Disabled Voter's Committee
of the Iowa Democratic Party's
Disabilities Caucus

November 15, 2007

Purpose: The following collection of candidates' statements is hereby provided so that Iowa voters who have disabilities can use the information in making their choice of the next President of the United States.

Note: Former Alaska Senator Mike Gravel and Congressman Dennis Kucinich do not have Iowa campaign offices. Senator Barack Obama is the only candidate who specifically addressed the issues listed on the Iowa Democratic Party Disability Caucus Issues List. Senators Biden, Clinton, Dodd, and Edwards and Governor Richardson answered a questionnaire from the A.A.P.D.; all information relating to issues is from that document and the candidates' websites and other published materials. The materials were all used with permission of the candidates' campaigns.

Issues: These are the issues that the Disability Caucus of the Iowa Democratic Party Disabled Voters' Committee chose as the most important because of their significant impact on the live of people who have disabilities. The Committee asked all the Presidential candidates for their positions on these issues.

1. Do you have a comprehensive, universal healthcare plan?

Sen. Joseph Biden supports universal health care to ensure that all Americans, including those with disabilities, have access to affordable, quality health care. He thinks we will get to universal health care by: (1) focusing on reducing the cost of health care; (2) covering all kids; (3) giving everyone access to, at a minimum, the same health care plans that members of Congress have; and (4) lowering the cost of providing health insurance for employers and providing catastrophic coverage.

Sen. Hillary Clinton has a plan that stresses simplicity, cost control, and consumer choice. It is the American Health Choices Plan, which greatly improves care for Americans with disabilities by guaranteeing them coverage. People with disabilities will have more health insurance options under this plan because they will be able to choose from an array of private health insurance plans that offer benefits like those offered to Members of Congress, as well as a public program similar to Medicare. Insurers will be prohibited from denying coverage or charging higher premiums for individuals with pre-existing conditions and they will be prohibited from charging significantly higher premiums based on medical condition, age, gender, or occupation. The American Health Choices Plan preserves and expands existing critical support programs that fill gaps in private insurance. It will also provide tax credits to assure that no American's health insurance premium exceeds a certain percentage of income and the Best Practices Institute will fund medical research and disseminate this information to health care professionals and patients. The American Health Choices Plan requires coverage of important prevention service to diagnose and treat illnesses before they become serious and require expensive intervention because it involves the use of privacy-protected information technology and the empowerment of physicians to be a part of the quality development process. In addition, since persons with disabilities who have chronic health conditions may often need coordinated care services, the Clinton plan revises reimbursement to health care providers to provide incentives for the development of innovative models of care including "medical homes" and chronic care management.

Sen. Chris Dodd would ensure that all Americans will have quality, affordable health coverage. He will create a health insurance marketplace called Universal HealthMart that is based on, and parallel to, the Federal Employees' Health Benefits Plan (FEHBP). The Dodd plan would include business and individual contributions based on the ability to pay. It will have premiums that are affordable based on leveraged negotiating power, spreading risk, reduced administrative costs, and incentives for technology and prevention care. It will also have portable coverage; insurance purchased at Universal HealthMart will follow individuals.

Sen. John Edwards understands that health case is of special concern to people with disabilities. His plan guarantees universal coverage for everyone in America. Under his plan, families without insurance will receive coverage at an affordable price and families that have insurance will pay less and get more security and choices. Managed care should be a choice for people with disabilities and they need access to specialists that is now artificially limited by narrow definitions of medical necessity.

Mike Gravel proposes a universal healthcare voucher program in which the federal government would issue annual healthcare vouchers to Americans based on their projected needs. All Americans would be fully covered and would be free to use their vouchers to choose their own healthcare professional. No one would ever be denied health insurance because of their health, wealth, or any other reason.

Rep. Dennis Kucinich would streamline national health insurance to create "Enhanced Medicare for Everyone". It would be publicly financed health care, privately delivered, and would put patients and doctors back in control of the system. Coverage would be more complete than private insurance plans, encourage prevention, and include prescription drugs, dental care, mental health care, and alternative and complementary medicine.

