After a tumultuous year for people with disabilities, advocates are pushing to expand access to primary and emergency care — and add nuance to the emerging conversations around genetic engineering and end-of-life care.
As STAT predicted this time last year, Donald Trump’s second term in office has been wildly consequential. Republicans gutted Medicaid, the tax-funded health insurance program that many people with disabilities depend on to pay for long-term care. Health secretary Robert F. Kennedy Jr. supported and promoted misinformation that vaccines cause autism and, in so doing upended autism research and sparked a nationwide panic in the autism community. How the rollback of Medicaid impacts Americans and federal initiatives around autism research will continue to be major health stories for the disability community in 2026. Beyond that, multiple disability health experts highlighted a few salient issues that should be on your radar in the next year.
Health systems should finally receive guidance on whether the Trump administration will continue the push started under former President Joe Biden to make health facilities more accessible for people with disabilities. Crisis care providers are also waiting for guidance after Trump’s executive order on involuntary commitment. And finally, new research on genetic engineering and new policies around end-of-life care have the disability community working overtime to reframe how disability fits into those conversations.
“It’s so normal in our society that disability is something bad, and it’s something you want to avoid,” said Susanne Muehlschlegel, a neurologist at Johns Hopkins. “But once [people] actually are disabled, let’s say through a stroke, they get used to their disability, they learn to live with their new normal, and end up changing their mind on disability.”
Improving accessibility at hospitals
When the Biden administration updated its interpretation of the Rehabilitation Act of 1973 in 2024, it promised to dramatically improve accessibility for people with disabilities in health care settings. Hospitals and health systems are gearing up to make sure they are in compliance with the rules, which go into effect next year. But so far, the Trump administration hasn’t explicitly signaled whether it plans to enforce these federal statutes.
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It’s been a roller coaster year for Section 504, which prohibits discrimination against people with disabilities in any setting that receives federal financial assistance, including clinics, hospitals, and other health care settings. Soon after the Biden administration’s changes, several states filed a lawsuit that challenged the constitutionality of the law, with the states’ attorneys general citing the addition of gender dysphoria as a protected disability as the reason behind the lawsuit. At the time, disability law experts worried that if successful, the lawsuit could topple one of the legal cornerstones of disability rights in the United States.
The states eventually dropped the suit in April after the Trump administration released guidance disavowing the gender dysphoria update. But the Trump administration’s targeted attacks on diversity, equity, inclusion, and accessibility throughout the year have made experts nervous. They worry about what will happen with the Section 504 updates, which require health care providers to ensure the availability of exam tables, weight scales, and other basic medical equipment so people with disabilities don’t face hurdles in accessing the care they need.
Procuring this equipment has not been an easy task, says Megan Morris, the founder and director of the Disability Equity Collaborative, a nationwide network of policy experts, researchers, and advocates. Morris says members have been “frantically working” to advise health care organizations on how best to proceed. The group is optimistic that federal health officials will not overturn this push towards equitable access for all Americans.
“It really took us a long time to get disability recognized as a population. I honestly was a little worried that we were [going to be] the last ones in and the first ones out,” said Morris, a rehabilitation researcher at N.Y.U. Langone Health. “But I don’t think that has happened.”
New push toward involuntary commitment
In a bid to end homelessness, Trump released sweeping orders in June making it easier to involuntarily commit people who are unhoused and have serious mental health conditions. The executive order runs counter to current judicial precedents that restrict the use of the controversial approach, in which individuals not accused of a crime are held in mental health institutions on suspicion of posing a threat to themselves or others due to their mental illness or substance abuse. Despite insufficient evidence of its benefits, involuntary commitments are already on the rise and Trump’s order could escalate them dramatically.
Crisis care providers are still waiting for instructions. Part of the confusion stems from the Trump administration’s decimation of the Substance Abuse and Mental Health Services Administration, the agency that drives federal policies around mental illness and substance abuse. But the White House hasn’t explained how the order is meant to be implemented, though it does direct federal agencies to crack down on public drug use and urban camping and suggests taking legal action against organizations that run supervised drug consumption sites.
It’s unclear what’s going to happen in 2026, says Margie Balfour, a psychiatrist and professor at the University of Arizona. She says that after Trump penned the executive order, crisis care experts met with White House policy office to discuss how involuntary commitment can lead to a “revolving door” that can drain health systems’ resources and hurt the individual going through an emergency. The administration seemed “very receptive” to getting those people better connected to services, but there’s been no word since that meeting.
It’s not just the Trump administration that wants to move unhoused people off the streets. In her conversations with health officials around the country, Balfour has found that there is increasing backlash towards the growing number of people who are unhoused, even in liberal bastions such as San Francisco and Seattle.
“The pendulum is starting to swing back,” she said. “I think there’s been a lot of rethinking of the [hands-off] approach for that population.”
Life, death — and eugenics
Designer babies are en vogue. In-vitro fertilization has become a hotly debated topic among conservatives, one of the few areas of disagreement between MAHA and Trump. Physician-assisted suicide is gaining traction in more states, even as some groups with disabilities challenge its legality. These ethically complex practices around the beginning and end of life have always stirred controversy, but the conversation is heating up — just as some American political leaders are espousing eugenic ideas.
As the idea of designer babies finds traction in Silicon Valley, it is also resurfacing long-running conversations in the disability community. Advocates say giving parents the ability to throw out embryos with higher risks of conditions like Down Syndrome is unethical, but scientists inched towards this reality this year using gene-editing tools.
These thorny ethical conversations are increasingly happening, and not just around the topic of birth. Some researchers are finding that ableist language is seeping into how some physicians talk with patients’ families about their loved ones after a gruesome injury has left them disabled. Muehlschlegel routinely participates in these conversations and says the routine use of ableist language can be highly influential.
“Are we nudging families towards withdrawing life-saving therapies?” said Muehlschlegel. “Nobody’s looked at the language we’re actually using.”New York Gov. Kathy Hochul (D) said in December that she will soon sign into law a bill that will legalize “Medical Aid in Dying.” The legislation will give terminally ill adults with less than six months to live the ability to have a doctor prescribe them a lethal medication. New York is the 12th state to legalize some form of physician-assisted suicide, joining New Jersey, Washington, and others. Even though disability rights groups were among the first to champion such laws, some advocates have pushed back against their adoption in recent years, especially in Canada, where a controversial decision has expanded the program beyond people with a terminal illness.
