State Olmstead litigation and the Affordable Care Act

Area of Science:

• Health Law
• Public Policy
• Disability Studies

Background:

• Significant efforts have aimed to broaden access to Medicaid home and community-based services (HCBS) for the elderly and disabled.
• Despite expansion initiatives, numerous states continue to face substantial waiting lists for HCBS.

Purpose of the Study:

• To analyze trends in Olmstead and related legal cases concerning states from 1999 to 2011.
• To assess the impact of these legal cases on the expansion of HCBS access.

Main Methods:

• The study examined data on legal cases filed against states between 1999 and 2011.
• Analysis focused on Olmstead and similar litigation related to HCBS.

Main Results:

• A total of 131 cases were filed during the study period.
• 90 cases were resolved through court rulings or settlements.
• These legal actions have been instrumental in motivating states to enhance HCBS programs.

Conclusions:

• Court cases, particularly those related to the Olmstead decision, have significantly influenced states to expand HCBS.
• Litigation has played a crucial role in facilitating the transfer of individuals from institutional settings to community-based services.