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Statement to House Ways and Means Subcommittee on Health regarding technology accessibility standards

Wednesday, July 9, 2025

July 9, 2025

Statement for the Record
U.S. House of Representatives
Committee on Ways and Means, Subcommittee on Health
Health at Your Fingertips: Harnessing The Power of Digital Health Data Hearing on June 25, 2025

Dear Chairman Smith and Health Subcommittee Chairman Buchanan:

I am writing in my capacity as Vice Chair/Acting Chair of the National Council on Disability (NCD), an independent, bipartisan federal agency that advises Congress, the President, and his Administration on matters affecting the lives of people with disabilities. Thank you for this opportunity to submit our agency’s Statement for the Record to emphasize the importance of ensuring that innovations in digital healthcare technologies – like wearable devices used to track vital signs in real-time and remote monitoring devices discussed in the Subcommittee’s June 25th hearing - comply with federal anti-discrimination laws, especially accessibility standards for Information and Communication Technologies (ICT) under Section 508 of the Rehabilitation Act of 1973,1 in order to ensure that these innovative technologies in healthcare are useable and operable by people with disabilities.

Members of this Subcommittee should be especially aware that digital health systems and technology have the potential to vastly improve treatment, management and health outcomes for people with disabilities and lower overall healthcare costs. As policymakers encourage the development of innovative technologies in healthcare, they should also encourage developers to test these digital technologies to ensure they comply with ICT standards before they are sold to healthcare providers and ensure that these devices meet accessibility standards. These accessibility standards are promulgated at 36 CFR part 1194 by the U.S. Access Board,2 a federal agency that provides technical assistance on accessibility requirements for ICT.3

People with disabilities will benefit the most from these innovations in healthcare monitoring and treatment. For decades, NCD has examined barriers that patients with disabilities encounter, leaving them unable to access timely and adequate healthcare. Our body of research, which analyzed years of healthcare studies and literature, found that people with disabilities are generally higher-frequency and higher-cost users of healthcare services than patients without disabilities.4 For example, in 2018, a National Academies of Sciences, Engineering, Medicine study illustrated that obesity rates for adults and youth with disabilities were 58 and 38 percent higher than those rates of their nondisabled peers; the annual number of new cases of diabetes was almost three times as high among adults with disabilities relative to adults without disabilities (19.1 per 1,000 versus 6.8 per 1,000); disability status was a high risk factor for early onset cardiovascular disease (rates of 12 versus 3.4 percent among 18- to 44-year-olds); and adults with disabilities were much more likely to experience cardiovascular disease during young adulthood as well as in their older years.5 Our body of research concluded that the health disparities between people with disabilities and their nondisabled counterparts have not materially improved in the 16 years since NCD published its 2009 seminal report, The Current State of Healthcare for People with Disabilities.6 It is therefore even more important that people with disabilities have access to these innovations in digital health monitoring systems which can help doctors provide real-time monitoring of vital signs to improve or modify primary and preventative healthcare treatments at the earliest possible state.

Under Section 1557 of the Affordable Care Act (ACA),7 the Americans with Disabilities Act (ADA),8 and Section 504 of the Rehabilitation Act (Section 504),9 healthcare providers must provide full and equal access to their services and facilities.10 In our 2021 report, NCD found that the lack of accessible medical and diagnostic equipment in most healthcare settings contributes to a lack of preventive care for patients with mobility disabilities that is necessary for early diagnosis of diseases contributing to poor health outcomes, poorer quality of life, and shorter length of life for people with mobility disabilities.11 In this report, NCD highlighted how barriers to the physical access of examination tables, weight scales, examination chairs, and imaging equipment and other vital medical diagnostic equipment adversely affected the quality of care, leading to delayed and incomplete care, missed diagnoses, exacerbation of the original disability, and increases in the likelihood of the development of secondary conditions.12 NCD has examined how rapid changes in technology often cause decreases in accessibility for people with disabilities.13 Policymakers should be aware that innovations in technology can create unintended digital barriers for people with disabilities which can also result in delayed and ineffective healthcare for patients who need it the most.

As policymakers encourage innovative start-up technology companies to develop cutting edge healthcare systems, policymakers must be aware that federal law also requires that people with disabilities have access to digital technology and services. Under Section 508 of the Rehabilitation Act, federal agencies and their contractors must ensure that the electronic and information technology allows, regardless of the type of medium of the technology, people with disabilities equal access and use of information or services that is comparable to the access to people who do not have disabilities.14 This requirement is not only limited to a healthcare provider that is a federal agency like the Veterans Health Administration but includes recipients of federal funds from Centers for Medicare and Medicaid Services (CMS) and recipients of federal grants to promote the research and development of innovative healthcare technology.

