issued for Section 504 of the Act until four years after its enactment, and after disability rights activists coordinated sit-ins across the United States, including a 26-day occupation of a federal building in San Francisco.(38) The 1977 regulations, issued by the Department of Health, Education and Welfare (the predecessor to the HHS), stated what federally funded entities had to do in order to ensure non-discrimination, including ensuring physical access, modifications to programs and effective communication.(39) The regulations themselves have rarely been amended, but legislative and judicial developments since then have changed the scope and strength of the nondiscrimination protections.(40) The developments that changed the nondiscrimination protections include amendments to the Rehabilitation Act, the enactment and amendment of the ADA, enactment of the Affordable Care Act and growing discrimination in accessibility of information and communications technology.(41) Regulations implemented in May 2024 were intended to ensure that implementation of Section 504 is consistent with those developments.
In May 2024, the Biden Administration published final regulations implementing Section 504.(42) The purpose of these final regulations was to address developments in the statutory and judicial landscape since the first regulations were issued in 1977 and to help service providers and service recipients better understand their rights and responsibilities.(43) The 2024 regulations were the culmination of decades of civil rights advocacy by people with disabilities, and represents a giant step forward in the disability rights movement, and contains a number of important provisions.(44)
Among other things, these regulations addressed discrimination in medical care, ensuring that treatment decisions are not based on bias, stereotypes or judgments about whether a person will be a burden on others or beliefs about the value of a disabled person’s life. It adopted standards for medical equipment to address barriers to care, such as mammogram machines that require a patient to stand to use them. The regulations prohibit the use of assessments, tools or measures that discount the value of life extension of a person based on disability. It also includes the integration mandate, clarifying obligations to provide services in the most integrated setting appropriate to the needs of a person with disabilities, consistent with the 1999 Olmstead decision discussed above.(45)
The publication of these regulations was cause for celebration. However, the regulations have not been without controversy, which has ultimately led to the lawsuit that currently threatens disability rights.
In the notice of proposed rulemaking for the Section 504 regulations, issued in May 2023 prior to the final regulations, Section 84.4(g) included a list of conditions taken directly from the Act that were consistent with exclusions in the ADA definition of “disability.”(46) The exclusions included “gender identity disorders not resulting from physical impairments.”(47) The proposed rulemaking also included a discussion of gender dysphoria in the context of a disability from a Fourth Circuit lawsuit brought under both section 504 and the ADA.(48)
HHS stated in the proposed rulemaking that restrictions interfering with a qualified individual’s access to care because of gender dysphoria may violate section 504.(49) In the 2024 final regulations, HHS again explicitly noted that gender identity disorders not resulting from physical impairment were excluded from the definition of disability. It also reiterated its prior statement that interfering with an individual who is disabled and has gender dysphoria may be a violation of Section 504. It did not state that gender dysphoria was a disability.(50)
Nonetheless, opponents of transgender and diversity, equity and inclusion laws saw an opportunity to further their attacks on transgender rights.
The Lawsuit: Texas v. Kennedy (formerly Texas v. Becerra)
In September 2024, 17 Republican-led states filed a lawsuit challenging the 2024 regulations on a number of grounds.(51) The primary allegation of the lawsuit was that the regulations upended established federal disability law by adding the term “gender dysphoria” to the definition of “disability,” unlawfully changing Section 504 and the ADA.(52) It also alleged, among other things, that both Section 504 of the Act and its regulations are unconstitutional. In January 2025, HHS notified the district court that the President had issued an Executive Order reflecting the current administration’s position that agencies shall not promote gender ideology and requested a stay in the litigation while it evaluated its position regarding the case.(53)
In April 2025, HHS published a notice of proposed rulemaking in the Federal Register stating—again—that the regulatory language in the 2024 regulations does not state that gender dysphoria is a disability and that the regulatory text incorporates and is consistent with language in the Rehabilitation Act that expressly excludes gender identity disorders as a disability.(54) This notice appears to be in response, in part, to the January 2025 Executive Order.55 That same month, the 17 Republican-led states and HHS filed a joint status report with the court and in it, HHS requested a continuing stay on litigation. The states informed the court they were no longer challenging the constitutionality of Section 504 of the Act. Eight of the 17 states dropped their challenge of the 2024 regulations altogether.
