Reasons for Optimism. No, Really.

Sometimes you just need someone to tell you everything's going to be okay. That's why I just read (and loved) Ruy Teixeira's The Optimist Leftist: Why the 21st Century Will Be Better Than You Think. As reporter and author E.J. Dionne, Jr., said, "Beware: This is the rare political book than could force you to smile."

Teixeira makes a compelling case that the best is yet to come for progressive policies. And the book was published just a few weeks ago, so yes, it takes into account the Trump administration and all of the threats it brings.

The Problem with Pessimism

As Teixeira puts it, "pessimism dramatically undermines the appeal of the left. Why on earth would anyone sign up with a movement that believes the situation is so hopeless? What's so inspiring about that?...Pessimism makes people less likely to believe in positive change, not more likely."

During the Obama administration, we saw a lot of policy successes that will not be reversed, he writes, but "when the left was winning, it often acted as if it was losing." Instead of telling people how bad things have become, he argues, we need to spotlight what's working and build on it. The left needs a positive vision, compelling arguments, and leaders who can embody them.

Reasons for Optimism

Progress has slowed down, but it hasn't stopped. "What's correct is that people want to move up from their current life, not that they believe there is nothing good about their current life....Today, we live in freer, more democratic, less violent, and more prosperous world than we ever have before."

Things are good, and they will get better. "The problems we face today are solvable and, moreover, are likely to be solved in the coming decades. Life for ordinary citizens should improve dramatically over the course of the 21st century."

Demographic changes favor the progressive movement. We're witnessing a societal shift from manufacturing toward a postindustrial, knowledge-based society that's part of a global economy, and that is not going to reverse. Conservatives are clinging to shrinking populations to win elections, and the math just doesn't add up to future success. At the same time, progressives must recognize that emerging constituencies -- including immigrants and minorities, professionals, the highly educated, women, singles, non-religious, Millennials -- "by and large are not the chief beneficiaries of existing welfare states and need a 21st-century version of progressive state action to enable their future."

The Piketty Problem

In Capital in the 21st Century, French economist Thomas Piketty notes that by its very nature, capitalism tends to lead to inequality, concentration of wealth among a few, and lower living standards for the masses. And the way the left and right approach "the Piketty problem," Teixeira says, is very different. "The left sees this as a real problem that can't be solved but the market alone. The right is defined by its defense of market outcomes, no matter how dismal." And that disconnect works in the favor of the left: "The right's view is out of touch with current and future economic reality and will be increasingly unpopular with voters."

We're seeing a real example of that now. Many lower- and middle-class voters bought into the criticisms of Obamacare -- and in fact didn't realize that "Obamacare" (which they hated and wanted repealed) was the same thing as the Affordable Care Act (which they supported because it gave them access to health care). But many of the people who love the rhetoric about making the government smaller, building a wall, and repealing Obamacare will be seriously hurt by the Trump administration's health care and budget proposals. The Republicans' game -- tricking people to get elected (Trump), lying to them about the consequences of cuts (Ryan), and disregarding the human impact of these decisions (Mulvaney) -- just isn't sustainable. In the short term, rich people will get richer and many poor and disadvantaged people will be hurt, but over time, our system will hold these officials accountable. Maybe as soon as the mid-term elections.

Teixeira argues that progressives will be more successful if they embrace the fact that in a capitalist society, good economic times will lead to upward mobility and personal optimism, which in turn will promote social generosity, tolerance, and a sense of shared purpose. So instead of whining about injustice, he says, progressives should point out that high inequality is an obstacle to growth -- for everyone. "Capitalism must be actively pointed in a different direction by adopting a new approach that pushes back against inequality and promotes the economic health of the middle and working classes as the key driver of growth." And the left needs to talk about inequality not just as a problem because it's unfair, but as an obstacle for growth -- for all.

The Opportunity Today

As I read The Optimist Leftist, I often found myself thinking, "Yeah, but..." -- because the challenges we face today are real. We can't ignore those threats, and while we embrace an optimistic view for long-term justice and equality, we have to fight to defend the progress we've made, and push back on bad policy. At the same time, Teixeira's advice is that we see this as a time for defense as we prepare to be on offense. "It is absolutely necessary to agitate for progress during bad times -- to defend progressive gains, to push reforms forward when they are possible, and, of course, to develop the strength of the left. But the strategic imperative of bad times should be to prepare for good times and help make those good times happen."

With a more optimistic view of the long term, I'm going to keep doing what I've been doing. Instead of just telling my elected officials why I oppose cuts to programs I support, I'm telling them how those programs have helped my family and people I know and care about. I'm not just calling the people I oppose, but also thanking my representatives who are supportive and reasonable -- and giving them the information they need to keep fighting.

