There's a lot at stake in the 2020 election, from reproductive rights [1] to climate change [2]. But at a time when the US is battling a pandemic, and the Affordable Care Act faces challenges in the Supreme Court [3], it's difficult to think of any issue more pressing than ensuring the health and safety of every American. For the one in four adults living with a physical or cognitive disability [4], issues like access to healthcare are especially important.
Whether you yourself have a disability, or you care deeply about someone who does, it's important to learn where candidates stand on issues that affect this community. In the presidential primary, more candidates released comprehensive plans addressing disability-related issues [5] than ever before. You can find Joe Biden's policy goals on his site [6], as well as a separate section for how he plans to support people with disabilities during the pandemic [7]. (Donald Trump [8] has not released a plan.)
But it's equally important to know where state and local candidates stand on these issues. Most provide information about their policies and proposals on their campaign website, so do some digging before you cast your ballot. Here are just a few issues that uniquely affect the health and wellbeing of people with disabilities — and can often be addressed on the state level.
Access to Affordable Healthcare
While there's still a lot that's unknown about the future of the Affordable Care Act (ACA), it's important that those who are in office are committed to improving access to healthcare, not walking back the progress that's been made. Among its many benefits, the ACA made it possible for young adults, including those with disabilities, to stay on their parent's insurance until age 26 — a policy that originated in state legislatures [9]. Many people with disabilities also rely on Medicaid, a benefit that under the ACA, should be more accessible than ever.
Michael J. Parker [10], an attorney who specialises in long-term disability and social security disability, explained that the ACA sought to expand Medicaid coverage for individuals by broadening the eligibility to adults with incomes of up to 133 percent of the federal poverty level. However, many states have opted out of the Medicaid expansion, making it more difficult for people to receive Medicaid coverage.
"There are far less restrictions under Medicaid than there are under the policies provided under the Affordable Care Act," Parker told POPSUGAR. "As the law stands now, an individual in South Carolina, where the state government refused the Medicaid expansion to protect people up to 133 percent of the federal poverty level, would be required to purchase insurance under the Affordable Care Act and would be forced to pay a deductible that they probably could not afford, if they used that insurance." If states like South Carolina would accept federal funds to expand Medicaid, people with disabilities would have better coverage with either no deductible or a smaller deductible.
It's an important reminder that elected officials at every level of government should be working to build on the ACA, as well as safeguard protections for the most vulnerable should the law not survive its legal challenges.
Early Voting and Mail-In Voting Policies
If there's anything to take away from this election, it's that people shouldn't have to risk their lives to vote during a pandemic or even a particularly harsh flu season. Many people with disabilities have weakened immune systems, making viruses like COVID-19 just another hurdle they need to clear in order to cast their ballot.
While there are many barriers to voting for people with disabilities, not all of which can be addressed with mail-in ballots or early voting, these policies are an important first step in helping them safely and comfortably exercise their rights.
"Voting issues that may affect people with disabilities include waiting in long lines," Monique May [11], MD, a board-certified family medicine practitioner with more than 20 years experience treating children and adults, told POPSUGAR. For people with musculoskeletal and nervous systems disabilities, waiting in line can aggravate chronic underlying problems — and some may not be able to do it at all, which could rob them of their constitutional right to vote.
Dr. May explained that this issue extends to people with psychiatric disabilities because being surrounded by crowds, loud noises, and long lines can cause stress and aggravate their symptoms. "Early voting and clear absentee voting policies will certainly help give these vulnerable citizens options that allow them to vote," Dr. May said. "Policies also need to be created and enforced so that voters who opt to vote by mail or early can track their votes to make sure they are counted."
Early and mail-in voting will be crucial in future elections, but realistically, this is something that needs to be addressed on the state level. Parker explained that although the Constitution ensures the right to vote, elections are conducted by the state, and each state has their own policies and procedures. The Constitution lays out the powers of the federal government and all other powers are reserved for the states," Parker told POPSUGAR.
He added that you could argue that, under the equal protection clause of the 14th Amendment, states should offer the same process for voting — but that argument is unlikely to gain traction with the current Supreme Court.
Access to Medical Cannabis
Medical cannabis is currently legal in 33 states [12]. Mauricio Consalter [13], MD, an internal medicine specialist who certifies patients for the medical cannabis program in Illinois, explained that it's often used to treat conditions like chronic pain and neuropathy. "Opioids are often prescribed for these medical conditions, but medicinal cannabis can be a better and safer alternative," Dr. Consalter told POPSUGAR. People with disabilities may need to take these medications for longer periods of time [14], and evidence suggests that, if they do develop a dependency, they may be less likely to receive treatment [15].
Scientific literature has shown that prescribing medical cannabis can help patients reduce dependence on opioids [16]. Dr. Consalter explained that, in his practice, between 40 and 60 percent of patients are able to decrease or stop opioids entirely. "Patients who used to utilise treatments such as methadone or suboxone are using medicinal cannabis to further decrease dependency," he said, adding that patients are increasingly seeking medicinal cannabis as an alternative to opioids even in hospital settings.
Furthermore, access to legal medical cannabis reduces the risk of people obtaining it illegally and ensures that patients are getting cannabis that has been tested and is safe. Legal access is also crucial in order to continue researching its benefits. "Medicinal cannabis has the potential to be a widely used and safe option for medical treatment," Dr. Consalter said.