Donald Trump has never been a fan of disabled people. He’s got an obsession with the appearance of being “weak” or “crazy,” was hyperfocused on the idea that Hillary Clinton had some kind of neurological disorder like epilepsy, which he clearly viewed as a sort of human failing, and infamously mocked reporter Serge Kovaleski. But of all of the groups out there whom Donald Trump disdains, whom his policies will endanger profoundly, autistic people stand to suffer the most.
Trump’s coming at them from all sides. First, there’s his coy dabbling with antivaccine generalissimos like Robert F. Kennedy, Jr., and theVaxxed crowd. Kennedy met with Trump and claimed that Trump had invited Junior to head up a “vaccine safety and scientific integrity” commission of some kind. It would certainly be richly ironic to have avowed antivaccine irrationalist Kennedy head up a commission on anything having to do with public health. The Trump team almost immediately equivocated about Kennedy’s statements, basically categorizing them as the equivalent of a nice chat. Currently, Kennedy is reported to be saying that he will be heading up such a commission while the Trump camp has no more comment.
But that chat, according to Trump’s team, was about autism, not vaccines, and about “forming a commission on Autism [sic].” Add that to Trump’s brash and reckless pre-election assertions about vaccines and autism, one of the few public health issues he attends to at all, and you’ve got the makings for an all-out destruction of the edifices that support the autistic population. Trump’s negative attention never bodes anything good and almost invariably means he intends to lay waste to the target.
Toying with Kennedy and bringing up autism yet again is just one way that Trump threatens this nation’s autistic population. And yes, it is a threat because every time someone raises autism as a specter and consequence to fear from vaccines, autism gets cast as the bogeyman. Trump’s own spouse seems to view a presumption of autism as an unforgivable insult. Vaccines aren’t the really scary thing in these narratives. Autism is. When you set up a neurobiological condition as something to fear, you set up the people who are that neurobiology as fearsome, too. And that has consequences ranging from social shunning and abuse to death and more death.
In addition to doing this nonfavor to autistic people by way of coying a relationship with RFK, Jr., Trump is coming at the autistic community on its flanks. His nominee for attorney general, Jeff Sessions, thinks that the Individuals with Disabilities Education Act “undermines the educational process,” and he shows a clear ignoranceof this and other federal protections for disabled children in the classroom. Based on Sessions’ own comments, if he had his way, these protections would be gutted or ignored, leaving autistic students and other disabled children warehoused and isolated, treated like second-class citizens or worse. Trump’s choice for education secretary, Betsy DeVos, is no fan of public schools, the only place where students with disabilities can receive their federally mandated educational rights.
With these attacks on the intrinsic humanity and education rights of autistic people, Trump also is coming at them on the health flank. With the collusion of most of the GOP in Congress, he plans to repeal the Affordable Care Act (ACA; a.k.a., “Obamacare”), a law that has been critical and lifesaving for the disability community as a whole and life-changing for autistic people. ACA allowed for early screening (and therefore early identification, awareness and, one hopes, understanding) without cost sharing. It removed lifetime caps and denial of coverage for pre-existing conditions. For the U.S., without ACA, 1% to 2% of the population would be considered to have a pre-existing condition called autism. Currently covered therapies for autistic people might no longer be covered. And then there are the co-existing conditions, like epilepsy, which about a third of autistic people have. And the coverage under ACA that extends to adult children up to age 26 years, critical coverage for young autistic adults whose access to jobs can be delayed or denied.
Then there are the threats to Medicaid. If Medicaid is gutted as threatened by being shifted to block grants, disabled and elderly people who received in-home care through its benefits will also be warehoused in institutions. Many of those affected will be adult autistic people. And lest you are not autistic and think that somehow will protect you, a reminder that in 2015, a total of 53 million adults in the United States had some kind of disability. That’s one in five adults, right now. How many adults do you have in your home? If you’re a family of five, odds are good that at least one of you will have a disability in adulthood. How would you like to be institutionalized and live with strangers to receive your care?