Asides

Medicaid Reform Legislation: Scope, Provisions, and Projected Effects

Across the country, Medicaid provides critical healthcare coverage and support services to millions of people, including older adults, veterans, people with disabilities, and low-income working families. One key component of Medicaid is the provision of Home and Community-Based Services (HCBS), which allow individuals to receive care in their homes rather than in institutional settings.

Recent developments in Congress have raised concerns about the future of these services. The U.S. Senate has approved legislation that includes more than $1 trillion in cuts to Medicaid over the next 10 years, along with changes to other federal health insurance programs. According to the Congressional Budget Office (CBO), nearly 12 million people could lose health coverage as a result.

The bill passed narrowly in a 51–50 vote, with the Vice President casting the tie-breaking vote. Compared to the House version, which proposed $800 billion in Medicaid reductions, the Senate bill introduces deeper cuts. In total, the CBO estimates that combined reductions to Medicaid, Medicare, and Affordable Care Act programs will reach $1.1 trillion. These cuts are partly intended to fund the extension of tax reductions and other federal spending priorities, including border security.

Proposed Changes to Medicaid Spending

The bill includes several policy changes intended to reduce overall Medicaid expenditures. These include:

  • Work Requirements: Some Medicaid recipients would be required to work or volunteer at least 80 hours per month. The requirements would apply to parents of older children and to childless adults without disabilities.
  • Provider Tax Restrictions: The legislation would limit the use of provider taxes—fees states collect from healthcare providers to increase federal Medicaid reimbursements.
  • Rural Health Funding: To address concerns about the impact on rural healthcare access, the bill includes increased federal support for rural hospitals beginning in 2026.

According to the CBO, the expansion of work requirements alone could result in an additional $325 billion in Medicaid savings.

Provisions That Were Removed or Delayed

Some proposals were removed or postponed due to procedural limitations under Senate rules. These included:

  • Accelerated reductions to provider taxes
  • Restrictions on Medicaid coverage for non-citizens
  • Limitations on gender-affirming care

According to Senate estimates, these exclusions prevented roughly $250 billion in additional reductions.

Arguments For and Against

Supporters of the legislation contend that the changes are designed to promote personal responsibility, reduce fraud, and encourage employment among those who are able to work. They emphasize that Medicaid should provide support while also reinforcing pathways to self-sufficiency.

Critics note that many Medicaid recipients are already employed. The Kaiser Family Foundation reports that 64% of adult Medicaid enrollees aged 19 to 64 are working, with 44% employed full-time. Opponents caution that additional administrative requirements—such as verifying work status—could lead to loss of coverage for eligible individuals due to paperwork challenges or misunderstandings.

Potential Implications

This legislation represents a significant shift in federal health policy. Key areas of potential impact include:

  • Loss of Coverage: The CBO projects that millions may lose access to Medicaid, increasing pressure on hospitals, clinics, and local governments.
  • Family and Caregiver Impact: Work requirements may disproportionately affect low-income individuals and caregivers balancing employment with care responsibilities.
  • Strain on Rural Providers: While new funding is included for rural hospitals, it may not fully offset the broader effects of reduced Medicaid funding.
  • Administrative Burden: Implementing and monitoring new eligibility rules may introduce complexity and confusion for both recipients and state agencies.
  • Legal and Political Challenges: The close vote margin and contested provisions suggest the potential for litigation and ongoing policy debate.

How to Share Your Perspective

Those who wish to contact their elected representatives can use the following sample letter:

Dear Representative [Name],

I am writing to share my concerns about the proposed cuts to Medicaid in the Senate’s version of the reconciliation bill.

These reductions could significantly impact individuals who rely on Medicaid-funded services to live independently, including older adults, people with disabilities, veterans, and low-income families.

Home and Community-Based Services (HCBS) in particular provide essential support that allows people to avoid institutional care and receive services in their homes and communities. Because HCBS is considered optional under Medicaid, it may be among the first services states reduce or eliminate in response to federal funding cuts.

I urge you to consider the long-term effects of these reductions and to work toward solutions that protect access to care, support family caregivers, and allow individuals to remain in the setting that best meets their needs.

Thank you for your attention to this matter.

Sincerely,
[Your Name]
[City, State]

Resources for Engagement

Staying informed and engaging with policymakers can help ensure that healthcare decisions reflect the needs and priorities of diverse communities.

A Note from Wiley’s Walk

At Wiley’s Walk, we focus on the intersection of public policy and daily life—particularly how systems and decisions affect individual choice, access to care, and community inclusion.

Our goal is to provide clear, balanced information that helps readers understand complex issues and engage constructively. We believe thoughtful, informed dialogue plays an essential role in shaping policy that meets the needs of individuals, families, and communities.

For more articles and insights, visit: https://www.wileywalk.com

Silent Drafts

Most things don’t end with certainty. They drift off in silence, or stop before anyone realizes they have finished. Some moments and circumstances remain standing, half-built. There are conversations left unresolved, doors left ajar, and paths taken without understanding why.

