Slate – The Vast Surveillance Network That Traps Thousands of Disabled Medicaid Recipients
This op-ed – authored by CDT’s Ariana Aboulafia with Henry Claypool, Technology Policy Consultant for The American Association of People with Disabilities – first appeared in Slate on July 26, 2023. A portion of the text has been pasted below.
In Arkansas, the Guardian reported on a disabled Medicaid recipient who depleted his savings to pay for a smartphone for his Medicaid-covered caregiver—and then had to pay even more to cover caregiver wages that were withheld due to technical glitches. In Ohio, the Mighty reported on someone who placed the electronic device meant to certify his caregiver’s activities in the refrigerator when not in use because he was concerned about privacy. And throughout the U.S., other outlets have reported on disabled people who have been forced to share photographs and biometric data with third-party apps if they want to continue receiving government support to pay for their in-home care.
All of this is thanks to a program known as electronic visit verification, or EVV. EVV ostensibly aims to reduce waste, fraud, and abuse in the Medicaid system by requiring that caregivers of disabled people “prove” that the covered individual is actually receiving their approved care. Under federal law, all states must require that health and home care providers utilize some form of electronic visit verification; if they do not, they risk a reduction in funding for their Medicaid programs.
Medicaid-funded in-home care helps to make life more accessible for many Americans with disabilities, and has done so for decades. However, EVV creates barriers to accessing that care, and in doing so contravenes the intent of anti-discrimination statutes like the Americans with Disabilities Act. When the ADA was signed into law on July 26, 1990, it marked a critical turning point in the modern disability rights movement. The ADA had the noble intention of eliminating discrimination against people with disabilities, partially by providing for accessibility in all arenas of American life. But 33 years later, the law has been unable to entirely fulfill its ideals—and in many cases, the rapid proliferation of technology can serve as a barrier, not only to the mission of advancing accessibility, but also to reducing discrimination against disabled people more generally. Electronic visit verification illustrates what discrimination can look like for people with disabilities in a digital age, and serves as a reminder that successfully combating disability discrimination requires looking beyond accessibility.
