Applying Independent Living Principles to State Health-Care Programs for People with Disabilities

As states develop managed health-care plans for Medicaid beneficiaries with disabilities, it is important to clarify principles that should shape these programs from an independent living perspective. This article identifies principles used by the disability community in assessing health-care policy and applies them to six selected state health-care programs for Medicaid-eligible adults and children with disabilities. Results suggest that these programs have addressed many of the principles of the disabilities rights and independent living movement, with consumer control being the key to achieving greater comprehensiveness, equity, and efficiency and reducing discrimination. Results also indicate that trade-offs among independent living goals were driven by state policy mandates and cost savings goals. Incorporating measures of independent living principles in future research would help advocates, policymakers, and health-care planners understand the complex issues in delivering managed health-care services to people with disabilities.