In January 2026, Texas, Alaska, Florida, Indiana, Kansas, Louisiana, Missouri, Montana, and South Dakota filed an amended complaint, renewing their attack on the 2024 regulations.(56) They argued that the regulations exceed HHS’s statutory authority under both Section 504 and the ADA because neither statute empowers HHS to mandate services be delivered in a community-based setting, or to authorize a discrimination claim where there is a serious risk of institutionalization without actual institutionalization.(57) Additionally, the states claim that the regulations are unconstitutional, because they redefine Section 504 to include the integration mandate and the at-risk theory of discrimination without Congressional approval.(58) On March 31, 2026, at the request of the plaintiffs, the judge lifted the stay on litigation. Indiana and South Dakota subsequently dismissed their claims, followed by Kansas and Missouri, leaving five states—Texas, Alaska, Florida, Louisiana, and Montana—as plaintiffs. On July 13, 2026, the court extended the deadline until September 22, 2026, for the remaining parties to respond to each other’s motions.(59)
If the Court Finds in Favor of the Trump administration
According to disability advocates, the Trump administration has engaged in an “all-out war” against people with disabilities.(60) An executive order signed in April 2025 ended the federal government’s practice of recognizing disparate-impact discrimination under civil rights laws.(61) Disparate-impact discrimination means that discrimination can occur even when it is not intended. It can occur when a policy or practice that applies to everyone causes a disproportionate and unjustified negative harm to a group.(62) The executive order directs federal agency leadership to stop enforcing policies, regulations and agreements that rely on theories of dispar ate impact liability, making it difficult to enforce civil rights laws such as the Rehabilitation Act and the ADA.(63) Texas v. Kennedy appears to be not just another weapon in the war against people with disabilities, but also a tool in broader efforts to dismantle everything that supports diverse and unique human beings that are not fully abled, not white, not Christian, not economically secure, and not cisgendered.
A worse-case scenario result from this lawsuit would be set back disability rights more than 50 years. Programs and services would no longer be required to be provided in community-based settings, if at all. This means that either people with disabilities would have access to fewer services, or they would have to seek them in more segregated, institutional settings—like nursing homes, residential facilities or psychiatric facilities, for example. And rather than having a cause of action against programs and services (or lack thereof) posing serious risk of institutionalization, people would have to wait for institutionalization and harm to occur before bringing a civil rights claim. Weakening the integration mandate and erasing the at-risk doctrine would clear the way for people with disabilities to again be segregated from their communities, increasing the possibility of a return to forced institutionalization and the discrimination that previously existed.
For Native Country, it is difficult to imagine how a win for plaintiffs in Texas v. Kennedy could make things worse for Natives with disabilities. One of the Association’s concerns is the threat of losing the integration mandate. The IDAC Report documents the absence of resources altogether in some cases and having to leave the reservation to access resources.(64) Without the integration mandate, it appears there would be nothing to protect Natives with disabilities from having to choose between services, resources, or even independence and their culture, family, and Native Nation. The threat of forced separation from family, Nation and culture carries a particular weight for Native Peoples, and it re opens a wound that has never fully healed.
Native Peoples already experience some of the most severe health disparities in the United States, including disproportionately high rates of diabetes, traumatic brain injury, behavioral health conditions, and chronic illness — meaning disability is not an abstract concern but a lived reality for a significant portion of the population. Without Section 504 and its regulations, health and disability disparities will only be exacerbated, and, as the IDAC Report reveals, there is not much more ground that can be lost for Natives with disabilities.(65)
Arguably nearly every barrier meant to be removed by Section 504 and the 2024 regulations exists because these dis ability discrimination protections are already underenforced. Indian Health Service facilities already lack specialized knowledge for disabilities and cultural responsiveness, leading to misdiagnoses and poor outcomes.(66) Indian Health Service funding limitations, staffing shortages and high provider turnover mean long wait times for appointments, and un affordable healthcare.(67) Physical accessibility to education and ensuring Individual Education Plans are enforced are already the most common challenge in education.(68) Affordable, accessible housing is scarce both on and off reservation; reliable, accessible transportation for even routine tasks like grocery shopping, attending community events or going to work is not available consistently and is expensive; the list is long.(69) Texas v. Kennedy and other attacks on the civil rights of Natives with disabilities is a direct threat to the resources that many depend upon to live independently, participate in community life, or in some instances, just to survive.