Sen. Barack Obama is committed to ensuring that all Americans have health care coverage by the end of his first term in office. He recognizes that people with disabilities experience difficulties gaining access to quality health care. As president, Sen. Obama will require all health care providers to collect, analyze, and report data on the quality of health care given to vulnerable populations, including those with disabilities. This will improve care and health outcomes. His plan will also help people with disabilities by emphasizing care coordination and integration, which can dramatically improve care for patients with multiple conditions and doctors. Sen. Obama also supports additional training of health care workers so that they are better able to address the needs of the disabled populations.

Gov. Bill Richardson's plan for universal coverage would ensure that Americans with or without disabilities would have access to affordable, guaranteed coverage.

2. What is your plan for total consumer control of prescription drug programs?

Sen. Joseph Biden will work to expand access to Medicare Part D for people with disabilities. He supports allowing the Federal Government to directly negotiate for better drug prices with the pharmaceutical companies which would lower the cost to consumers. He will also close the "doughnut hole" gap in coverage that occurs once someone hits $2,250 in coverage.

Sen. Hillary Clinton has been actively involved with ensuring fair and equal access to Medicare Part D prescription drugs. She introduced legislation in the Senate to help the most vulnerable seniors and disabled Americans transition to new Medicare plans. As president, she will continue to fight for fair access to Medicare Part D prescriptions and to ensure that policies do not undermine continuity of care for any population served. Sen. Clinton also believes that we need to have a better understanding of the best pharmaceutical treatment options for all patients. Thus, she proposes establishing an independent public-private Best Practices Institute, which would be a partnership between the public and private sector that would let doctors, nurses, and other health professionals know what drugs, devices, surgeries, and treatments work best.

Sen. Chris Dodd will assure that people with disabilities have fair access to Medicare Part D by requiring Medicare to negotiate drug prices and immediately eliminating the so-called "doughnut hole" in Medicare Part D drug plans.

Sen. John Edwards believes that the federal government must ensure that Medicare Part D participants are able to access the prescription drugs they need to maintain their health and independence. As president, he will rewrite the drug bill to put patients and people above drug companies and HMO's, empower the government to negotiate better drug prices, and allow the safe reimprtation of drugs from other countries.

Sen. Barack Obama worked with Sen. Ken Salazar (D-CO) to urge the Department of Health and Human Services to provide clear and reliable information on the Medicare prescription drug benefit and to ensure that the Medicare recipients were protected from fraudulent claims by marketers and drug plan agents.

Gov. Bill Richardson will establish programs in each state to ensure that people with disabilities are made aware of all options available to them under Medicare Part D.

3. How will you adequately fund Medicaid waivers and other programs that facilitate independent living?

Sen. Joseph Biden was an original cosponsor of the Medicaid Community-Based Attendant Services and Supports Act (MiCASSA), which would provide a variety of personal assistance services under the Medicaid program to enable disabled individuals to live at home rather than in institutions. He cosponsored the Family Opportunity Act to allow low-income families with disabled children to buy into the Medicaid program. He cosponsored the Lifespan Respite Care Act, which would facilitate the provision of temporary rest breaks (respite care) for caregivers who take care of a chronically ill or disabled individual. Sen. Biden sponsored legislation to protect children, the elderly, and individuals with disabilities by providing non-profit groups that work with or care for such individuals with easy access to thorough, efficient criminal background checks through a national center on volunteer and provider screening.

Sen. Hillary Clinton understands that people with disabilities need assurance that individuals who provide direct-care services in home- and community-based settings are in sufficient supply and are well-trained. Therefore, addressing the shortage of health-care professionals and increasing choice of providers is critical to improving access to care for community-based services. The American Health Choices Plan addresses this issue by providing funding to schools of nursing to recruit and train faculty. Sen. Clinton believes that the Medicare homebound rule has been enforced in a far too restrictive manner and, as President, she will embrace a fair modification of Medicare rules so that Americans with disabilities are able to live their lives fully, without fear of losing their Medicare benefits. Sen. Clinton co-sponsored the Medicaid Community-Based Attendant Services and Supports Act, which provides individuals with disabilities and older Americans with equal access to community-based attendant services and supports. She believes the Olmstead opinion was a tremendously important moment in the disability movement and will support efforts to help states comply with it.

Sen. Chris Dodd will support creation of additional community-based options for individuals with disabilities because he understands their right to live their lives to the fullest in whatever setting they choose. In a Dodd Administration, Medicaid policy will not be stacked against community living. Sen. Dodd's Living with Dignity Initiative includes specific steps to attract, support, and retain home health aides and attendants; he will provide resources to improve wages, training, and working conditions for aides and will also establish strong workplace safety regulations such as ergonomics regulations.