We're moving in the right direction, and Trump's election does not change who we are -- and will be -- as a country and society. And in the meantime, we can't sit by and wait for things to get better.

Who's the Most Heartless of These Heartless Bastards?

During the campaign, Donald Trump offered a populist message that resonated with just enough people to get him elected. He promised he wouldn't cut Medicaid. He told people their health insurance would be better and more affordable. Well, it turns out he either lied or changed his mind about improving people's lives, because his proposed health plan and budget would devastate millions of people while benefitting the wealthiest Americans.

According to the Congressional Budget Office, his health plan would leave 14 million more people without health insurance in 2018, which will rise to 21 million in 2020 and then 24 million in 2026. But his billionaire friend need not worry. Repeal of taxes in the Affordable Care Act will largely be passed on to the wealthiest Americans. People in the top 0.1 percent (earning at least $3.9 million per year) will get a tax cut of $207,000.

After Trump got elected, I told friends I was worried about a lot of things. But my overarching concern was that Trump and the people he was surrounding himself with simply don't care about other people (or at least haven't demonstrated any interest in improving the lives of average citizens).

That matters, because you have to be pretty heartless to support these devastating policies and budget cuts. In addition to taking away health coverage from millions of people, Trump and his team are pushing to cut funding for medical research, mental health care, the Centers for Disease Control and Prevention, energy assistance for poor families, and after-school programs -- and that's just a few examples. It also eliminates Community Development Block Grants, which help fund programs like Meals on Wheels, a program that provides meals to 2.4 million poor senior citizens.

Let's play a game called "Which Bastard is Most Heartless?"

Nominee: Paul Ryan, Speaker of the House
Nominated for: Says taking away people's health care is an "act of mercy." I'll let Representative Joe Kennedy III respond:


Nominee: Mick Mulvaney, Office of Management and Budget
Nominated for: Says there's no evidence that providing food to poor children helps them do better in school.

Nominee: Tom Price, Secretary of Health and Human Services
Nominated for: Tells a cancer survivor who's alive because of Medicaid expansion that he should settle for a small tax cut instead of getting heath coverage.


Nominee: Donald Trump, President of the United States
Nominated for: Lies, broken promises, and actions that hurt poor people and make millionaires and billionaires richer. Do you remember his campaign promise to not cut Medicaid? What about these assurances? "We're going to have insurance for everybody." "I am going to take care of everybody. Everybody's going to be taken care of much better than they're taking care of now.""It'll be another plan. But they'll be beautifully covered."

I am calling on Congress to REPEAL & REPLACE OBAMACARE with reforms that expand choice, increase access, lower costs & provide better care.

— President Trump (@POTUS) March 1, 2017

I was the first & only potential GOP candidate to state there will be no cuts to Social Security, Medicare & Medicaid. Huckabee copied me.

— Donald J. Trump (@realDonaldTrump) May 7, 2015

The Republicans who want to cut SS & Medicaid are wrong. A robust economy will Make America Great Again! https://t.co/u25yI5T7E8

— Donald J. Trump (@realDonaldTrump) July 11, 2015

Read "President Trump's False Promises on Healthcare," from The Hill, March 2, 2017.

Medicaid Cuts: "A War on Disabled People"

For families affected by disabilities, the threat to Medicaid is one of the greatest concerns about the proposed American Health Care Act. I don't need to rewrite all the information about this, but if you want to understand the risk and how it may affect people with disabilities, here's some recommended reading.

During the campaign, candidate Trump promised he would not cut Medicaid. But boy, has he backed off of that, as shown by the budget estimates from the bipartisan Congressional Budget Office.
Read "Trump Promised Not to Cut Medicaid. His Health Bill Will Cut $880 Billion From It," Vox, March 13, 2017

This headline from Forbes speaks for itself. Citing a column in the New England Journal of Medicine, this article shows that shifting Medicaid to a block-grant program will let states decide who gets services and which services they get. For example, they could choose to deny behavioral health services, which is what people with autism and other developmental disabilities depend on.
Read "A Shift to Medicaid Block Grants is a Threat to People with Disabilities," Forbes, March 9, 2017

This isn't really about the Affordable Care Act (ACA). Do you realize that Medicaid covers 57 million people, six times the number covered by the marketplaces created through the ACA?
Read "Sleeper Issue of Medicaid's Future Could Prove Health-Care Plans' Stumbling Block," The Washington Post, March 12, 2017

In the Post article, Bob Kafka, a Texas leader of the national disability rights group ADAPT says he is concerned that cuts to Medicaid would lead to the elimination of home- and community-based services that allow people to live independently -- and force them into nursing homes. "What the Republicans are doing," Kafka says, "is basically a war on disabled people."

