The American College of Physicians (ACP) released two companion position papers in Annals of Internal Medicine on March 10, 2026, identifying patients with disabilities as a population experiencing health disparities and calling for structural reforms across medical education, health care delivery, insurance coverage, and research participation.

An estimated 42.5 million to 61 million Americans report having a disability. However, disability prevalence remains difficult to quantify because of differences in survey methods, variation in how disability is defined across federal data sets, and exclusion of patients living in long-term care facilities.

Recent national data illustrate persistent disparities. In 2024, the employment rate among patients with disabilities was 23% compared with 66% among those without a disability. Patients with disabilities were four times more likely to report fair or poor health and had nearly twice the mortality risk of nondisabled adults. They were also five times more likely to report stroke or depression. In 2023, 51% of patients with disabilities reported delays in primary or preventive care because of costs.

Despite representing about 13% of the civilian noninstitutionalized US population, patients with disabilities account for only 3% of practicing physicians, 8% of residents, and 5% of medical students.

Policy Development

The ACP Health and Public Policy Committee developed the position papers through a review of English-language peer-reviewed studies, government reports, and professional policy analyses identified through PubMed, Google Scholar, and federal agency websites including the US Department of Health and Human Services.

Additional sources included policy and research organizations such as KFF and the Center for American Progress. The committee prioritized data-driven sources but also reviewed commentary and policy analyses to characterize the broader policy landscape.

Draft recommendations were refined with input from ACP’s Health Equity Committee, Education Committee, Board of Governors, Board of Regents, and multiple specialty and trainee councils. The ACP Board of Regents approved both papers in November 2025.

Patient Care Findings

One paper focuses on barriers faced by patients with disabilities within the health care system. The researchers described ableism—beliefs or practices that devalue or discriminate against patients with disabilities—as a structural factor affecting care delivery.

In one physician survey cited in the paper, 41% of respondents reported being “very confident” in providing the same quality of care to patients with disabilities as to nondisabled patients, and slightly more than half strongly agreed they welcomed patients with disabilities into their practice.

Access barriers remain widespread. For example, physicians whose offices lack accessible scales have referred patients using wheelchairs to locations such as supermarkets or grain elevators to obtain a weight measurement. In addition, a qualitative study found many physicians had an incomplete understanding of legal obligations under the Americans with Disabilities Act.

Insurance coverage patterns also influence care access. In 2023:

• 21% of patients with disabilities were covered only by Medicaid

• 15% were covered by both Medicaid and Medicare

• 34% had Medicare coverage alone

• 26% had employer-based or other private insurance

More than 10 million patients qualify for Medicaid based on disability status.

The paper also highlights access challenges in long-term services and supports. The national Medicaid Home and Community-Based Services waiver waitlist includes nearly 820,000 patients, with average wait times of 39 months. Patients with intellectual or developmental disabilities account for about 73% of that waitlist.

The ACP also raised concerns about potential insurance coverage losses associated with federal policy changes affecting Medicaid and health insurance marketplaces.

Patient Care Recommendations

The paper outlines 11 recommendations, including:

• Designating patients with disabilities as a Special Medically Underserved Population under the Public Health Service Act

• Expanding disability education in medical schools and continuing medical education

• Requiring health systems to evaluate accessibility of facilities and medical equipment

• Supporting policies that ensure affordable coverage through Medicare, Medicaid, and private insurance

• Addressing workforce shortages in the long-term services and supports sector

• Improving care coordination among patients eligible for both Medicare and Medicaid

• Increasing inclusion of patients with disabilities in clinical trials

• Expanding disability-specific data collection in health research.

Barriers in the Physician Workforce

The second position paper focuses on physicians, trainees, and medical students with disabilities.

Technical standards—criteria that determine admission to and graduation from medical school—have changed little in more than 50 years, according to the researchers. A 2016 analysis found only 33% of medical schools explicitly stated in their technical standards that accommodations could be provided.