Conclusion
The health disparities Native Peoples experience and the barriers faced by Natives with disabilities did not emerge overnight. They are the product of generations of colonial violence, including forced assimilation, separation from culture, lack of education, housing, healthcare, and nutrition owed to Native Nations and Peoples through treaties and other federal laws, and outright neglect. They persist in the waiting rooms of understaffed IHS facilities, in IEP meetings where caregivers are confused and outnumbered, in in accessible and unaffordable housing, and in the silence of responses to requests for assistance or accommodation. While Section 504 and the implementing regulations are not a fail-safe or complete solution to these issues, they do represent a significant legal framework available to ensure inclusion, dignity and care for Natives with disabilities. Losing these basic civil rights protections would be a long fall for some and would embolden those who want to strip other marginalized people of their rights, too.
Though it seems grim, there is still a light on. Texas v. Kennedy seems to be a slow-moving case and Kansas and Missouri have now joined Indiana and South Dakota in dismissing their claims. The litigation is being monitored by disability rights champions, civil rights activists, and other allies. A win for the plaintiffs would be tempered with likely years of litigation on appeal. There could be an intervening regime change. And it remains true that we are not powerless—there are things we can do.
Contact the attorneys general of the five remaining plaintiff states: Texas, Alaska, Florida, Louisiana, and Montana. Demand they withdraw from the lawsuit and remind them that their attack does not protect the citizens of their respective states, it abandons the most vulnerable of them.
Contact your Representatives and Senators and demand they take a stand in defense of Section 504 and the regulations. Urge them to oppose any legislation that weakens disability and civil rights protections. Demand that they approve full, sustained funding for Indian Health Service and for Bureau of Indian Education services and programs to Native Country.
Support Native advocacy organizations, such as the Native American Disability Law Center whose work centers the voices and lived experiences of Native Peoples with disabilities. Make donations, share their social media, volunteer.
Disability rights, civil rights and Native rights movements progressed and survived because people refused to accept that their lives were less valuable, their inclusion unimportant or that their People deserved less. Natives and non-Natives with disabilities and their allies continue this forward movement, despite the history that has tried to break them. Now is the time to be a good Relative and join them.
Sources
1 Texas v. Becerra, No. 5:24-cv-00225 (N.D. Tx. filed Sept. 26, 2024), sub nom. Texas v. Kennedy, No. 5:24-cv-00225-C (filed Feb. 19, 2025). See Free Law Project. Court Listener. State of Texas v. Becerra, 5:24-cv-00225, (N.D. Tex.). Courtlistener.com/docket/69200578/state-of-texas-v-becerra/, accessed May 26, 2026.
2 Education Rights Counsel. Protect 504 Public Means Everyone Educationrightscounsel.org/pdfs/Section504-WhitePaper.pdf, accessed March 11, 2026.
3 Disability Justice. Dehumanization, Discrimination, and Segregation. Disabilityjustice.org/justice-denied/dehumanization-discrimination-andsegregation/, accessed March 10, 2026.
4 Bhattar, Kala. “The American Education System and the Treatment of Disabilities in America.: A History.” University of Alabama Institute for Human Rights Blog. February 2023. Sites.uab.edu/humanrights/2023/02/20/ the-american-education-system-and-the-treatment-of-disabilities-inamerica-a-history/, accessed March 10, 2026.
5 Id.
6 Yellow Bird, Pemina. Wild Indians: Native Perspectives on the Hiawatha Asylum for Insane Indians. Power2u.org/wp-content/uploads/2017/01/ NativePerspectivesPeminaYellowBird.pdf, accessed March 10, 2026.