Proposed Health Changes "Would Fail My Disabled Brother"

Please read and share stories like this. Writing in the Denver Post this week, Alyssa Roberts expressed concern about how severe cuts to Medicaid would affect her 19-year-old brother, who has physical, intellectual, and developmental disabilities. 

"Overlooked in the Republican bill to repeal the Affordable Care Act is a drastic change to traditional Medicaid funding that threatens services for more than 10 million people with disabilities," she writes. "For decades, Medicaid has been their lifeline — providing everything from specialized therapies to support for daily living. Medicaid keeps people with disabilities out of institutions. It pays for caretakers so their parents can go to work. And it’s more efficient than private insurance."

Capping the federal share of Medicaid funding "leaves two options," she says. "Either shift costs to already stretched state budgets or cut services drastically." And those cuts will likely include "hearing aids, at-home care, physical therapy, and some people denied coverage altogether." Other likely consequences? Pay cuts for low-paid providers and more institutionalization when people can't access in-home care. Yeah, it's bad.

Read "Republicans' Plan for Medicaid Would Fail My Disabled Brother."

Is Vaccine Debate Diverting Attention from the Real Risks to People with Autism?

When you hear "Trump" and "autism," you may first think about the president's support for debunked myths that vaccines cause autism. But the uproar over that issue maybe detracting from the real concern -- the harm that will be caused by repealing protection in the Affordable Care Act (ACA) and Individuals with Disabilities Education Act (IDEA), according to health policy experts at the Johns Hopkins Bloomberg School of Public Health and the Center for Mental Health Policy and Services at the University of Pennsylvania.

In a column posted today in the New England Journal of Medicine, the authors point out that the ACA has expanded access to health insurance for low-income people in 31 states and the District of Columbia by expanding the Medicaid program -- the largest health care payer for people with autism and developmental disabilities.

One of the authors, Colleen Barry of the Bloomberg School of Public Health, said, "These rollbacks could be devastating for children and adults with autism and other disabilities. It is important not to let the controversy over the debunked link between vaccines and autism distract from what is at stake in terms of the potential loss of critical benefits this vulnerable group relies on."

The authors are also concerned about threats to the rights of students with disabilities. Barry said, "People who care about preserving and expanding services for children and adults with autism need to pay attention to the conversations in Washington around the ACA repeal and threats to IDEA to make sure important protections and guarantees are not lost."

Read "Care for Autism and Other Disabilities -- A Future in Jeopardy."

New Analysis: 5 Ways Trump Agenda is Disastrous for People with Disabilities

More than 15 million people with disabilities, including children and seniors, would be at risk under the Medicaid cuts proposed by House Republicans and endorsed by President Trump, according to a new study by the Center for American Progress. I'm going to address some of these points in future posts, but for now, here's the short version:
1. Trump's health care plan would push millions with disabilities into institutions.
2. Trump's policies would make it harder for people with disabilities to work.
3. Trump's education plan would harm students with disabilities.
4. Trump would slash programs that provide basic living standards.
5. Trump's administration would weaken disability rights and protections.

The analysis concludes: "If Trump were serious about helping the workers and families who've been left behind -- including millions of Americans with disabilities and their families -- he would reject policies that undermine health care, education, and other basic living standards; push people put of the labor force as well as from their homes into institutions; and erode enforcement of disability rights in favor of a policy agenda that gives people with disabilities and their families a fair shot."

Read more at "5 Ways President Trump's Agenda is a Disaster for People with Disabilities."

This is a great article to share with your friends and family members who support the Republicans' proposal. If you have a personal connection to disability issues, you have a powerful voice -- this is a short, powerful analysis that can change minds and inspire action.

SHARE THIS VIDEO: How Medicaid Cuts will Harm People with Disabilities

Just released today, this video by the Center for American Progress shows three perspectives on how proposed cuts to Medicaid will threaten the health, independence, and lives of people with disabilities. Watch and share.



Use this link to share on your Facebook and Twitter accounts:
https://youtu.be/s_aHP3O432Y

Reaction from Guest at Congressional Address: "We all left feeling expendable and disposable."

Jeannine Chartier, Executive and Artistic Director, VSA Arts Rhode Island

Jeannine Chartier had a unique vantage point for President Trump's address to Congress on Tuesday night. As a guest of Congressman David Cicilline (D-RI), the disability advocate and director of VSA Arts Rhode Island watched in the gallery with other invited guests. She shared some reflections with me yesterday as she waited to board her flight back to Rhode Island.