Plans often fade not because they fail, but because they erode—worn down by delay, avoidance, or distraction. Emotions are offered without clarity, and decisions are made without enough intent to leave a lasting mark.

This piece speaks to those spaces—the in-between moments.
It turns toward the structures that were started but never completed, the gestures interrupted before they could become action, and the silences that hold meaning, even when no one acknowledges them.

It is about how presence can exist without participation, how opportunities can pass unnamed, and how the absence of conclusion does not erase the fact that something happened. Even unfinished things leave a trace.

Silent Drafts

By Kerry Ann Wiley

I. Framework
 A structure stands—
  not new,
   not whole.
 Access is conditional,
  dependent on
   who names the door.

II. Movement
 Steps were taken.
  Direction?
   Irrelevant.
 No signs remain,
  only soft ground.

III. Language
 A phrase was offered—
  unmarked,
   plain.
 No punctuation.
   Unclear.
   Not yet decided.

IV. Intention
 Motive: obscured.
 Affection—
  a resemblance,
   not a confirmation.
 It audits instead of comforts.

V. Witnesses
 Some watched.
  They said nothing.
   Their silence:
    not consent,
    not refusal.
  Just presence—
  or the absence
   of leaving.

 Others did not arrive.
  Choice?
   Only partially.

VI. Interruption
 What arrests the hand
  before it moves?
 What presses in
  when the ceiling drops
   without a sound?

VII. Opportunity
 It was mentioned.
  Not defined.
   Not repeated.

VIII. Threshold
 A door opened—
  not because it was unlocked,
   but maybe because
    no one noticed
    it was there.

IX. Pathways
 Was there a route?
  Possibly.
   Maybe implied,
    or inferred,
     or misread.

X. Completion
 Who declares success
  when the base was flawed?
 Who laid the first stone?      

XI. Absence
 It accumulates—
  not in the rubble,
   but in corners left
    untouched,
    uncontested,
     unsought.

XII. Record
 Possibility remains
  unscheduled.
 The ledger holds
  only those
   who were seen
    in time.

XIII. Interpretation
 The story survives
  not in what is told,
   but in what is
    deliberately
     withheld.

Not all stories are remembered because they were completed. Some remain unfinished, growing louder with time. They linger in the choices nearly made, in the gestures that rose and then fell away, unanswered. A door left open—whether by intention or by neglect—still leads somewhere.

“Let’s Find a Way”: A Life Shaped by Possibility

For over five decades, I have lived with a disability, a journey shaped by persistence and the collaborative support of those around me. During this time, I completed both high school and college, established a fulfilling career, and achieved home ownership. These milestones reflect the importance of accessible opportunities and the collective efforts that have made inclusion and participation possible.

From an early age, my family instilled a mindset of possibility. Obstacles were never endpoints. If there was a mountain in my path, the approach was simple: climb it, go around it, or go through it. There was always a way. That philosophy became my compass.

So imagine my surprise when, during a quiet conversation, someone close to me said, “We wondered if you would get here.” This was someone who had walked much of the journey alongside me. The words were offered with affection and were meant to acknowledge the experiences I had navigated and the progress I had made. Even so, they lingered with me in an unexpected way. They weren’t offensive, but they did prompt a deeper reflection. I began to consider what had truly made this journey possible from the start.

What if I had grown up hearing, “You can’t”? What if the expectations had been lower, the encouragement more cautious, the belief more conditional? The word “can’t”—when repeated enough times—becomes more than a limitation. It becomes a boundary, an invisible fence around what a person believes is possible. Over time, it doesn’t just shape opportunities—it shapes identity.

I’ve seen how the word “can’t” can quietly shape the experiences of others—bright, capable individuals who were not given the tools, the trust, or the opportunity to try. It can be found in the quiet resignation of someone who has stopped asking for more, perhaps having learned over time not to expect access or opportunity. It’s present in the paths not taken, when no one ever said, “You should,” or “You could.” The influence of “can’t” is often subtle, but it can linger. Over time, it can subtly limit possibilities, shaping both the path a person is able to follow and who they have the chance to become.

I am here because I was surrounded by people who viewed challenges through a lens of possibility. Their belief didn’t eliminate the barriers—but it shaped how I approached them. It encouraged me to look for openings where others might see only walls. I am deeply grateful for that foundation. It influenced not just the path I followed, but how I’ve come to understand what’s possible—for myself and for others.

Still, I find myself reflecting on what happens to those who are not met with the same perspective. What becomes of someone who grows up under the shadow of doubt, surrounded by more restrictions than encouragement? The word “can’t” may seem simple, but over time, it closes doors—internally and externally. It narrows vision, limits choices, and eventually reshapes a person’s sense of what is even worth reaching for. I think often about the lives that could have unfolded differently if someone had simply said, “Let’s see what’s possible.”

These reflections remain with me. They remind me that creating space for possibility—for the chance to try, to strive, to belong—is not a matter of idealism. It is a matter of equity, of dignity. My story should not stand out; it should be one of many. And that will only happen when we replace the quiet doubt of “can’t” with a shared commitment to “let’s find a way.”