More recent analyses found disability representation in recruitment materials and training policies remains limited. In a 2025 review, only 31% of allopathic medical schools referenced disability in public diversity, equity, and inclusion recruitment materials.

A review of graduate medical education handbooks at the 50 largest training programs found:

• 68% included a disability policy

• 38% encouraged disability disclosure

• More than half required disclosure to direct supervisors.

Researchers note that disclosure requirements can discourage trainees from requesting accommodations.

Stigma remains another barrier. Among first-year residents who reported a disability, 51% indicated they needed accommodations but did not request them. Fear of stigma was the most frequently cited reason.

Testing accommodations also affect training progression. In the 2018 to 2019 academic year, 52% of medical students with disabilities who requested accommodations for the United States Medical Licensing Examination Step 1 were denied those requests. Among students denied accommodations, 51% delayed advancing in the curriculum, 32% took the exam without accommodations and failed, and 3% withdrew or were dismissed from medical school.

Physicians with disabilities also reported financial and workplace disparities. In adjusted analyses, annual income was 21% lower, and hourly income was 13% lower, compared with physicians without disabilities.

Workforce Recommendations

The ACP outlines 13 policy recommendations addressing barriers across medical education and professional practice.

Key recommendations include:

• Affirming nondiscrimination in career opportunities for physicians with disabilities

• Promoting a physician workforce inclusive of disability

• Encouraging accreditation organizations to require inclusive technical standards

• Recommending transparent and legally compliant accommodation policies in medical schools

• Aligning accommodation request processes across national licensing examinations

• Ensuring accessibility of facilities and workspaces for trainees and physicians

• Expanding research and data collection on physicians with disabilities.

From Policy to Practice

An accompanying editorial in Annals of Internal Medicine by Christopher J. Moreland, MD, MPH, and Lisa M. Meeks, PhD, MA, emphasizes that policy commitments alone will not eliminate structural barriers.

The editorial notes that disability disclosure among trainees has increased to approximately 13% of graduating medical students and 12% of residents, while the proportion of practicing physicians with disabilities has remained near 3% in recent years.

The authors propose three implementation priorities:

• System-level environmental changes, including transparent disclosure processes and faculty training

• Community-building initiatives and institutional feedback systems

• Investment in disability resource professionals with expertise in medical education and disability law

They also highlight a major evidence gap: relatively little research has examined long-term career trajectories and workplace experiences of practicing physicians with disabilities.

“Strengthening and retaining a disability-inclusive physician workforce holds promise beyond professional equity and well-being,” the editorial authors wrote. “Offering a powerful pathway toward reducing long-standing health and health care disparities experienced by patients with disabilities—and positioning disabled physicians to thrive in the practice of medicine.”

Study Limitations

The ACP committee noted several limitations in the evidence base. Disability prevalence estimates vary across surveys, and many national data sets exclude patients living in long-term care facilities. In addition, most research on physicians with disabilities focuses on trainees rather than practicing physicians.

The committee also highlighted the need for additional research examining potential benefits of disability-concordant physician-patient relationships.

Disclosure forms for all authors are available at annals.org.

Sources

1. Cline K, Beachy MW, Carr PW, et al. Improving the health of and access to health care for people with disabilities: a position paper from the American College of Physicians. Ann Intern Med. Published March 10, 2026. doi:10.7326/ANNALS-25-04524. Available at annals.org.

2. Cline K, Beachy MW, Carr PW, Hall J, et al. Fostering support and inclusion for physicians, postgraduate trainees, and medical students with disabilities: a position paper from the American College of Physicians. Ann Intern Med. Published March 10, 2026. doi:10.7326/ANNALS-25-04518. Available at annals.org.

3. Moreland CJ, Meeks LM. Disability inclusion as equity in medicine: from position statements to practice [editorial]. Ann Intern Med. Published March 10, 2026. doi:10.7326/ANNALS-25-05480.