What was it like to watch the speech in person?
It was an honor to be invited by Congressman Cicilline, and he graciously pushed my wheelchair through the long and winding underground "accessible" pathway over to the Capitol. It was an incredible experience, even if it was sometimes horrifying to hear the president's vision for our country.

Who were you seated with?
I was with other guests who had been invited by Democratic members of Congress, and our seating was scattered throughout many Republican guests. Mixed into my corner of the gallery: a woman who told me she had had a heart transplant, women wearing headscarves, several Native Americans in traditional dress, and people of difference races, ethnicities, and sexual orientation -- some wearing buttons promoting causes or simply #resist.

What was it like to be sitting with such a diverse group while President Trump presented his policy proposals?
During much of the speech, we sat stoic while enthusiastic Republicans leaped to their feet applauding his calls to dismantle laws regarding the Dakota Access Pipeline, EPA, health care, and education, while ignoring the rights of minorities (race, gender,  LGBTQ, etc.). While the speech started out on a positive note acknowledging disapproval of anti-Semitism and racism, his words still ultimately seemed to promote stigma and fear, and I feel we all left feeling expendable and disposable.

The president did acknowledge Rare Disease Day.
Yes, the individuals and their stories in the later part of the speech -- a parade of "victims" overcoming hardships. It just seemed to be exploitation and pandering, and completely disconnected from his previous speeches and actions. Sorry if I sound cynical or jaded, but the young woman in the wheelchair and how she was referenced reminded me of the old Jerry Lewis telethon days. No disrespect to the individuals, but his stated plans to dismantle policies and regulations that protect many of us who are minorities to have access to education and health care will only increase our struggles.

What other moments stand out?
A few come to mind. The shock and groan that went out from our side of the aisle about VOICE (Victims Of Immigration Crime Enforcement) was palpable. I don't know if that translated on TV, because the cheers from Republicans may have overwhelmed it, but it was obviously scary to a LOT of people in the room -- people looked at each other in eyes-wide-open shock. And my side of the room couldn't contain WTF laughter over the line, "The time for trivial fights is over." Did he really say that? Oh Lordy...and he pointed to Democrats like they are the ones tweeting at 3:00am.

Are you happy you went?
Yes. It was exhausting physically, but more so emotionally – it was a long speech full of disturbing rhetoric outlining a dark path we are heading down in this Trump presidency. It was a powerful reminder that there's so much to fight for -- and fight against. But I keep reminding myself, it's a marathon and not a sprint.

Likely Winners and Losers in Trump Budget Proposal

You can read a detailed budget analysis in many places, including this one from Ronald Brownstein in The Atlantic (one of my favorite sources for news and commentary). But I know you're busy, so here's a quick take on likely winners and losers.

WINNERS
Military
Defense contractors
Older white Americans (4/5 of seniors today are white)

LOSERS
Younger generations and minorities (47 percent of Americans under 30 are minorities)
Poor people
People with disabilities
National debt -- more spending and lower taxes = more debt
The environment
Diplomacy

The president's budget proposal protects Social Security and Medicare but slashes other domestic programs that represent important investments in our future, like education, training, and scientific research. As Brownstein points out, "In the long run, the older white population needs more of the younger non-white population to obtain the skills to reach the middle class -- and pay the payroll taxes that support the federal retirement programs on which those graying whites depend." Or in other words, "There is no financial security for the gray without economic opportunity for the brown." (A point Brownstein makes in his excellent article "Why Trump Has It Backwards on Minority Groups.")

For more budget details, read "Trump's Budget Proposal Threatens Democratic and Republican Ambitions."

Medicaid Cuts a "Prescription to Hurt the Neediest Kids"

Proposed cuts to Medicaid will significantly harm students with disabilities, according to a national survey of school superintendents. A plan that Republican leaders are pushing would reduce Medicaid spending by 25 percent by distributing Medicaid funding through a block grant or a per-capita cap, shifting costs to states. It's estimated that these cuts would actually be 30 to 35 percent when combined with the repeal of the Affordable Care Act.

Under Medicaid, schools are eligible to receive funding for medically necessary services for students under the Individuals with Disabilities Education Act (IDEA). This revenue helps cover the costs of nurses, therapists, and others that provide services for children with disabilities and health services for students living in poverty.