Medicaid, Community, and Care: Weighing the Cost of Proposed Cuts

Families, caregivers, and disability advocates are paying close attention as the Senate considers a proposal that could further reduce Medicaid funding. This development follows similar cuts recently passed by the House. Although lawmakers describe the legislation as a strategy to reduce costs, many within the disability community are concerned. They believe these changes may seriously affect access to vital services and supports.

The Senate proposal outlines several changes to Medicaid. It includes limits on how states can fund the program, stricter eligibility checks, and new work requirements for many recipients. Lawmakers have framed these changes as efforts to improve efficiency and reduce waste. However, many community advocates disagree. They believe the burden of these reforms will likely fall on the people and services that Medicaid was created to support.

Medicaid offers a broad range of supports for people with disabilities. A significant portion of this support comes through home and community-based services, often referred to as HCBS. These services include help with daily tasks, in-home care, and programs that enable individuals to live and participate in their communities. Without them, many would have to rely on more restrictive, facility-based settings. Although these services are considered “optional” under federal law, they form the foundation of independence and inclusion for millions of people.

Historically, when the federal government has reduced Medicaid funding, states have responded by scaling back their home and community-based services. These cutbacks have resulted in, and continue to contribute to, lengthier waiting lists, reduced care hours, and a shrinking pool of providers equipped to handle the growing demand. As a consequence, those who depend on consistent and individualized support frequently face service delays or disruptions.

Families may need to step in to cover gaps in care, which can sometimes involve personal and financial strain. The workforce that delivers these services is already under considerable pressure, and additional funding constraints could make it more difficult to maintain staffing levels and meet the demand for care.

While the current Senate proposal does not directly reduce funding for services specific to people with disabilities, analysts observe that a large share of optional Medicaid spending—about 86 percent—is directed toward older adults and individuals with disabilities. Therefore, broad reductions in Medicaid funding could disproportionately affect these groups, particularly those who use services designed to help them live independently and remain part of their communities.

More than a thousand organizations nationwide have expressed concern about the proposed Medicaid cuts, warning that such changes could disrupt both the continuity and quality of care. They emphasize that federal policy shifts often have swift and tangible consequences, especially for individuals who rely on these services within their own communities.

Reducing funding for home and community-based services impacts much more than just healthcare. These services enable people to live safely and with dignity in their own homes. They also relieve pressure on families, employers, and local economies. When support is available at home, family members can keep working and stay involved in their communities. Without it, many are forced to step away from jobs to provide full-time care. This leads to workforce disruptions and puts additional financial stress on households. The effects are widespread and lasting.

If these services are reduced, more individuals may need to rely on institutional or less personalized care, which may not align with their specific needs or preferences. This could increase the responsibilities of family members who are already managing work, care-giving, and financial obligations. As a result, families might need to adjust their employment or daily routines, potentially affecting their overall stability and participation in the workforce and local economy.

As Medicaid discussions continue in Washington, advocates for people with disabilities and older adults are urging policymakers to recognize the program’s full impact—not just on budgets, but on individual stability, independence, and well-being.

This is an important time to consider how public policy aligns with widely held values and impacts the daily lives of individuals who use essential services. Decisions about Medicaid involve more than administrative details—they influence whether people can live independently, exercise personal choice, and participate in community life.

As the Senate evaluates potential changes to Medicaid, questions have emerged about possible unintended effects: reduced access to home- and community-based services, increased demands on family caregivers, and new challenges to community integration. For those who rely on these supports, it is a significant moment to share experiences and remain involved in the policy process.

Medicaid represents more than a budgetary item; for many, it is a foundational support that makes it possible to work, live independently, and participate in their communities.

As the policy discussions about Medicaid and related services continue to unfold, it highlights not only matters of budget and resource allocation but also the underlying values that shape how care and support systems are designed. At every stage of this conversation, it is important to recognize that each policy choice has real-world implications—and that rebuilding inclusive systems, once disrupted, can be a complex and slow process.

What Belonging Demands

Who Gets to Belong? A Reflection on Disability, Inclusion, and System Readiness

William Harkness’s essay is thoughtful, personal, and carefully constructed. It surfaces a reality that many within the disability community have quietly navigated for years: that the principles of inclusion, while widely embraced, often diverge from how inclusion is enacted in everyday environments.

At the heart of his argument—outlined compellingly in The Disability Caste System: Who Gets to Be “Disabled Enough”?—is the observation that different types of disabilities are not met with the same degree of acceptance or accommodation. Disabilities that are more visible, predictable, or familiar—such as mobility impairments—are often acknowledged and supported with greater ease.

Others, particularly those that affect communication, processing, or mental health, tend to generate uncertainty or hesitation. A professional with depression, for example, may find that their need for flexibility is interpreted as inconsistency, while a colleague with a physical impairment may be perceived as more straightforward to support.

