On September 23, 2026, a federal court removed six provisions from the Department of Health and Human Services (HHS) regulations that spelled out how federally funded programs are supposed to protect community-integration rights: the rights of people with disabilities to live, work, and receive public support in the most community-integrated setting possible. This was the Texas v. Kennedy order—and it applies nationally across the United States.
Federal disability law still protects community integration, and those protections reach far beyond people with physical disabilities, intellectual or developmental disabilities, or autism. More than 8.4 million Medicaid beneficiaries received home- and community-based services (HCBS) in 2023. Those services included home health, personal care, rehabilitative services, waiver programs, and other supports that allowed people—including older adults—to receive help outside institutional settings. The Medicaid count doesn’t even capture everyone whose community-integration rights may be at stake.
Amber Smock, vice president of advocacy at Access Living in Chicago, Illinois, stressed that community integration also impacts nonprofit systems serving people with mental health disabilities, people in substance-use recovery, and disabled people experiencing homelessness. Permanent supportive housing, she explained, can combine housing with services to help someone remain in the community rather than go into an institution.
For example, Bill Bogdan’s brother lives in a community setting with round-the-clock support. The care allows him to live in his community instead of in an institution. “I think that every person with a disability has a right to live in the community, has a right to live where they choose with or without supports,” said Bogdan, an independent manual wheelchair user who lives in the Chicago suburbs.
What the court decision changed
Federal Section 504 regulations required integrated service delivery for decades before Olmstead v. L.C., but Olmstead applied the integration principle under the Americans with Disabilities Act (ADA) and established a landmark Supreme Court precedent.
The 2024 HHS rule didn’t create community integration from scratch. Instead, it gave HHS-funded programs more detailed instructions about what the existing requirements meant in practice.
Seventeen states under Republican control challenged the updated Section 504 regulations in Texas v. Kennedy. By September 2026, five remained as plaintiffs, and the US District Court of Texas approved the parties’ joint request for final judgment and “vacated” six pieces of HHS’s integration regulations nationwide, closing the case.
The order erased HHS’s definition of the “most integrated setting,” and it removed all of Section 84.76, the rule’s detailed community-integration section.
Three narrower provisions applying the same integration principle to program accessibility, postsecondary education, and accessible medical diagnostic services were also removed.
Section 84.76 is particularly important because it spelled out what unnecessary segregation could look like. It stressed that policies and practices could violate the rule not only when they resulted in institutionalization, but when they placed a person at serious risk of institutionalization.
“It’s one thing to be fighting against everything else in life to build your way forward. But it’s another thing when the government is against you doing it too.”
The court removed those regulatory instructions, not the underlying disability-rights laws, which understandably has caused great confusion and concern in the disability community and for the nonprofits serving people receiving HCBS.
The ruling didn’t repeal or invalidate Section 504 nor the ADA, it didn’t overturn Olmstead nor require states to reduce HCBS funding. The Department of Justice’s (DOJ) separate Section 504 integration regulation also remains. Those distinctions were emphasized during an October 8 briefing by the Defend Community Integration Coalition (DCIC).
Why the missing rules matter
Charles Petrof, a senior attorney who works on ADA and Section 504 issues for Access Living, said that one way to understand the change is that disabled people have “confronted an opposition from their own government to their rights to live in the community.”
“It’s one thing to be fighting against everything else in life to build your way forward,” he said. “But it’s another thing when the government is against you doing it too.”
Petrof compared Texas v. Kennedy to “the umpire and the pitcher agreeing to call the ball a ball, regardless of whether or not it was a strike,” in order “to take out the regulations that are supposed to make it easier to understand for everyone how to comply with Olmstead.”
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The disappearance of those regulations is only part of the shift. The court ruling also comes after a larger shift inside the federal government, whose own interpretation of the integration mandate changed.
On June 18, 2026, the DOJ’s Office of Legal Counsel issued an opinion arguing that neither Section 504 nor Title II of the ADA itself imposes an integration mandate on states. The opinion cannot overturn Supreme Court precedent by itself, but it establishes the executive branch’s current legal position.
“People with disabilities first and foremost in the immediate term have lost the DOJ as an important partner in safeguarding civil rights.”
Destabilizing the environment
For nonprofits, that federal change isn’t simply a legal argument. It can affect how organizations plan programs, pursue funding, and help people enforce their rights.
Smock said that the immediate effect for disability advocates is not that existing rights suddenly disappeared, but that a federal enforcement partner they previously relied upon has changed course.
“People with disabilities first and foremost in the immediate term have lost the DOJ as an important partner in safeguarding civil rights,” she said.
Access Living is hardly alone in facing this new reality. Smock pointed to organizations serving people experiencing homelessness, people with developmental disabilities, people with mental health conditions, and people in substance-use recovery programs, along with nonprofits carrying out deinstitutionalization work under Olmstead consent decrees. “What something this big does is, it destabilizes the environment for all of us,” she said.
That leaves organizations facing practical questions about their own futures. “We don’t know if our states will continue funding us,” Smock said. “We don’t know how, once our grants are done, are they going to be renewed? Are the feds going to have some sort of issue with it?”
The advocacy response didn’t begin with the September order. Disability organizations were already working to build public understanding before the September decision. In a July 2, 2026, podcast episode of the American Council of the Blind’s ACB Advocacy Update, advocates discussed Texas v. Kennedy and Section 504, as well how state and local advocacy could affect the outcome.
What advocates are doing next
Policy choices can be changed: “Somebody made a decision to do this. You can also make a decision not to.”One immediate resolution is to get the House of Representatives on record reaffirming community-integration rights. H. Res. 1586, introduced September 28 by Rep. Debbie Dingell (D-MI) with bipartisan cosponsors, would recognize the 27th anniversary of Olmstead and affirm the House’s position that the Rehabilitation Act and ADA require federally funded services to be provided in the most integrated setting appropriate to disabled people’s needs.
The resolution doesn’t restore the six vacated HHS provisions, but DCIC describes it as a first step in a longer legislative strategy. It also calls on federal, state, and local governments to support community living through HCBS, integrated employment, education, skills development, and other supports.
The resolution is only one part of that strategy. During DCIC’s October 8 briefing, advocates outlined several other steps:
- Urge House members to support H. Res. 1586 and senators to support a companion resolution
- Educate policymakers and communities that federal community-integration rights remain
- Work for Section 504 protections in state law
- Continue state-level Olmstead enforcement
- Share legal and advocacy resources
- Defend HCBS, housing, transportation and employment supports
For Smock, the immediate strategy is prevention and said that “what we’re trying to do is stop bad policymaking decisions before they happen right now.”
And despite the uncertainty, she emphasized that policy choices can be changed: “Somebody made a decision to do this. You can also make a decision not to.”