School leaders surveyed by AASA, the School Superintendents Association, said a 30 percent cut to Medicaid would disproportionately affect children with disabilities. Survey respondents (school superintendents and assistant superintendents, school business officials, and special education directors) anticipate the following consequences:

• Schools would need to reduce services and support for students with disabilities.
• Schools would be less able to provide qualified therapists (physical, occupational, and speech).
• Many schools will struggle to comply with the requirements of the IDEA, which is already "woefully underfunded."
• Health services for children with chronic conditions would be reduced.
• The inability of families to access regular check-ins, immunizations, and screenings for vision, dental, and hearing would increase absenteeism and interfere with their children's ability to learn. 

Read the report.

It's important to note that cuts to Medicaid would impact all children, not just those who are low-income or in special education. As one respondent said, "Without Medicaid funds, we would be forced to cut services to the majority of our students to make up for the special education mandates, which are mostly underfunded or not funded at all." That would mean larger class sizes, tighter budgets for salaries and programs, and cuts to important support like guidance counselors and mental health services. It would also be difficult to attract and retain high-quality educators and administrators.

The report concludes:
"School leaders are deeply concerned by the impact a block grant would have on districts’ ability to deliver critical special education supports and health services to students. We urge mem- bers of Congress to weigh how children will be impacted by a Medicaid block grant and to reach out to school leaders for speci c insights about the importance of their school-based Medicaid programs for students."

Read "School District Chiefs: Proposed Medicaid Changes Would Hurt Poor Children and Students with Disabilities" from the Washington Post.

Read the report, "Cutting Medicaid: A Prescription to Hurt the Neediest Kids."

The Trump Era: What It Means for People with Disabilities, and What You Can Do

If you or someone you know has a disability and are looking for encouraging words about the election of Donald Trump, you won't find it here. But it's important to evaluate the potential impact of a Trump presidency, understand how you can be involved, and how to move forward.

Where We Are Today

I started this blog in 2008 to advocate for people with disabilities during a presidential campaign that I knew would have a major impact. Looking back, there's no doubt that our choice of President Obama led to eight years of progress. Here are just a few examples:

• Health care reform that provided coverage for millions of people, prevented insurance companies from denying coverage for pre-existing conditions, and removed lifetime caps on coverage.
• Advocated for rights. The Obama Administration strongly advocated for the rights of all citizens. The Department of Justice and Department of Education issued a letter to schools telling them not to tolerate bullying -- including bullying against the 6.5 million students with disabilities.
• Signed the Workforce Innovation and Opportunity Act, pushing the Department of Labor, Department of Education, and other agencies to advance employment opportunities for individuals with disabilities.
• Launched the "Curb Cuts to the Middle Class" initiative focused on hiring people with disabilities to prepare to qualify for jobs with federal contractors and giving those employers tools to recruit and promote them.
• Signed the United Nations Convention on the Rights of Persons with Disabilities, the first new human rights treaty of the 21st century.

Many of my friends and/or Facebook friends have children with disabilities but don't appreciate the advances that have been made under President Obama. People complain about the health system, and there's certainly room for improvement, but if you have a child with a disability or chronic condition, you should cherish and fight to protect the Affordable Care Act. One way or another, changes will be made (and need to be made), but the fundamental principles -- 1) the right to health care, 2) the right to coverage for people with pre-existing conditions, and 3) the ban on lifetime caps -- must be preserved.

The Impact of a Trump Presidency

There is much fear and speculation about what Trump will do as president, but the first place to look is his stated priorities:

• Repeal the Affordable Care Act. (Something the Republican-led Congress also wants to do.)
• Reverse the expansion of Medicaid. About 10 million people on Medicaid have disabilities, representing 15 percent, and it covers not just health care, but home health aides and other critical services. If Trump repeals the ACA and turns Medicaid into a block grant program, as many as 30 million people could lose their insurance.

There is also concern that Trump will soften enforcement of the Americans with Disabilities Act, by shifting the priorities of the Department of Justice's civil rights division and other agencies. See "Disability Rights Advocates are Terrified of a Donald Trump White House" from the Huffington Post.