Sen. John Edwards supports providing choices for people with disabilities to live in the community and will support legislation that strengthens freedom of choice. He has proposed a Living with Dignity Initiative that will fund state efforts to expand home care and reform the long-term care, including tax credits for long-term care, asset and income protection programs that prevent families from spending above their incomes, and experiments with long-term care insurance. He will also support the recruitment and retention of home care workers through better wages, training, and working conditions. His plan guarantees quality, affordable health care for American; it will strengthen Medicaid support for long-term care and emphasize home and community-based care to allow caregivers to keep their family members nearby.

Sen. Edwards believes that people with disabilities should be able to fully enjoy the benefits of living in a home of their choosing and in a community of their choosing. His Living with Dignity Initiative includes specific steps to attract, support, and retain home health aides and attendants.

Sen. Barack Obama believes that individuals who want to remain in the community and can safely do so should be provided the necessary assistance and supports. Therefore, he would increase funding for both HCBS and Independent Living Programs and prioritize efforts to streamline application and administrative requirements for states which choose to implement or expand these initiatives.

Gov. Bill Richardson supports providing choices for people with disabilities to live in the community. He would increase the wages of care attendants.

4. How would you create a standardization of government entitlement programs, e.g., housing, medical care, and income supplementation?

Sen. Barack Obama would standardize and coordinate government entitlement programs to make them more user-friendly. He believes that too many Medicare and Medicaid "dual eligibles" are subject to time-consuming
and complicated administrative processes that delay access to care and can result in lower quality care. He supports streamlining the benefits process for individuals with disabilities so that people receive the care they require in a timely manner. Both programs should give individuals with disabilities more information about the care to which they are entitled to receive under both programs so that decisions about care can be made in a unified manner. He also believes that the demonstrations projects that the Community Choices Act of 2007 seeks to create to improve coordination between benefits received by dual Medicare and Medicaid recipients are an important step to undertake in addressing this problem.

5. Do you support an ADA affirmative action provision like the one in the Civil Rights Act of 1964?

Sen. Joseph Biden co-sponsored the Americans with Disabilities Act, which extended the civil rights protections to individuals with disabilities. He will ensure that United States Supreme Court and other federal judges follow established precedent and Congressional intent with respect to the ADA and all other civil rights laws, thereby preserving equal rights for people who have disabilities and other minorities. Sen. Biden understands that the greatest barrier to full integration of individuals with Disabilities into mainstream society is not the limitations of their individual disability, but rather, it is the physical and attitudinal barriers imposed by society.

Sen. Hillary Clinton was a co-sponsor of a Senate Resolution that recognized and honored the fifteenth anniversary of the ADA because she is a strong believer in the value of the ADA. As president, she pledges to uphold the values intrinsic in the ADA and she will welcome advocacy groups to meet with her administration and voice their concerns. She will appoint judges who understand and respect the value of civil rights.

Sen. Chris Dodd supports an ADA Restoration Act because of the incremental erosion of the rights guaranteed by the ADA by the courts.

Sen. John Edwards is committed to protecting the civil rights of people with disabilities with full enforcement of the Americans with Disabilities Act and the Rehabilitation Act. He will ensure that the ADA remains consistent with the original intent of Congress.

Sen. Barack Obama is a former civil rights lawyer. Therefore, he knows firsthand the importance of strong protections for minority communities in our society. He is committed to strengthening and better enforcing the ADA so that future generations of Americans with disabilities have equal rights and opportunities. Sen. Obama believes we must restore the original legislative intent of the ADA in the wake of court decisions that have restricted the interpretation of this landmark legislation. He supports the ADA Restoration Act, a law that would bring us closer to the ADA's ideal of barring discrimination against anyone on the basis of disability.

Gov. Bill Richardson supports an ADA Restoration Act because the ADA has been seriously weakened by Supreme Court decisions.

6. Do you support insurance coverage for mental health treatment that is equal to treatment for physical health treatment, i.e. mental health parity?

Sen. Joseph Biden was a cosponsor of the Paul Wellstone Mental Health Equitable Treatment Act and remains committed to the goals of that Act as a cosponsor of the Mental Health Parity Act of 2007.