The issue is not one of merit or capability, but of how closely someone’s needs align with what systems are already designed to manage. Mr. Harkness calls this phenomenon a “disability caste system,” where proximity to established norms affords greater access and legitimacy.

This dynamic is not always the result of explicit bias. Explicit bias refers to beliefs or decisions that are knowingly prejudiced or discriminatory, where the exclusion of someone is intentional and conscious. What Mr. Harkness describes is often more subtle. In many cases, choices about who to accommodate and how to do so are shaped by practical concerns such as limited resources or the desire for simplicity.

Even when decisions are made with good intentions, the outcome can still lead to exclusion. Individuals who fit easily into current systems are welcomed. Others, whose presence requires adjustments or flexibility, may be left out—not because they are less capable, but because change is perceived as too costly.

The essay gives several clear examples. Oral Deaf professionals, for instance, are often hired or promoted more readily than signing Deaf colleagues. This is not always because they are more qualified, but because they ask less of the system around them. Oral Deaf refers to Deaf individuals who communicate primarily through speech, lip reading, and assistive technology like hearing aids or cochlear implants.

Many oral Deaf individuals are educated in environments where spoken language and lip-reading are emphasized rather than sign language. This is one of several valid communication approaches within the Deaf community. In some workplace settings, spoken communication may be perceived as more compatible with existing structures, based on the assumption that fewer adjustments such as providing interpreters or modifying communication protocols will be needed. As a result, Deaf professionals who primarily use sign language may be unintentionally passed over, despite having comparable or exceptional qualifications.

A similar pattern can be seen in hiring initiatives aimed at neurodivergent candidates, particularly those on the autism spectrum. The term neurodivergent refers to individuals whose brains process information, learn, or communicate in ways that differ from what is considered typical. This includes autism, ADHD, dyslexia, and other variations that influence how individuals engage with their surroundings. These hiring programs often highlight strengths such as focus, technical ability, and reliability, which tend to align closely with conventional workplace expectations.

Candidates who communicate in expected ways or fit neatly into structured environments tend to progress more easily. Others, who may use alternative communication methods, work in non-linear ways, or challenge long-standing cultural habits, are often screened out early. These decisions are usually presented as matters of fit or readiness. In practice, they reveal a discomfort with needs that require deeper structural flexibility or cultural shift.

Over time, these patterns shape not only who gets hired, but also who becomes visible in leadership, who is seen as a role model, and whose needs are considered legitimate. Mr. Harkness describes this as lateral ableism. It is a kind of internal sorting that happens within disability communities as well as outside them. It often favors those who appear easiest to accommodate, while placing heavier burdens on others to prove their worth or suppress their needs.

Mr. Harkness does not suggest that inclusion efforts are without value. His message is that inclusion should not be defined by convenience. When systems choose to accommodate only those who ask the least of them, they are not advancing equity. They are preserving comfort. Real inclusion is not always simple. It may involve discomfort, adjustments, or slower timelines. It may require people to reexamine habits or question assumptions. These are not failures. They are signs of growth.

The process of becoming more inclusive does not require dramatic change all at once. Often it begins with small but important questions. Who is consistently supported in this environment? Who is quietly struggling? Which needs are met quickly, and which are put off or explained away? These questions do not assign blame. They open the door to greater awareness.

For those in leadership, this reflection can help identify where systems fall short. For those navigating exclusion, the words in this essay may offer clarity and recognition. For those working to build better structures, the message is simple. Inclusion is not measured by how easily someone fits into what already exists. It is measured by how far a system is willing to stretch to include those who do not.

This kind of work is not always visible. It does not always reward speed or certainty. It moves more like water—steady, deliberate, reshaping what it touches. Over time, it finds the places that have gone ignored and brings them back into view. There is dignity in that approach. There is meaning in choosing presence over performance, awareness over ease. And there is quiet power in every decision that says: belonging should not depend on being simple to accommodate.

Accessibility Through the Five Senses: Why It Matters More Than We Think

Many people think of accessibility as something visible: a ramp leading to a door, a button that opens it, or a sign that points the way. In this view, accessibility is functional, mechanical, and reactive. It is often reduced to a checklist of features, something to be installed after the fact rather than considered from the beginning. Yet accessibility is not merely a feature of good design. It is a mindset, an ethic rooted in the principle that no individual should have to work harder than others just to be present, to engage, or to feel welcome.

Despite growing awareness of inclusion, there remains a persistent belief that accessibility is optional, something relevant only to a specific group. This belief is not always expressed outright. Often, it is assumed unconsciously. Yet this assumption, this idea that accessibility is someone else’s concern, continues to reinforce barriers, often unnoticed by those who don’t face them.

Part of the issue lies in how disability is commonly imagined. It is typically associated with the most visible markers: someone using a wheelchair or walking device, or a white cane on a sidewalk. These images hold a powerful sway over public perception, shaping understanding in ways that ultimately constrain a fuller grasp of exclusion.