As innovations in digital health systems and devices continue to evolve and become an integral tool in delivering quality healthcare, policymakers must ensure that people with disabilities have full and equal access to these systems and devices.15 To that end, the developers, manufacturers, and suppliers of these technologies that receive federal grants for research and development should use current standards for ICT as a best practice to spur innovation and promote more accessible innovative digital health systems that are accessible to all patients. As federal grants continue to fund the research and development of these healthcare innovations and they become more widespread aimed to modernize and improve the healthcare system, compliance with accessibility guidelines for ICT is a critical piece in modernizing the healthcare system.16

Once again, I thank Subcommittee Members for this opportunity to inform policymakers about the importance of accessible digital health systems for people with disabilities. If NCD can assist the Subcommittee’s work through any other means, please do not hesitate to contact our Executive Director, Ana Torres-Davis, atorresdavis@ncd.gov, and Director of Legislative Affairs and Outreach, Anne Sommers McIntosh, amcintosh@ncd.gov, who will coordinate a response.

Respectfully,

David Shawn Kennemer
Vice Chair/Acting Chair
National Council on Disability

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  1. 29 U.S.C. § 794d. ↩

  2. 29 U.S.C. § 794d, 47 U.S.C. § 255. ↩

  3. 29 U.S.C. § 794d(b). ↩

  4. See Nat’l Council on Disability (2021) Enforceable Accessible Medical Equipment Standards: A Necessary Means to Address the Healthcare Needs of People with Mobility Disabilities, available at: https://www.ncd.gov/report/eames-report/. ↩

  5. S. Yee et al., Compounded Disparities: Health Equity at the Intersection of Disability, Race, and Ethnicity (Washington, DC: National Academies of Sciences, Engineering, and Medicine, April 13, 2018), available at: https://dredf.org/wp-content/uploads/2018/01/Compounded-Disparities-Intersection-of-Disabilities-Race-and-Ethnicity.pdf. ↩

  6. Nat’l Council on Disability (2009) The Current State of Healthcare for People with Disabilities, available at: https://www.ncd.gov/report/the-current-state-of-health-care-for-people-with-disabilities/. ↩

  7. 42 U.S.C. § 18116. ↩

  8. 42 U.S.C. § 12131 (Title II); 42 U.S.C. § 12181 (Title III). ↩

  9. 29 U.S.C. § 794. ↩

  10. ADA National Network “Healthcare and the Americans with Disabilities Act,” available at: https://adata.org/sites/adata.org/files/files/Health%20Care%20and%20the%20ADA%20FINAL%202-11-2020.pdf. ↩

  11. Nat’l Council on Disability, Enforceable Accessible Medical Equipment Standards: A Necessary Means to Address the Health Care Needs of People with Mobility Disabilities, (May 20, 2021), available at: https://www.ncd.gov/report/eames-report/. ↩

  12. L. I. Iezzoni, “Eliminating Health and Healthcare Disparities Among the Growing Population of People with Disabilities,” Health Affairs 30, no. 10 (2011): 1947–54; L. Ramjan et al., “Barriers to Breast and Cervical Cancer Screening for Women with Physical Disability: A Review,” Women and Health 56, no. 2 (2016): 141–56; J. R. Pharr et al., “Health Disparities Experienced by People with Disabilities in the United States: A Behavioral Risk Factor Surveillance System Study,” Global Journal of Health Science 4, no. 6 (2012): 99. ↩

  13. Nat’l Council on Disability, Design for Inclusion: Creating a New Marketplace, (October 28, 2004), available at: available at: https://www.ncd.gov/report/design-for-inclusion-creating-a-new-marketplace-industry-white-paper/. ↩

  14. 29 U.S.C. § 794d. ↩

  15. See Nat’l Council on Disability, The Power of Digital Inclusion: Technologies Impact on Employment and Opportunities for People with Disabilities (December 4, 2011), available at: https://www.ncd.gov/report/the-power-of-digital-inclusion/. ↩

  16. Currently, these standards are referred to Web Content Accessibility Guidelines 2.1 levels A and AA (WCAG 2.1 AA). ↩

NCD.gov

An official website of the National Council on Disability

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