I don't have a crystal ball, but several patterns are emerging:

• President-elect Trump, the "outsider," is filling his transition team with "insiders." Many of them come from the Heritage Foundation, which advocate for traditional conservative positions like cutting taxes on wealthy people and corporations, repealing the Affordable Care Act, and reforming Social Security and Medicaid in ways that would negatively affect families. If you wonder how much the Heritage Foundation cares about families like yours, consider that they strongly advocated AGAINST signing the Convention on the Rights of Persons with Disabilities.
• The people he is putting on his transition team gives you a good idea of the kind of people who he will appoint to his Cabinet. Remember, many experienced, admired Republican policy experts and government officials have distanced themselves from Trump, so he will have a hard time finding qualified people for many positions. Most will argue for less government "interference," which families like ours may call "protection" for those who most need it. For example, Ben Carson, who's been mentioned as a potential secretary of education or HHS, has said that disability issues can be better managed by "businesses, industry, Wall Street, churches, and community groups." I don't know about you, but I'm not counting on Wall Street to ensure my child's education rights and health care.
• Trump's statements and behavior on the campaign trail have created more division than unity. Now that he's been elected, he's paying lip service to bringing America together, but everything he's said and done so far has had the opposite effect. His campaign has empowered bigots, racists, anti-Semites, and misogynists -- which is even more apparent now that he's been elected. Discrimination is likely to increase, and we can only hope that Trump will enforce existing laws and not weaken them. Let's just say that people with disabilities are not and will not be a high priority among his various constituencies.

What You Can Do

1. Advocate for People with Disabilities

Here are just a few organizations that will busy fighting for your rights, services, and programs in the next four years. Don't just visit these websites. Sign up for their newsletters, register for advocacy alerts, follow them on Facebook and Twitter. When issues come up, be ready to learn about them and take action.

• Here are Autism Speaks' legislative priorities. Join Autism Votes to get involved in your state.
• See Easter Seals' priorities and sign up for their Legislative Action Network.
• Follow The Arc's Action Center to keep up with issues that affect you. Sign up for alerts.
• Post a comment or email me to suggest other resources, and I'll add them here.

2. Focus on Your Family and Loved Ones

The night Donald Trump was elected president, I was in the hospital with my daughter, during an almost two-week stay. I was disappointed -- devastated -- by the results, but it wasn't the most important thing to me at the time. Do what you can do for the people closest to you. Being a good parent, spouse, and caregiver is one of the most important things you can do, no matter what else is going on in the world. Love and support the people who need you, and take care of yourself.

3. Be Nice

This may seem trite, but as much as we complain about Trump's behavior, comments, and actions, all we can control is how we act ourselves. Set an example for your children, neighbors, and colleagues by treating people with respect, tolerating different views, and trying to understand where people are coming from. We are not as divided as much as a 50-50 election may suggest. Let's focus on what we have in common, what we can do for others, and fight for what we believe in.

"I'm a Disabled American. Trump's Policies Will Be a Disaster for People Like Me."

Ari Ne'eman, president of the Autistic Self Advocacy Network, is not encouraged by the prospects of a Trump presidency. Ne'eman, one of President Obama's appointees to the National Council on Disability from 2010 to 2015, says he was bothered by Trump's mocking of people with disabilities, but he has been more focused on policy.

He writes, "Hillary Clinton offered clear, specific, and timely policy proposals to expand the social safety net and civil rights of people with disabilities, while Trump made clear his intent to slash services and roll back legal protections. For the millions of Americans with disabilities who depend on Medicaid and the Affordable Care Act to access the health care and public services that mean basic survival, it is policy -- not personal insult -- that has brought terror and despair in the aftermath of Trump's victory."

His concerns:

• Trump plans to slash the main source of federal financing for disability and aging services.
• Trump plans to eliminate critical legal protections for disabled people in the health care system.
• Trump may be about to set back federal autism policy by at least a decade.

But there's hope:

• Disability activists have faced down conservative attempts to roll back disability rights before -- and won.
• The Trump presidency will be a disaster -- but even a disaster presents certain opportunities.

Read his detailed analysis at vox.com, "I'm a Disabled American. Trump's Policies Will Be a Disaster for People Like Me."

Undecided: My Civil Discussion with a Confused Voter

I had a rare experience the other day -- a conversation with an undecided voter who was interested in hearing my thoughts. It was particularly interesting because she was a nurse helping to take care of my daughter during a scary stay at the hospital.

In a setting like that, I'm pretty good about not raising politics or forcing my views on anyone. But it was the day after the Cubs had won the World Series, and I mentioned that my Facebook friends seemed pretty excited about it, and it was a nice break from all the political chatter.

She said, "I know what you mean. Boy, what do you think about Hillary's emails? It sounds pretty bad." I told her that I think people are suggesting the "scandal" is worse than it is -- and that if Hillary had broken the law, she'd be prosecuted and convicted. She's not above the law and has never claimed to be.

But the nurse said she just doesn't know what to believe because there's so much bad stuff on both sides -- and many of her friends have told her some really negative things about Hillary. I asked innocently, "Would you like to hear what I think?" And here's what I said:

1. EXPERIENCE
While many people don't like Hillary, there's no doubt she's experienced. She's been First Lady, the Secretary of State, and a senator. She knows our international allies, and understands the complex relationships we have. So I think she's the best choice for people who care about national security international stability.

