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This supplement is a companion to GAO's report entitled, HEALTH CARE ACCESSIBILITY: Further Efforts Needed to Address Barriers for People with Disabilities, GAO-26-107120. The purpose of this supplement is to provide an "Easy Read" version of the report. Easy Read is a way some groups make their written information easier to understand. For example, Easy Read documents use short sentences and plain language. In this report, GAO found that people with disabilities face barriers related to accessibility in health care. Potential barriers include the design of medical settings and equipment, technology, communication with providers, and lack of training. The U.S. Department of Health and Human Services (HHS) does not collect national-level data from people with disabilities about health care barriers related to disability and , which it could use to help improve accessibility. HHS inspects some aspects of accessibility and performs different kinds of reviews to make sure health care organizations are following disability laws. In 2024, HHS updated accessibility requirements. However, the agency has not taken certain steps to ensure that health care organizations follow the new requirements and improve accessibility. GAO made five recommendations in this report to address HHS's data collection and oversight of accessibility for people with disabilities.

What GAO Found Medicare payments to hospitals to support graduate medical education (GME) for physicians are capped by the number of residents. As of September 2025, the Centers for Medicare & Medicaid Services (CMS) allocated 600 of the 1,000 new Medicare-funded positions to hospitals from three annual distributions. To date, about half of the 393 hospitals that applied received new positions. Percentage of Hospitals Receiving New Residency Positions Under Section 126, 2023–2025 Note: Figure represents the 393 hospitals that applied for or received residency positions in at least one of the first three annual distributions of Section 126 of the Consolidated Appropriations Act, 2021. Hospitals that received positions in the first three distributions were similar to hospitals that applied for and did not receive positions. For example, nearly all were in geographically urban areas and most applied to expand existing residency programs that had been approved to train residents for over 10 years. In addition, about half of hospitals that received positions applied to train more residents in primary care specialties. Further, hospitals that received positions were generally larger in terms of their resident cap and total Medicare GME payments in 2023, compared to other hospitals that applied but did not receive positions. Selected stakeholders identified benefits of these additional positions, such as expanded training opportunities and increased physician services in their communities. For example, one rural hospital expanded its family medicine program which allowed it to implement a resident mentoring approach; another hospital expanded outpatient training, enabling residents to follow patients in later care, according to representatives. Selected stakeholders also described how CMS’s decision to distribute positions by prioritizing applications with the highest health care provider shortages may have disadvantaged some hospitals. In addition, stakeholders said funding challenges, such as up-front costs of new residency programs, also affected hospitals’ decisions to apply for new positions. Why GAO Did This Study Communities across the U.S., and rural areas in particular, face a growing risk of having too few physicians to meet health care needs. In 2023, Medicare paid about $22 billion to support GME residency positions at over 1,400 hospitals. Section 126 of the Consolidated Appropriations Act, 2021 requires CMS to distribute 1,000 new Medicare-funded GME residency positions to qualifying hospitals through permanent increases in their resident caps. The law requires CMS to distribute these positions in at least five annual distributions, with the first of these positions being available for use in 2023. The new positions are expected to cost about $1.8 billion over the first 9 years. The law also includes a provision for GAO to study the implementation of this process. This report describes the number of hospitals that applied for and received additional positions, their characteristics, and benefits and challenges identified by selected stakeholders related to the distribution of these additional positions. GAO analyzed hospital application data submitted to CMS for the first three annual distributions from 2023 through 2025; Medicare Cost Reports; and residency program data from the Accreditation Council for Graduate Medical Education. GAO also reviewed CMS documentation and public comments on CMS rulemaking and interviewed officials from CMS and the Health Resources and Services Administration. GAO also interviewed 14 stakeholders, including those representing hospitals and physicians, and seven selected hospitals that received new positions under Section 126. For more information, contact Leslie V. Gordon at GordonLV@gao.gov.

What GAO Found People with disabilities may encounter barriers related to accessibility in the U.S. health care system; these barriers can affect the quality of their care. GAO analyzed research literature on health care accessibility and conducted interviews with stakeholders and identified the following potential barriers. Types of Potential Barriers to Accessibility in Health Care Described by Literature and Selected Stakeholders The Department of Health and Human Services (HHS) does not collect national-level data on the accessibility of health care from people with disabilities. GAO analyzed 12 HHS population health surveys. One survey included a question on bias, but none covered other barriers to accessibility. HHS has established goals to increase the accessibility of health care through data collection, but officials stated that they do not have plans to collect related national-level data. Such plans would better position HHS to accurately identify barriers and evaluate the effects of HHS regulations that cover nondiscrimination in health care. Within HHS, the Centers for Medicare and Medicaid Services (CMS) and Office of Civil Rights (OCR) oversee aspects of health care organizations’ compliance with federal laws, but oversight related to accessibility has been limited. Specifically, CMS (1) uses an on-site inspection process to ensure that organizations participating in Medicare comply with health and safety standards and (2) inspects some aspects of accessibility. OCR investigates some accessibility issues through compliance reviews and from complaints. But it does not routinely share information on the results of its compliance reviews or complaint investigations. Sharing these results could broaden the impact of OCR’s efforts to other health care organizations. In 2024, HHS amended its regulations, adding accessibility requirements, and HHS’s current strategic plans state that accessibility is a priority. However, these plans do not include details or time frames for achieving this priority. As a result, HHS may not take appropriate steps to ensure that health care organizations meet accessibility requirements and some people with disabilities may continue to face barriers to obtaining health care. Why GAO Did This Study Millions of adults in the U.S. report having some form of a disability, such as a condition that affects vision, movement, hearing, or mental health. Federally funded programs such as Medicare pay for health services, including for people with disabilities. Although federal laws prohibit these programs from discrimination on the basis of disability, people with disabilities may face barriers to obtaining health care. GAO was asked to review federal efforts, including data collection and oversight, to ensure the accessibility of health care for people with disabilities. This report examines (1) barriers to accessible health care that people with disabilities may face, (2) HHS data collection efforts on the accessibility of health care, and (3) related HHS oversight. GAO reviewed relevant federal laws, regulations, and HHS policies and guidance; examined peer-reviewed literature on barriers to accessible health care published between 2013 and 2024; analyzed HHS accessibility-related data collection efforts; and conducted a nongeneralizable survey of 1,194 adults with disabilities. GAO also interviewed HHS officials and representatives from nine disability associations and research groups and two accrediting organizations.