Sen. Hillary Clinton believes that government must ensure parity in health insurance coverage of mental health benefits. She cosponsored the Mental Health Parity Act of 2007, which prohibits employers and health plans from imposing durational treatment limits and financial limitations on coverage for mental illness that do not apply to all other medical conditions.

Sen. Chris Dodd has long supported and will continue to support efforts to ensure mental health parity for all Americans because he believes that it is essential that we require employers and health plans to cover treatment for mental health conditions on the same basis of all other illnesses. A Dodd Administration would not only pass mental health parity legislation, it would strongly enforce it.

Sen. John Edwards believes mental illness and physical illness must get the same insurance coverage. He has long supported mental health parity legislation; he co-sponsored the Wellstone Mental Health Parity Act.

Sen. Barack Obama supports efforts to increase federal support for researching and fighting mental illnesses, as well as legislative efforts to mandate that private insurers cover physical and mental illnesses in a similar manner. He will make combating mental health and substance abuse disorders a higher priority. This is why he supported the Mental Health Parity Act of 2007, which requires employers and insurance companies that offer mental health coverage to provide parity between mental health and physical health coverage.

Gov. Bill Richardson supports mental health parity legislation because he believes it is time for us to treat behavioral health issues the same as we treat other medical disorders.

7. How will you reduce the number of individuals with serious mental illnesses who are in the criminal justice system?

Sen. Barack Obama believes that tackling the problem of the high number of mentally ill prisoners will require a concerted effort to reach out to and provide treatment for the mentally ill before some end up in the criminal justice system. He supports efforts to increase federal support for researching and fighting mental illnesses, as well as legislative efforts to mandate private insurers to cover physical and mental illnesses in a similar manner. He will make combating mental health and substance abuse disorders a higher priority. He supported the Mental Health Parity Act of 2007. Sen. Obama will also help state and local governments improve the availability of mental health services, train their law enforcement personnel to recognize the signs of mental illness in offenders, and give prosecutors more tools to deal appropriately with mentally ill offenders. He is a strong supporter of the Mentally Ill Offender Treatment and Crime Reduction Act of 2004, and, as president, will ensure that it is adequately funded. He also supports improving our background check system to keep guns from ending up in the hands of people who are mentally ill.

8. How do you plan to fully include people who have disabilities in all phases of disaster planning and hazard mitigation?

Sen. Joseph Biden will guarantee that people who have disabilities are fully included by appointing activists with disabilities to the Homeland Security agencies. He will also fully fund Homeland Security.

Sen. Barack Obama passed legislation to require states to properly plan the evacuation of special needs individuals because one of the most devastating aspects of Hurricane Katrina is that most of the stranded victims were society's most vulnerable members—low-income families, the elderly, the homeless, and Americans with disabilities. He knows that too many states and cities do not have adequate plans in place to care for special-needs populations. He believes that the legislation is only the first step in ensuring that the most vulnerable individuals in local and national emergencies are adequately safeguarded.

More Issues: Here are other statements from the Presidential candidates with respect to issues of importance to people who have disabilities.

IDEA

Sen. Joseph Biden has repeatedly voted in favor of the federal government fulfilling its original commitment to pay forty percent of the costs of the Individuals with Disabilities Education Act (IDEA).

Sen. Hillary Clinton has repeatedly called for full funding of IDEA. She also cosponsored the Instructional Materials Accessibility Act, which would significantly improve access to instructional materials for students who are blind or have other print disabilities by creating an efficient system for acquiring and distributing these materials in special formats, including Braille, large print, synthesized speech, digital text, and digital audio. Sen. Clinton also cosponsored the Individuals with Disabilities in Education Improvement Act, which strengthened IDEA by expanding monitoring and enforcement mechanisms and enabling parents and schools to resolve disputes adequately while also improving access to professional development for all teachers.

Sen. Chris Dodd believes that the time has come to fully fund IDEA and his action will reflect his commitment on this issue. He will take a more aggressive approach to enforcement by instructing the Department of Education to establish clear, objective, and publicly available criteria for applying sanctions, funding and directing an immediate review of compliance across the states, and ensuring that sanctions are then fully applied.