While some forms of exclusion are overt and recognizable, many others emerge more subtly, embedded within the routine decisions that shape everyday design. These decisions often overlook the sensory dimensions through which people engage with their environments, thereby marginalizing those whose experiences fall outside the assumed norm.

Sight
Visual impairments are not always absolute, as many individuals live with partial vision, reduced contrast sensitivity, or have difficulty reading small text. Many environments are designed with the assumption that everyone has ideal vision, an oversight that can unintentionally exclude many people. For example, websites frequently use low contrast fonts that are difficult to read, signage is often poorly lit or positioned too high to be easily seen, and instructions may rely solely on color coding without providing text alternatives.

While these design choices are not always made with the intent to exclude, they still create significant barriers for individuals with visual impairments. Clear, high contrast, and scalable design elements are beneficial for all users, but for those with limited vision, they are not just helpful—they are vital. Vision differs from person to person, and inclusive, thoughtful design should reflect that reality.

Hearing
Barriers to auditory access often arise not from what is present, but from what is missing. When announcements come through unclear speakers, when meetings proceed without captions, or when videos are shared without transcripts, individuals who are deaf or hard of hearing may be left without access to important information.

These situations are not uncommon; they occur regularly and reflect a broader oversight. They can unintentionally suggest that the needs of all listeners were not fully considered. Ensuring that information is available in spoken, written, and visual forms should be a standard part of inclusive design, rather than viewed as an added feature.

Touch
In an era of sleek surfaces and minimal interfaces, the sense of touch is frequently overlooked. Glass panels now dominate phones, elevators, and appliances. While they may appear modern, they often lack tactile feedback, making them difficult or impossible to use for individuals who are blind or who experience limited sensation.

Raised buttons, textured surfaces, and Braille are not outdated features; they are tools that allow more people to navigate independently. The assumption that all users rely on sight and fine motor skills fails to reflect the diversity of how people interact with their surroundings.

Smell
Scent is rarely mentioned in conversations about access, yet it plays a significant role in whether an environment is usable. Strong fragrances used in cleaning products, air fresheners, or perfumes can trigger migraines, asthma, or sensory overload.

For individuals with scent sensitivities or certain neurological conditions, these environments are not just unpleasant—they can be dangerous. Creating spaces that are low-scent or fragrance-free is a small shift with a large impact. It signals consideration, safety, and care.

Taste
Although taste might seem unrelated to accessibility, it is central to shared experiences. Meals are often the setting for connection—in meetings, events, or informal gatherings.

For individuals with allergies, medical dietary restrictions, or sensory aversions, such moments can sometimes feel isolating. The recurring experience of having limited or no safe options, or needing to politely decline food, can create a quiet sense of being overlooked.

These small experiences may build up over time, contributing to a feeling of exclusion. Offering clearly labeled and inclusive food choices helps ensure that everyone feels acknowledged and welcomed, not just those whose needs are more frequently anticipated.

Understanding Why It’s Dismissed
Why, then, is accessibility so often overlooked? In many cases, it’s because well-executed accessibility tends to go unnoticed. A ramp that isn’t personally needed blends effortlessly into the surroundings. Captions that aren’t read slip quietly into the background.

A scent-free policy might appear as just another line of text, easily missed by those it doesn’t directly impact. When something functions smoothly for one person, it can be easy to overlook the fact that, without those accommodations, someone else might not have been able to participate at all.

This lack of awareness is not evidence that accessibility is unnecessary. It is a reminder that those who benefit from accessible design are not always visible. The absence of complaints does not indicate the absence of barriers. A solution that serves one individual may still fail to meet the needs of another.

When accessibility continues to be treated as optional, it can quietly suggest that not everyone was fully considered from the start. It suggests that inclusion is a secondary concern, rather than a fundamental part of the design.

Toward a More Inclusive Standard
Designing with the five senses in mind isn’t about adding extras; it is about broadening the default to reflect the diverse ways people live, feel, and connect. Instead of asking, “Is this good enough?” the more crucial question becomes, “Who might be excluded by this?” That shift transforms design from a solution into an invitation.

Accessibility often goes unnoticed when it is done well—but poor accessibility never does. That fact alone makes it clear: accessibility isn’t a bonus; it is a baseline. It is not a special favor or an extra step. It’s common sense—a foundational principle that fosters participation, inclusion, and a genuine sense of belonging.

This is not merely a matter of policy or law; it speaks to a deeper respect for each individual—the belief that everyone deserves the same opportunities to engage with their surroundings. Accessibility means giving everyone an equal opportunity to participate.

It goes beyond physical accommodations to embrace all five senses—sight, hearing, touch, smell, and taste—because these are how we connect, communicate, and find belonging. Whether it’s entering a building, sharing a meal, or joining a conversation, every person deserves to feel included, respected, and truly part of the community.

Federal Moves Signal Potential Rollback in Disability Accessibility Standards

Delayed Protections, Proposed Rollbacks: What’s at Stake for Disability Access

Recent federal actions signal a potential shift in how accessibility is treated in public policy, with implications for millions of Americans who rely on accessible infrastructure and services.

