The One Big, Beautiful Bill Act's Medicaid reforms will not affect community-based programs for people with disabilities; instead, they address ineligible recipients, administrative fraud and able-bodied adults who choose not to work.

But more must be done to strengthen incentives for people with disabilities to move to, remain in, and thrive within their communities.

As an advocate who has fought for services to emancipate people with disabilities from institutional warehousing for nearly half a century, I can, without equivocation, write that large congregate care is less effective and significantly more expensive than any home- or community-based living arrangement. Funding can and should be allocated in a more humanitarian and utilitarian way when it comes to community programs.

When President Ronald Reagan signed the Omnibus Budget Reconciliation Act of 1981, the federal government recognized home- and community-based care as an alternative to costly institutions. Although the idea was to save money, the bill gave rise to the........

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