Sen. John Edwards intends to strengthen federal enforcement of IDEA by the Department of Education so children with disabilities receive the free, appropriate education they deserve and to which they are legally entitled. He will appoint strong enforcement officials, nominate fair judges, provide adequate resources, and exercise leadership to make enforcement of IDEA a priority.

Sen. Barack Obama is a strong supporter of the Individuals with Disabilities Education Act (IDEA) and has supported increases in funding to truly ensure that no child is left behind.

Gov. Bill Richardson would withhold federal funding for school districts that are out of compliance with IDEA.

Transportation

Sen. Joseph Biden would expand access to affordable, accessible transportation for people with disabilities; he has consistently supported expansion of accessible public transportation options.

Sen. Hillary Clinton is very aware that providing meaningful transportation opportunities to people with disabilities is an invaluable first step in empowering individuals to fulfill their potential and live self-sufficiently. She has consistently supported the Community Service Block Grant Program, which traditionally helps fund and support transportation projects (among other projects). She has also tried to secure funding for agencies that provide transportation services to those individuals who have disabilities.

Sen. Chris Dodd includes as part of his energy plan to increase access to affordable and convenient mass transit systems that are fully accessible to people with disabilities across all regions of the country.

Sen. John Edwards understands that accessible transportation is a critical component of increased work opportunities for people with disabilities because for most jobs, you cannot work if you cannot get from your house to the job site. He supports increasing federal funding for nonprofit groups to meet the transportation need of people with disabilities when public mass transit is not available and he intends to increase funding and enforcement of transportation access requirements under federal law. Sen. Edwards believes that, since the federal government has the power through Section 504, it must enforce the law to ensure that efforts like clearing snow and removing standing water are done because these can be very important in ensuring accessibility.

Sen. Barack Obama believes Congress must enact pending transportation reauthorization legislation without further delay and make provisions for accessible options for individuals with disabilities, including highways, mass transit, commuter rail, and air transportation improvements.

Gov. Bill Richardson will work with the disability community and the National Council of Disability to address the transportation shortages and problems throughout the U.S.

Voting

Sen. Joseph Biden supported the Help America Vote Act and will work to ensure its enforcement, including the requirements that enable people to case their ballot privately and that every polling location be accessible for people with disabilities.

Sen. Hillary Clinton authored legislation, the Count Every Vote Act, which requires that at least one voting machine per precinct allows voters who have disabilities and language minority voters to cast a vote in a private and independent manner.

Sen. Chris Dodd, as the primary author of the Help America Vote Act, worked to ensure that new voting protections for persons with disabilities were included in the final legislation. He is cosponsoring new legislation to provide for a voter-verified paper ballot record while preserving full access for persons with disabilities.

Sen. John Edwards will ensure that voters with disabilities are able to vote privately and independently, consistent with the requirements of HAVA. He will help every precinct provide enough trained poll workers and secure voting machines that are physically accessible to all. He believes that voting rights is an example of an area where the disability community provides the best information about which ballot systems work best and his administration will have an ongoing dialogue with the community to ensure meaningful disability voting rights protections.

Sen. Barack Obama believes that Americans with disabilities would be among the most disenfranchised by recent efforts to require mandatory photo identification at polling places because more than three million Americans with disabilities lack a government-issue form of identification. Therefore, he opposed unreasonable voter identification requirements and believes that the constitutional rights of individuals with disabilities should be safeguarded.

Gov. Bill Richardson made each of New Mexico's 1,200 polling sites HAVA compliant.

International Civil Rights

Sen. Joseph Biden supported the United States signing, and then ratifying, the UN Convention on the Rights of Persons with Disabilities.

Sen. Hillary Clinton believes the UN Convention on the Rights of Persons with Disabilities was undertaken with the same goals that the U.S. had in enacting the ADA, namely, the goals of empowering individuals with disabilities and integrating these individuals into all aspects of society. She will champion these principles as president.

Sen. Chris Dodd supports U.S. ratification of the UN Convention on the Rights of Persons with Disabilities because people with disabilities around the world deserve these rights and protections.

Sen. John Edwards supports the United Nations Convention on the Rights of Persons with Disabilities.

Sen. Barack Obama supports the United States' ratification of the UN Convention on the Rights of Persons with Disabilities, the first human rights treaty to be approved by the UN in the 21st Century.

Gov. Bill Richardson supports ratification of the UN Convention on the Rights of People with Disabilities.

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