Two recent developments—one involving a delay in the enforcement of airline passenger protections, and the other proposing changes to federal accessibility standards in construction—prompt important reflections on the direction of civil rights enforcement, the commitment to equity in federal initiatives, and the potential implications for consistent access nationwide.

For individuals with disabilities, these changes could affect whether schools, transportation, research facilities, and public buildings are usable and inclusive. For institutions, they may alter how accessibility is interpreted, funded, and prioritized in federally supported projects.

Two federal agencies are moving forward with regulatory changes that could influence the way accessibility standards are applied in public infrastructure and transportation. These actions—one concerning a postponement of enforcement and the other involving a proposed revision—may affect individuals with disabilities nationwide and raise broader considerations around civil rights, design practices, and the responsibilities of public institutions.

The U.S. Department of Transportation (DOT) has postponed enforcement of the “Wheelchair Rule” until at least August 1, 2025. Finalized in December 2023, the rule requires annual training for airline staff and contractors who assist passengers with disabilities or handle mobility devices. It also defines baseline standards for how assistance must be provided and stipulates that any delay in returning or damage to a mobility device is a direct violation of the Air Carrier Access Act.

Originally scheduled to begin implementation in early 2024, the rule’s enforcement was first delayed and has now been extended to allow for legal and administrative review. Several major airlines have filed lawsuits challenging the DOT’s authority to implement the new requirements.

For air travelers who rely on mobility devices, the delay may mean continued inconsistency in service and limited recourse when equipment is damaged or lost. These incidents can lead to more than temporary inconvenience—travel disruptions can result in missed job obligations, canceled medical treatments, or weeks of logistical difficulties. In some cases, the physical consequences of using unsuitable replacement devices can be long-lasting.

While the DOT delay concerns air travel, another federal agency is considering a broader shift that could influence the accessibility of physical spaces across multiple sectors. The U.S. Department of Energy (DOE) has proposed a rule that would remove explicit accessibility design requirements from its regulations for construction and renovation projects receiving federal funding.

The Department has described the proposal as a technical update intended to streamline regulatory language. However, the revision would eliminate specific references that have long ensured that features such as accessible paths, signage, and maneuverable spaces are built into DOE-supported infrastructure.

This proposal intersects with Section 504 of the Rehabilitation Act of 1973, which prohibits discrimination based on disability in any program or activity receiving federal financial assistance. Section 504 has shaped how federally funded facilities are designed and operated, from university labs and health centers to clean energy demonstration sites and workforce training hubs. Removing explicit accessibility standards could create inconsistencies across agencies and complicate compliance for contractors and institutions.

If adopted, the DOE proposal could have a ripple effect beyond the agency’s direct authority. Without detailed requirements, federally funded projects could vary widely in how (or whether) they incorporate accessible design. This could result in new schools, labs, and workforce facilities being built without features that enable equal use by people with disabilities. It could also place a greater burden on individuals to file complaints or seek legal remedies after the fact, rather than relying on proactive, codified standards during the design and construction phases.

The proposed rule could set a precedent for other federal agencies considering regulatory rollbacks. If one agency successfully removes enforceable accessibility language from its regulations, others may follow suit, potentially weakening uniform expectations for access in federal programs across housing, healthcare, transit, and education.

Although the rule change is administrative, its effects may be felt in day-to-day experiences. Without clear, enforceable standards, accessibility often becomes variable—dependent on interpretation, available resources, or project priorities.

The potential costs of inaccessibility extend beyond individual hardship. When a wheelchair user cannot safely travel for work, or a public innovation lab is built without accessible entry points or workstations, the impact is felt not just by one person but by the broader community. It limits workforce participation, restricts access to public services, and undermines federal investments intended to serve all citizens.

Accessibility is not only a legal requirement—it is a design principle that supports a wider range of users, including people recovering from surgery, older adults, delivery personnel, and those navigating complex environments. Features like step-free entries, clear signage, and adjustable work spaces increase efficiency and safety for everyone, not just those with permanent disabilities.

The DOE’s proposed rule is currently open for public comment. Its future will depend in part on whether it receives a substantial number of well-supported objections that raise legal, operational, or equity concerns. As both the DOT and DOE consider the next steps in their respective processes, these decisions will influence how consistently accessibility is integrated into federally supported services and infrastructure. They also reflect broader questions about how public institutions prioritize equity, accountability, and participation in a rapidly changing built environment.

Individuals, advocacy organizations, and institutions concerned about these potential changes are encouraged to review the proposed rule and submit formal comments. Participating in the public comment process remains one of the most direct ways to influence how accessibility is protected and implemented in future federal policy.

Proposed Department of Energy Rule Could Impact Accessibility Standards for New Construction

The U.S. Department of Energy (DOE) has introduced a proposed rule that could significantly affect accessibility requirements for new construction and alterations in projects it funds. The rule would remove specific mandates that currently ensure accessibility features are incorporated into federally supported buildings. While the Department describes the proposal as an effort to streamline its regulations, disability advocates have raised concerns about the potential implications for inclusive design and civil rights protections.