2. HEALTH
One of the issues I most care about the most is health care. (And since she's a nurse, I assume she cares a little about that too.) And an independent analysis shows that under Trump's health proposals, as many as 25 million people would lose health coverage. And low-income families and people with complex medical needs would be hurt the most.

3. TEAM
The president is only one person. Hillary will appoint good people, and I don't care if they're "insiders" if they will work toward positive change.

She then asked about the Supreme Court, and I conceded that if that's the only thing she cares about and wants the NRA and right-wing groups to select our justices, that's what Trump would do. But I told her that even if I shared her views about that, I'd still vote for Hillary for all the other reasons.

It was a civil, candid exchange of ideas, which is all too rare this year. And it was obvious that she's pained by this choice. She will vote, and she wants to make the right decision, and she's confused by all the name-calling, rumors, and accusations. So yes, there are undecided voters among us, and they're not all jerks.

Fact Check: Real Data on the Candidates' Health Proposals

If you or someone you know wants more than rhetoric, hyperbole, and personal attacks, take a look at these issue briefs from The Commonwealth Fund. Lots of data, charts, and easy-to-read analysis.

• A Look at the Clinton and Trump Health Reform Proposals
• Donald Trump's Health Care Reform Proposals: Anticipated Effects on Insurance Coverage, Out-of-Pocket Costs, and the Federal Deficit
• Hillary Clinton's Health Care Reform Proposals: Anticipated Effects on Insurance Coverage, Out-of-Pocket Costs, and the Federal Deficit

Four Threats to Medicare if Trump is Elected

Read "The 4 Ways Congress Could Weaken Medicare if Trump Becomes President" by Diane Archer, founder of JustCareUSA.org, in the Huffington Post.

1. Republicans in Congress want to privatize Medicare and turn it into a defined contribution program. This will force people to pay more for health care, because private insurers would have few limits on what they can charge for premiums, deductibles, and copayments.

2.  Republicans want to eliminate traditional Medicare. Traditional Medicare is the preferred option for 70 percent of people, because of the choice it offers for doctors and hospitals. This would restrict the government's ability to improve the program, which will mean fewer choices and higher costs.

3.  Republicans want to means-test Medicare even more, which would increase costs for middle-class and wealthier Americans.

4. Republicans want to raise the age of Medicare eligibility. People eligible for Medicare based on age can enroll when they are 65, but Republican leaders in Congress want to increase that to 67.

Read more.

LA Times Op-Ed: Trump's Pattern of Discrimination

An op-ed in today's Los Angeles Times calls Donald Trump "the most ableist presidential nominee in modern American history." David Perry, a disability rights journalist who has a son with Down syndrome, describes ableism as "discrimination against and stigmatization of people with disabilities or people perceived to have disabilities." He writes, "Ableists convey the message that disabled people are not full members of our society, leading to exclusion and even abuse. Trump is fully complicit in sending precisely that message."

Perry cites numerous examples of Trump's pattern of discrimination:

• He mocked a reporter who has a physical disability.
• He made fun of Hillary Clinton for her alleged illness, including pretending to wobble and faint to draw laughs from a crowd.
• He has made fun of people's weight, including Alicia Machado, Rosie O'Donnell, and even Chris Christie. 
• He has stated that some people are born with qualities to lead, while others aren't.*

But Perry explains that words are not what he's concerned about -- it's what Trump would do as president. He's promised to repeal the Affordable Care Act, which would once again make it legal to discriminate against people with a pre-existing condition. When asked by Perry and disability advocates to explain Trump's position on issues, his campaign has been silent. Read "Trump's Not Just Racist and Sexist. He's Ableist."

* Trump's biographer Michael D'Antonio has said that Trump's father taught him that "there are superior people and that if you put together the genes of a superior woman and a superior man, you get a superior offspring." Called "eugenics," this theory until the 1940s was used to justify sterilizing disabled people. And Adolf Hitler's theory of racial hierarchy was the justification for the Holocaust. Read "Donald Trump Believes He Has Superior Genes, Biographer Claims," from The Independent.

Disability Policy and the Election: A Wrap-Up

Still trying to decide who to vote for? Want to easily share a summary of the top issues to people with disabilities? Review this blog's most popular posts this election season:

Easter Seals on Campaign Issues: Exclusive Interview. The head government relations official at Easter Seals on the record of the Obama Administration, health care reform, special education, and key differences between the candidates' positions.

