26 Jul Thirty-Four Years Later, the ADA’s Healthcare Promise Remains Unfulfilled
Thirty-four years ago today July 26, President George H. W. Bush signed the bipartisan Americans with Disabilities Act into law. The landmark legislation promised a new era of inclusion and equality that would reshape American society.
But while the law undoubtedly improved the lives of Americans with disabilities, it hasn’t fulfilled its full promise, especially when it comes to the health care sector.
The statistics are stark: Americans with disabilities are four times more likely to report poor health and 2.5 times more likely to skip care due to cost. But numbers alone can’t convey the frustration of navigating inaccessible medical offices, the insult of facing biased healthcare providers, or the exhaustion of fighting insurance denials for essential treatments or equipment.
These aren’t isolated incidents. They represent systemic failures that jeopardize the health, independence, and dignity of millions of Americans. When a wheelchair user can’t access a mammography machine, when a deaf patient is denied an interpreter, when someone with an intellectual disability receives substandard care due to provider bias — these are not just violations of the ADA. They are violations of our most basic human rights.
The roots of this crisis run deep. Medical schools provide inadequate training on disabilities. Healthcare facilities remain riddled with physical barriers. Insurance policies are often mazes of exclusions and denials. And underneath it all is a persistent ableism that views disability as a medical problem to be solved rather than a natural part of the human condition.
But we are not without hope. The pandemic highlighted both the challenges and the resilience of the disability community. It has also accelerated innovations like telehealth that, if thoughtfully implemented, could dramatically improve healthcare access. But these advances will only matter if they’re designed with disability inclusion at their core.
The path forward is clear, though challenging. We must improve medical education, mandating comprehensive disability competency training for all healthcare professionals. This means integrating disability-focused content throughout the curriculum, from anatomy and physiology to clinical rotations. It means bringing in people with disabilities as educators, not just subjects of study. And it means teaching future doctors to see disability as a dimension of diversity, not just a diagnosis.
We need to overhaul our healthcare infrastructure, ensuring every facility and piece of equipment is universally accessible. It’s about adjustable exam tables, wheelchair-accessible scales, and mammography systems that can accommodate women who can’t stand. It’s about ensuring that every aspect of the healthcare experience, from scheduling to follow-up care, is designed with disability in mind.
And we must reimagine our insurance systems to prioritize the unique, often complex needs of people with disabilities. We need expanded coverage for assistive devices, home modifications, and long-term support and services. And we must streamline approval processes for necessary treatments and equipment. We need to tailor preventive care and wellness programs to meet the needs of people with disabilities.
As we seek to build a more equitable healthcare system, we must prioritize lower-cost solutions that genuinely serve all Americans. Recent reforms, such as the 2022 Inflation Reduction Act’s changes to Medicare Part D, have aimed to improve healthcare access and affordability. Now we must ensure that IRA implementation doesn’t result in reduced access to treatments used to manage disabilities — for example, psychotropics for those with intellectual disabilities.
We must remain vigilant and adaptable in our approach. This means not only addressing existing barriers but also anticipating and preventing new ones. Take telehealth, for instance. The pandemic accelerated its adoption, offering a promising path to reduce costs and improve access. Yet for many in the disability community, telehealth platforms present their own set of challenges — from inaccessible design to the persistent digital divide.
Whether it’s policy reform or technological innovation, we must ensure that our efforts to lower healthcare costs don’t leave anyone behind. This requires ongoing assessment, adjustment, and, above all, a commitment to centering the voices and needs of people with disabilities in every step of the process.
As we mark this anniversary, we must remember that our journey toward equality was not completed with the passage of the ADA. It was merely a beginning. We have much more work to do to fulfill the ADA’s promise.