If adopted without modifications, the rule would carry the force of law, potentially weakening the Department’s accountability for ensuring that its funded projects meet accessibility standards.

Understanding the Legal Context

This proposed rule intersects with Section 504 of the Rehabilitation Act of 1973, the first federal civil rights law to protect individuals with disabilities. Section 504 prohibits discrimination on the basis of disability in any program or activity receiving federal financial assistance.

Among its most visible legacies is the integration of accessible design features—such as ramps, elevators, wide doorways, and tactile signage—into public infrastructure. These features are more than just design elements. They represent access, independence, and participation. For many people with disabilities, they are essential for taking part in education, work, health care, and civic life, which includes activities such as voting, community involvement, and engagement with public services.

What the Proposed Rule Would Change

The DOE’s proposal would remove explicit accessibility standards from its construction and renovation regulations. While other federal statutes—like the Americans with Disabilities Act (ADA)—continue to provide important protections, this rule could create inconsistencies in how different agencies interpret and enforce accessibility requirements.

If put into effect, the proposed regulation would have the force of law and could weaken or confuse existing accessibility requirements for programs funded by the Department of Education, potentially putting important protections at risk.

Why This Matters

While the proposal is framed as a technical update, its potential effects are far-reaching. Concerns raised by disability rights organizations and legal experts include:

  • Reduced clarity in how accessibility is implemented across federal programs;
  • Barriers to enforcement if explicit design requirements are no longer specified;
  • Risk of precedent, where other agencies might follow with similar rollbacks;
  • A possible weakening of Section 504’s influence on inclusive infrastructure design.

Many in the disability community see this proposal as out of step with the intent and spirit of Section 504, which was created to promote inclusion, access, and fair participation for people with disabilities.

The new regulations will take effect unless the DOE receives a large number of significant adverse comments. A “significant adverse comment” is one that clearly expresses opposition to the proposed rule and offers a meaningful rationale—such as legal concerns, practical implications, or alignment with broader civil rights goals.

To be effective, your comment should include:

  • An introduction of who you are
  • Your personal or professional experience with disability and accessibility, including any credentials or relevant background
  • A brief explanation of why accessible design is essential
  • A statement that your comment is “a significant adverse comment” on the regulation

The Disability Rights Education and Defense Fund (DREDF) have created templates to help you prepare your comment:

When your comment is ready, submit it in two places:

  1. Submit your comment here (first site)
  2. Submit your comment here (second site)

For additional support, including step-by-step instructions, you can watch DREDF’s recorded webinar here.

Public comments must be submitted by 11:59 PM EST / 8:59 PM PST on Monday, June 16, 2026, in order to be considered.

Closing Thoughts

The DOE’s proposed rule presents an important moment for public engagement. While regulatory modernization is sometimes necessary, accessibility must remain a core commitment in federal policy.

Participation in the comment process allows individuals and organizations to help shape how laws like Section 504 are interpreted and implemented. By adding your voice, you contribute to the ongoing work of ensuring public infrastructure is designed for all—now and into the future.

Standing Firm: Honoring the Life and Legacy of Denise DiNoto

“Be sure you put your feet in the right place, then stand firm.” – Abraham Lincoln

The quote from Abraham Lincoln resonates deeply when reflecting on the life and work of Denise DiNoto. When I think about effective advocacy—what it looks like in action and what it asks of us—I think of Denise DiNoto.

I came to know Denise through the New York State Department of Health’s Disability and Employment Health program, but our connection quickly grew beyond professional collaboration. Denise was not only a skilled advocate and strategist; she was a generous colleague and a steadfast supporter of others’ growth. Her clarity, compassion, and belief in the power of both systems and individuals to create change left a lasting impression on me—and on so many others whose lives and work she touched.

She had a clear understanding of the importance of effecting change from within established systems, yet she was never reluctant to speak out when it counted. Our mutual interest in writing created a meaningful connection between us. When I first considered launching this blog, Denise offered thoughtful guidance and encouragement that played a key role in moving the idea forward.

At a time when I was still finding my voice, Denise encouraged me to keep writing and reminded me that my message and creative work had value. Her belief in what I had to say made a lasting and deeply personal impact. Her insight and generosity left a lasting impression on me, as they did on so many others whose lives and work she touched. The impact she had on those around her continues to resonate in both personal and professional ways.

What made Denise such an effective advocate was her nuanced understanding of how to create meaningful, lasting change. She believed in the ability of institutions and systems to evolve and improve. With insight and care, she navigated these structures in ways that encouraged broader participation and a more thoughtful response to diverse needs.

In meetings and public forums, she brought a thoughtful blend of facts, personal insight, and quiet determination. She built relationships, remained well-informed, and worked skillfully within established systems to encourage progress. By reminding decision-makers of their responsibilities and offering clear, constructive ideas, she helped shape meaningful and realistic paths forward.