7 Richards, Richie. “The nation’s only insane asylum for Indians was in South Dakota.” Indianz.com September 2018. Indianz.com/News/2018/09/28/thenations-only-insane-asylum-for-india.asp, accessed March 10, 2026.
8 Whitt, S., (2022) “‘Care and Maintenance’: Indigeneity, Disability and Settler
*Kim Mettler is a citizen of the Mandan, Hidatsa and Arikara Nation and serves as the Next Generations Director for the Association on American Indian Affairs.
*Karen Wheeldon is a Ph.D. student in special education at Texas Tech University. Having had the opportunity to serve students with disabilities, their families, and communities for about thirty years, Karen is serving while learning as an intern through the Association on American Indian Affairs.
Disability rights, civil rights and Native rights movements progressed and survived because people refused to accept that their lives were less
valuable, their inclusion unimportant or that their
People deserved less.
Colonialism at the Canton Asylum for Insane Indians, 1902-1934”, Disability Studies Quarterly 41(4). Dsq-sds.org/article/id/753/, accessed on March 10, 2026.
9 Id.
10 Dr. Kimberly Yellow Robe. Personal conversation. February DATE, 2026.
11 National Council on Disability. Understanding Disabilities in American
Indian and Alaska Native Communities Toolkit Guide. February 2023 at page 10. Nicoa.org/wp-content/uploads/2023/03/NCD_Understanding_ Disabilities_in_American_Indian_508.pdf, accessed March 7, 2025.
12 Singh, Gopal K, and Sue C Lin. “Marked ethnic, nativity, and socioeconomic
disparities in disability and health insurance among US children and adults: the 2008-2010 American community survey.” BioMed research international vol. 2013 (2013). Article ID 627412. Pmc.ncbi.nlm.nih.gov/articles/ PMC3819828, accessed March 16, 2026.
13 National Council on Disability, note 11 at page 10.
14 Singh, Gopal K, and Sue C Lin at note 12. The Indian Health Service (IHS)
is an agency within the U.S. Department of Health and Human Services that delivers health care to Natives and funds Native Nation and urban Native health programs. The obligation for the U.S. to provide health care to Natives Peoples arises from the Constitution, treaties, laws, Supreme Court decisions and Executive Orders. The IHS plays a central role in Native healthcare access, especially in rural and reservation areas. However, IHS is not health insurance and does not ensure access to all medical care. Native Peoples still need health insurance. For one reason, IHS is chronically underfunded and not all needed services are available. For another reason, IHS may not provide specialists for health conditions requiring specialized treatment. Third, IHS facilities are not available everywhere and therefore it may be difficult for Natives to access care when they are away from an IHS facility. To learn more about IHS, see: Cms.gov/outreach-and-education/ american-indian-alaska-native/aian/downloads/10-importantfacts-about-ihs-and-health-care-.pdf; Ihs.gov/forpatients/faq/#; and Nativereach.com/native-american-healthcare-access/#elementortoc__heading-anchor-1 all accessed April 7, 2026.
15 National Council on Disability, note 11 at page 11.
16 Lyon, JoLynne. “USU Researchers: Nationwide, 80% of Adults with Disabilities
Report Chronic Illnesses.” April 10, 2025. Usu.edu/today/story/usuresearchers-nationwide-80-of-adults-with-disabilities-report-chronicillnesses# conditions, accessed on March 19, 2026.
17 Indian Health Service. Disparities. October 2019. Ihs.gov/newsroom/
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18 Lyon, JoLunne, note 16.
19 National Indian Council on Aging, Inc. American Indian Health Disparities.
Nicoa.org/elder-resources/health-disparities/, accessed on March 16, 2026.
20 National Council on Disability, note 11 at page 11.
21 The Inter-Tribal Disability Advocacy Council. Personal Journeys Towards
Hozho (Holistic Wellness): The Lives of Indigenous Relatives with Disabilities. July, 2024. Nativedisabilitylaw.org/about-us/latest-updates/351-intertribal-disability-advocacy-council, accessed March 16, 2026.
22 Id at pages 13-17.
23 Employer Assistance and Resource Network on Disability. “Rehabilitation Act
of 1973 (Rehab Act).” Askearn.org/page/the-rehabilitation-act-of-1973rehab-act, accessed March 11, 2026.
