The United States Government Accountability Office (GAO) in December 2025 conducted a review on federal efforts to guarantee the equitable treatment of people living with disabilities in a health care setting, examining the barriers of access, measures implemented by providers, and the extent of the Department of Health and Human Services (HHS) data collection and oversight on accessibility. GAO focused on health and safety standards for organizations that provide sustained patient care including hospitals, hospice, skilled nursing facilities, and home health agencies.

Many older adults will age into disability, making health care accessibility not just a legal requirement, but a growing necessity as the population ages. The 2022 Behavioral Risk Factor Surveillance System Survey estimates that 28.7% of people in the United States have a disability, including those born with disabilities or acquired at any point in their lives. The report describes that while the Americans with Disabilities Act of 1990 (ADA), Section 504 of the Rehabilitation Act of 1973, and Section 1557 of the Patient Protection and Affordable Care Act protect individuals from discrimination on the basis of disability, these individuals may still face barriers obtaining health care.

The report reviews HHS’ 2024 final rules to amend both Section 504 and Section 1557 regulations, which address requirements for organizations receiving federal funds. Section 504 updated their requirements explicitly prohibiting discrimination against individuals with disabilities in medical treatment, web content, and medical diagnostic equipment, requiring facilities and equipment to be accessible for all. Section 1557 regulations were updated to ensure entities inform patients that accessibility services are available at no cost. In addition, entities receiving federal funds from HHS must make reasonable modifications for procedures, practices, and policies to avoid discrimination. This can include allowing service animals to be present during appointments, providing instructions in large print, and ensuring accessibility of examination rooms.

The report reviews how medical facilities and equipment can present potential barriers for individuals with disabilities. This could be represented in physical disabilities such as narrow hallways, stairs, and inadequate signage. Automatic door openers in bathrooms, changing rooms providing sufficient space to maneuver a wheelchair, and high contrast signage include practices in health care settings to ensure physical accessibility. Medical equipment in facilities that require patients to stand, climb, or instruments not designed for wheelchair access can pose impediments to people with disabilities. In addition to physical, sensory differences in medical facilities can become overwhelming for certain adults. Long wait times, crowds, bright lighting, and loud noises are all elements that can increase feelings of anxiety and produce undue stress.

Technology can be implemented in health care settings to aid people with disabilities, but some may struggle with using and accessing them. Innovations such as telehealth services, electronic health records, and digitized services can improve efficiency but must be designed with accessibility in mind to ensure usability for everyone. Some providers have adopted AI-based tools on patient-facing websites to increase font sizes and limit flashing media. Furthermore, GAO highlights the necessity for providers to implement policies to document patient accessibility needs within their electronic health records to provide the needed accommodations. Older adults are more prone to face difficulties navigating the health care system due to age-related hearing and vision loss; continued technological advancements are integral to help bridge the digital divide.

Receiving information from medical staff is crucial for one’s confidence with care providers; this communication can be challenging for some people with intellectual or developmental disabilities. GAO found in their literature and interviews with stakeholders that patients reported difficulties in understanding written or verbal health information, especially when providers use medical terminology over plain language. Without clear instruction, individuals can feel poorly prepared for later appointments and procedures. Moreover, some individuals with intellectual or developmental disabilities experience feeling dismissed by health care providers, emphasizing a need for effective communication, such as longer or more frequent appointments and the use of plain language.

Providers can also pose biases on people living with disabilities, lacking the training and understanding of disabilities and relying on misconceptions and perceived stereotypes in their care. According to a review of studies, women with physical disabilities are less likely to be informed about the importance of preventive screenings than others without disabilities. Social misconceptions and perceived bias challenge individuals to advocate for their own care, navigate systemic barriers, and overcome feelings of exclusion in health care environments.

Just these barriers alone can make it difficult for people with disabilities to receive the care they deserve, but these obstacles exclude affordability, transportation, and availability of services challenges, GAO says. In 2021, the U.S. Census Bureau estimated that 27% of households with at least one member living with a disability had medical debt, compared to the 14% of households without. Continued documentation and advancements of accessibility are essential to ensure individuals are treated fairly. GAO found that HHS has no plans to collect national-level data from people with disabilities on the accessibility of healthcare settings. In its report, GAO recommends the Secretary of HHS establish a detailed plan and ensure consistency for the collection of data using its Data Standard for Disability Status. Furthermore, GAO recommends the Office of Civil Rights (OCR) to develop a mechanism to compile and publicly share data on resolved complaints and compliance reviews.

Read the full report here or the highlights page here.