Denise also understood that systems have limits. She knew that progress isn’t always timely or fair when it relies only on institutions. When she reached those limits, she didn’t hesitate to step outside the system and speak out in other ways. Whether through public speaking or engaging directly with the community, she used her voice to highlight the barriers faced by people with disabilities and to advocate for equity, fairness, and real change in clear and powerful ways.

Denise’s effectiveness as an advocate stemmed from her ability to balance two essential approaches: engaging with systems when they offered a path forward, and stepping beyond them when that path became too narrow. Rather than seeing these roles as contradictory, Denise understood them as complementary aspects of thoughtful advocacy.

Her ability to work within systems while also recognizing when to step outside them reflected a steady commitment to dignity, self-determination, and equity. For her, this dual approach reflected a belief that meaningful progress often depends on both working with established structures and knowing when to seek alternatives.

Denise DiNoto’s work and presence left a lasting impact. She demonstrated that the heart of advocacy lies in standing firmly in the right place—with empathy, conviction, and a commitment to possibility. Her legacy will continue to guide and inspire.

— K.A. Wiley

Knots That Won’t Hold

By Kerry Ann Wiley

The Space Just Inside the Door

The room held two, yet little passed between.
One stood just inside the doorway—not quite arrived, not yet gone.
The other moved silently, fixing what was never broken.

The movements were not purposeful.
They were only repeated.

There was no greeting and no conversation.
Yet the silence had a shape.

It was not angry.
It was not final.

It was the kind of silence when the unspoken takes hold,
A shift with no name, a truth left untold.
The air did not press—it simply stayed,
Not heavy, not harsh, just quietly laid.

Even waiting bore its own strain.

Instinct Before Intellect

The body registers,
before the mind can explain.

A shift in breath.
A break in rhythm.
Hands reach, then hesitate.

There is a hollow where certainty used to be.
Fingers intertwine, but the hold falters.
Elbows become barricades.

What once felt like home,
became a negotiation of distance.

Touch misfires.
Movement becomes mimicry.

Still, the gestures continue—
not out of connection,
but habit.

Metal strikes metal.
Silence gathers.

It is a ritual,
but one without resolve.

The Weight of a Single Truth

Something is spoken.
It is not loud.
It is not cruel.
It strikes with a clarity that shifts perception.

Perhaps it is a truth.
Perhaps a decision.

It is a line drawn—
not without consequence.

One truth, spoken in the voice of someone
who expected a conversation,
and received a verdict.
The silence that follows
speaks what the words could not.

There is no reply—only the ache
of something recognized too late.

What is carried cannot be shared.
It includes what is chosen,
what is withheld,
and what cracks without falling.

This is not collapse.
It is the slow untying
of something that once held fast.

A pause.
Memory begins where language fails.

What Memory Knows

What follows is not a retelling.
It is a form of holding—
the weight of silence,
sculpted into permanence.

The movement is circular,
echoing the way memory works—
not to change the outcome,
but to understand the shadow it left behind.

When Silence Replaces Shelter

One enters. One remains.
Light flickers. Rain hesitates.
Something arrives—
not words.

There is a hollow where certainty used to be.
Fingers intertwine, but the hold falters.
Elbows become barricades.

Silence gathers.
Metal meets metal.

A ritual, without resolve.

One truth said,
in the voice of someone
who expected a conversation
and got a verdict.

What is carried cannot be shared.
It includes what is chosen,
what is withheld,
and what cracks but does not fall.

Words linger longer than warmth.
Mouths closed like windows
against a storm
that already passed—
or hasn’t yet.

What Lingers After the Storm

This isn’t the first time.
This is grief’s second breath.

Grief, reheated.
Words linger longer than warmth.

What one releases, the other holds.
What one withholds, the other senses—too late.

The knot doesn’t slip free.
It doesn’t tighten.

It simply remains—
drawn loose between what was said and what was not.

Only tension—
quiet, persistent,
unresolved.

The Stillness That Remains

Not every unraveling ends in goodbye.
Some threads stay knotted—
not out of strength,
but because they were never untied.

They hold, even as they fray.

Whatever shifted
has now settled into silence.
It no longer seeks a name—
it only lingers.

What remains
does not speak.
It does not reach.
It does not break.

It stays.

Author’s Note

Knots That Won’t Hold is a quiet meditation on emotional distance—not the kind shaped by conflict, but by silence, hesitation, and the things left unsaid. It traces the slow unraveling of closeness, where presence lingers but connection quietly slips away.

The piece unfolds through memory, gesture, and stillness—where the body often senses what the mind hesitates to name. Much of it lives in the in-between: not quite arrival, not quite departure. Emotional truths aren’t resolved here, but gently revisited. Some knots come loose because they were never meant to hold; others remain, not through force, but through quiet persistence.

At its core, this work lingers in what remains: the weight of silence, the echo of what was nearly spoken, and the stillness that follows when understanding recedes. It offers a soft place to land—for those who’ve lived these silences, and those still learning their language.— K.A. Wiley