24 U.S. Department of Health and Human Services, Administration for
Community Living. Final Rule Implementing Section 504 of the Rehabilitation Act of 1973. Administration for Community Living. September 25, 2024. Acl. gov/504rule, accessed March 12, 2026.
25 29 U.S.C. §720 and §741.
26 29 U.S.C §791 and §793.
27 29 USC §794(d).
28 29 USC §794.
29 Id.
30 U.S. Department of Health and Human Services, Administration for
Community Living, note 19.
31 U.S. Department of Health and Human Services, Administration for
Community Living. 25th Anniversary of Olmstead Decision. June, 2024. Acl.gov/news-and-events/events-and-observances/25th-anniversaryolmstead-decision#, accessed March 19, 2026.
32 ADA National Network. “What is the Americans with Disabilities (ADA) Act?”
adata.org/learn-about-ada, accessed May 26, 2026.
33 Olmstead v. L. C., 527 U.S. 581 (1999).
34 U.S. Department of Health and Human Services, Civil Rights. Understanding
Olmstead and Community Integration. June 23, 2025. Hhs.gov/civil-rights/
for-individuals/special-topics/community-living-and-olmstead/servingpeople-disabilities-most-integrated-setting, accessed March 13, 2026.
35 Oded, Yair and Veliz, Jesus. “The Right to Community Integration.” Bazelon
Center for Mental Health Law. September 11, 2025. Bazelon.org/the-ada-at- 35-the-right-to-community-integration/, accessed March 9, 2026.
36 Dubé, Kate. “Community Integration: What It Is and Example Activities:
Foothold Technology. October 31, 2023. https://footholdtechnology.com/ news/community-integration, accessed March 10, 2026.
37 Center for Public Representation. The Right to Community Participation:
Olmstead v. L.C. Centerforpublicrep.org/the-right-to-communityparticipation-olmstead-v-l-c accessed March 14, 2026.
38 Education Rights Counsel, note 2, at page 5.
39 Id.
40 Nondiscrimination on the Basis of Disability in Programs or Activities
Receiving Federal Assistance. 89 FR 40066. May 9, 2024.
41 Id.
42 Id.
43 Discrimination on the Basis of Disability in Health and Human Service
Programs or Activities. 88 FR 63392. September 14, 2023.
44 U.S. Department of Health and Human Services, Administration for
Community Living, note 19.
45 Id.
46 Discrimination on the Basis of Disability in Health and Human Service
Programs or Activities, note 40 at 63463.
47 Id.
48 Id. at 63464.
49 Id.
50 Nondiscrimination on the Basis of Disability in Programs or Activities
Receiving Federal Assistance, note 40.
51 Texas v. Becerra at note 1.
52 Id.
53 Texas v. Becerra, note 1. Unopposed motion for stay of all deadlines.
January 24, 2025. See also Executive Order 14168, 90 Fed. Reg. 8615.
54 Nondiscrimination on the Basis of Disability in Programs or Activities
Receiving Federal Financial Assistance; Clarification. 90 FR 15412.
55 Texas v. Kennedy, note 1. Joint Status Report January 9, 2026.
56 Texas v. Kennedy, No. 5:24-00225 (N.D. Tex. Jan. 23, 2026).
57 Id.
58 Id.
59 Id.
60 Ives-Rublee, Mia and Doherty, Casey. “The Trump Administration’s
War on Disability.” The Center for American Progress. July 28, 2025. Americanprogress.org/article/the-trump-administrations-war-ondisability/#, accessed March 7, 2026.
61 Executive Order 14281, 90 Fed. Reg. 17537. April 28, 2025.
62 Congress.gov What Is Disparate-Impact Discrimination? Congress.gov/crs-
product/IF13057, accessed March 14, 2026.
63 Ives-Rublee, Mia and Doherty, Casey, note 6.
64 The Inter-Tribal Disability Advisory Council, note 19 at page 21.
65 Id.
66 Id at page 16.
67 Id at page 14.
68 Id at page 17.
69 Id at page 14, 19.
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