09/28/2009 05:12 am ET Updated May 25, 2011

At Sestak Town Hall, Disability Activists Draw Their Own Red Line on Long-Term Care Funding

I scanned the aisles for mustachioed presidential portraits and Obamacare warning-signs at a health care town hall with Rep. Joe Sestak (D-PA) in Philadelphia. "Before we get started," intoned the understated moderator, "we know that these meetings here in the Commonwealth have been somewhat heated."

Yesterday's meeting was hosted by Liberty Resources, an organization that promotes independent living for disabled people, and the Philadelphia chapter of ADAPT, a seriously militant disability rights organization.

But the town hall with Sestak, who is challenging Republican-turned-Democrat Senator Arlen Specter in the party primary, went uninterrupted, the ground rules unchallenged.

No teabaggers showed up. No screaming. No fearful questions about "death panels" or socialism, national or otherwise. Yet the nearly 200 disability rights activists that showed up were mad.

For disability rights activists, the public option--which they do support--isn't the only red line that Democrats shouldn't cross. Activists say they will oppose any bill that fails to include the core provisions of the Community Choice Act, legislation that gives in-home long-term care the same funding priority as nursing home care. These people want to live independently--an option that, fiscal watchdogs be advised, turns out to be almost three times cheaper than institutional care.

As I wrote in a piece this June about the situation in Pennsylvania:

Federal and state Medicaid law requires that disabled people receive a state-granted waiver to get reimbursed for homecare, making the system highly biased toward placing people in institutions. This is the system's default setting, especially for the elderly disabled.

The Community Choice Act would change what activists call the "institutional bias" in long-term care funding. This is the "rationing" that actually takes place under our current system. While the House legislation didn't include these long-term care provisions, activists are hopeful that Senate allies will come through and that a comprehensive bill will make it out of conference.

In a debate dominated by crazed, gun-toting teabaggers and a series of incoherent Democratic proposals, disability rights activists present a different--and undercovered--angle on health care reform. The room full of people with chronic health care needs offered a poignant counterpoint to the crazies who have terrorized politicians over the past weeks, people more concerned with obscure and tenuous historical comparisons (circa 1933) than an everyday person's very real problems.

ADAPT was out in full force in orange shirts emblazoned with their trademark logo of a person in a wheelchair breaking free of her chains. Indeed, ADAPT says they secured the meeting after they blockaded a Sestak town hall two weeks back (although I wasn't able to confirm this independently), protesting the fact that the event wasn't accessible. These are amazing political activists, people who excel in chaining their wheelchairs to things in order to get a point across.

But Specter is also a cosponsor of the Community Choice Act, so Sestak--who claimed that he was the first congressman to put Braille on his business cards--had the big challenge to put some daylight between the two on disability rights issues.

A few healthcare workers showed up, too, some members of AFSCME and SEIU locals.

Henry Nicholas, President of the National Union of Hospital and Health Care Employees (AFSCME), was one of the first to speak. "I'm one-hundred percent committed to single-payer health care, its less complicated and its the way to go"--but, he said, he thought a public option was the second best scenario, and hoped that Sestak would support it.

Sestak spoke out forcefully in favor of a pubic option, but refused to to vote against a bill that did not include it. An aide told me he didn't want to have his hands tied when a final bill came up.

I ran into a friend from the Philadelphia Weekly on her way out of the event. She confessed that she had hoped to catch a bit of drama at the town hall--and I had to agree. The state of American politics is such that people painting Hitler mustaches on photos of our president get more attention than a grassroots movement to provide sensible, humane and cost-effective long-term care to people with disabilities. What a shame.