The development of disability policy is intimately linked to the rise of the American welfare state. In the early-to-mid 20th century, driven by the belief that the federal government must do something to help the “disabled help themselves,” rehabilitationists laid the ground work for the more contemporary struggle against needless institutionalization and equal opportunity well before a minority rights model of disability became available. The emergence of rights-based policy and subsequently, the disability rights movement, continued to challenge policymakers to address inequality, marginalization and isolation, including residential care which was increasingly seen as a form of discrimination. By the 1990s and 2000s, sympathetic policymakers and activists thought they could rely on the landmark Americans with Disabilities Act and the pivotal Olmstead Supreme Court case which ruled that needless institutionalization constitutes discrimination under the ADA. But, despite bipartisan elite and grassroots efforts to reform policy biases favoring nursing home care, little significant change has come about. Not surprisingly, disability groups have organized large disruptive protests (many leading to arrests) against federal and state governments, and against the nursing home industry. Today, with a presidential election in full swing, and with healthcare reform on the minds of legislators and the public, activists are once again mobilizing to pressure political leaders to finally do something about a system favoring institutionalization over community-based care; a violation of the civil rights of a historically marginalized group. The ongoing saga of community-based care showcases an important theme throughout Politics of Empowerment: that American policy reform (and the political process) is best characterized as a cycle of innovation retrenchment, mobilization and restoration.