Equal access is the law. Make it the practice.

The Americans with Disabilities Act of 1990 prohibits discrimination on the basis of disability across employment (Title I), state and local government services (Title II), and public accommodations (Title III). The law has produced substantial change. It has also been enforced unevenly. Title I has been narrowed by Supreme Court rulings (most consequentially the 1999 Sutton trilogy and 2002 Toyota v. Williams, partially restored by the 2008 ADA Amendments Act). Title II enforcement against state and local governments depends on Department of Justice capacity, which has been chronically inadequate. Title III enforcement depends on private litigation, since DOJ rarely brings Title III cases — which produces the recurring political backlash against 'drive-by lawsuits' but reflects a structural underfunding of public enforcement. Reform options: substantial increases in DOJ Civil Rights Division disability-rights capacity, statutory updates clarifying ADA application to digital infrastructure (a 2024 DOJ rule began this work), and tighter enforcement of remedy timelines so settlements actually produce accessibility rather than indefinite plans.

Medicaid Home and Community-Based Services are the primary alternative to institutionalization for disabled Americans (and increasingly for older Americans needing long-term care). HCBS includes personal care attendants, home health, respite care, supported employment, and adaptive equipment that enable people to live in their own homes and communities rather than nursing homes or institutions. The 1999 Supreme Court ruling in Olmstead v. L.C. established that unjustified institutionalization is discrimination under ADA Title II — but states retain substantial discretion over the scope and funding of HCBS programs. The result: waiting lists exceeding 700,000 people across 38 states, with waits of five to ten years or more in many states. The cause is inadequate state funding, low Medicaid reimbursement rates that produce direct-care worker shortages, and the structural pattern in which institutional care has historical funding precedence over community-based alternatives. Reform options: federal HCBS funding with conditions (the Build Back Better framework included substantial HCBS investment that did not survive Senate negotiations), federal direct-care worker wage floors, mandatory HCBS rate-setting parity with institutional rates, and expanded mandatory Medicaid HCBS coverage.

Section 14(c) of the Fair Labor Standards Act, enacted in 1938, authorizes the Secretary of Labor to issue certificates allowing employment of workers with disabilities at rates below the federal minimum wage. The original premise — that some disabled workers might otherwise not be employed at all — has been thoroughly contested by disability advocates and recent empirical work, which finds the framework concentrates disabled workers in segregated workshop settings (often called 'sheltered workshops') at very low wages, with limited transitions to competitive employment. The Transformation to Competitive Integrated Employment Act would phase out 14(c) certificates over a transition period while expanding supported-employment funding. Several states have already eliminated subminimum-wage authority for disabled workers (Maine, New Hampshire, Maryland, Vermont, others); others have set phase-out timelines. The federal phase-out has had bipartisan technical support but has not yet been enacted. The political constraint is partly the workshop network's institutional defense of the existing model and partly federal legislative bandwidth competing with other priorities.

Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI) are the primary federal income programs for disabled Americans. Both have structural problems. SSI's asset limits — $2,000 for individuals and $3,000 for couples — have been frozen since 1989; adjusted for inflation, they are equivalent to roughly $1,000 in 1989 dollars. The limits effectively prohibit emergency savings, retirement planning, and durable assets. The marriage penalty (combined-asset limits for couples) creates structural disincentives to marriage. SSDI's work-incentive provisions — Trial Work Periods, Substantial Gainful Activity thresholds, Continuing Disability Reviews — are documented as functioning poorly in practice, with beneficiaries reporting they avoid work attempts because of administrative complexity and benefit-loss risk. The SSI Restoration Act and similar proposals would update asset limits, eliminate marriage penalties, and reform earned-income disregards. Reforms have had bipartisan support in principle for years; they have not advanced through enactment. Administrative reform — Social Security Administration staffing, processing time reductions, and front-line case management — is a parallel track that doesn't require statutory change.

The ADA was enacted in 1990, before the consumer internet, before smartphones, before most of what we now consider routine digital infrastructure. The law's text has been read by courts and DOJ to apply to digital accessibility — but the application has been uneven, with circuit splits on whether websites unaffiliated with physical places of public accommodation are covered, and what specific standards (WCAG levels, etc.) constitute compliance. The 2024 DOJ rule on Title II digital accessibility (state and local governments) was a substantial step toward clarity. Title III digital accessibility regulation remains pending. Beyond digital, accessibility gaps remain widespread in transit (paratransit chronically underfunded), housing (visitability standards rarely required in new construction), polling places (most states have ongoing accessibility issues for voters with disabilities), and healthcare (medical equipment is often inaccessible, exam rooms inaccessible, language access for deaf patients spotty). Reform: federal standards setting (with adequate transition periods), public investment in accessibility upgrades for public infrastructure, and enforcement capacity to make the standards meaningful.