Thank You, Ann Coulter! A response to Coulter's offensive use of the "r-word."

Ayn Rand and Disabilities: Part 1 and Part 2. Why author Ayn Rand is relevant to this year's election, and her shocking disdain for people with disabilities.

Advocates Agree: Health Care Law is Good for People With Disabilities

Will Romney Cut Funds for Autism Program He Supported in Massachusetts?

Ryan Budget: "Dangerous to People with Disabilities"

Romney's Voucher Plan: "Disaster for Special Education Students" and Vouchers: What Would They Mean for Special Education?

Obama vs. Romney: The Bottom Line

All things considered, the 2012 presidential election comes down to one issue for people who care about people with disabilities -- and that's health coverage. Put aside the misleading attack ads and confusing statistics, and consider the following facts.

• Fact 1: The Affordable Care Act prevents insurance companies from denying coverage based on pre-existing conditions or disabilities.
• Fact 2: The Affordable Care Act expands Medicaid coverage for people with disabilities.
• Fact 3: Governor Romney has vowed to repeal the Affordable Care Act on his first day in office.

From the Arc of the United States, read "How the Affordable Care Act Helps People with Disabilities."

Having a major health need, or a chronic health need like a disability, can easily lead to bankruptcy even for working Americans. In Massachusetts, Governor Romney implemented a plan very similar to the Affordable Care Act. Now he wants to deny coverage to 45 million Americans, including veterans, families living in poverty, and people with disabilities. Is that the America we want?

Krugman: This Election Is Really About [Which Program?]

Writing in the New York Times, columnist Paul Krugman says that in many ways, this election is all about Medicaid. That's because if Governor Romney wins, his plan will deny health coverage for up to 45 million people who will have coverage if President Obama is reelected, and two-thirds of those people are current Medicaid recipients. 

More than 9 million Americans benefit from both Medicaid and Medicare, most of them elderly or disabled. Krugman outlines the program and its beneficiaries and points out a fact that would surprise many people -- most Medicaid recipients are in working families.

"For those who get coverage through the program," Krugman writes, "Medicaid is a much-needed form of financial aid. It is also, quite literally, a lifesaver. Mr. Romney has said that a lack of health insurance doesn’t kill people in America; oh yes, it does, and states that expand Medicaid coverage show striking drops in mortality."

Another perception that Krugman corrects is that Medicaid is poorly managed, with skyrocketing costs. Actually, Medicaid controls costs better than the rest of our health care system -- the average cost of care for adult Medicaid recipients is about 20 percent less than it would be under private insurance, and the difference for children is even larger.

Krugman concludes: "By any reasonable standard, this is a program that should be expanded, not slashed — and a major expansion of Medicaid is part of the Affordable Care Act. Why, then, are Republicans so determined to do the reverse, and kill this success story? You know the answers. Partly it’s their general hostility to anything that helps the 47 percent — those Americans whom they consider moochers who need to be taught self-reliance. Partly it’s the fact that Medicaid’s success is a reproach to their antigovernment ideology.

"The question — and it’s a question the American people will answer very soon — is whether they’ll get to indulge these prejudices at the expense of tens of millions of their fellow citizens."

Read "Medicaid on the Ballot."

Scary Statistics: Romney's Plan Would Deny Coverage for 30-37 Million Americans

Governor Romney has said several times that he wants to turning Medicaid into a block grant program to the states. A good idea? Sure, if the goal is to take health insurance away from tens of millions of poor people, which is what a new report says it will do. Oh -- and it will also reduce benefits for other Medicaid recipients. And if Romney keeps his promise to repeal the Affordable Care Act, even more people will lose their insurance.

The study comes from the nonpartisan Kaiser Family Foundation's Commission on Medicaid and the Uninsured. By cutting Medicaid spending by $1.7 trillion between 2013 and 2022, the plan would save $810 billion -- by kicking tens of millions of poor people out of the program. And estimated 14.3 million to 20 million Americans would no longer be eligible. By repealing the Affordable Care Act, another 17 million people would not be able to get health insurance, according to the Congressional Budget Office.

The report says it could be much worse. "If there are no requirements that federal payments be matched by state contributions, states could reduce state spending more than federal spending and these enrollment estimates would be understated.” And state payments to hospitals and nursing homes could fall by more than 20 percent, likely resulting in reduced services for seniors in long-term care facilities. So in other words, the people most affected by these cuts would be people with disabilities, poor people, and seniors.

Read the MSNBC article.

Download the 21-page white paper from the Kaiser Family Foundation.