Antimicrobial Innovation
Spinal cord injury can weaken the immune system, and urinary tract infections are a frequent concern for many wheelchair users, particularly those with neurogenic bladder. Developing new antibiotics is a key priority.
Policy Spotlight:
Equal Access to Health Care
Health care should be accessible to everyone, including the 5.5 million wheelchair users in the United States.
Too often, it isn’t. United Spinal Association works on both fronts: the physical and structural barriers that keep wheelchair users from getting basic care, and the knowledge, policy and systemic barriers that shape our health long after we make it through the door.
Why Health Access Matters
Wheelchair users have long-term, comprehensive health care needs. Many of us live with spinal cord injuries and disorders, multiple sclerosis, rare diseases and other conditions that bring secondary complications, from urinary tract infections and pressure injuries to spasticity and autonomic dysreflexia, on top of the routine care everyone needs.
That makes good care more important for us, and harder to find. Clinics, equipment and medical training were largely built around people who can stand, walk and transfer on their own, and the people providing our care often don’t understand our lives.
“Patients report that many physicians ‘just don’t get disability’ — they have little understanding about living with disability or the consequences for daily life or health-related behaviors.”
82.4%
of physicians surveyed said people with significant disability have a worse quality of life than nondisabled people.
40.7%
were very confident they could provide the same quality of care to patients with disability.
National survey of 714 practicing physicians. Lisa I. Iezzoni et al., “Physicians’ Perceptions of People With Disability and Their Health Care,” Health Affairs, February 2021.
Barriers to Care
Our community still struggles to get the fundamentals of health care. Something as basic as an exam table we can transfer onto, or a scale that can weigh us, is still missing from too many doctors’ offices.
Physical Access
Waiting rooms and clinical areas without room to maneuver a wheelchair. Exam tables that don’t lower to transfer height. Scales that can’t weigh a person who can’t stand. When there’s no way onto the table, too many of us are examined in our wheelchairs, or not examined at all.
Clinician Awareness
A widespread lack of disability awareness among clinicians leads to misdiagnosis, lower standards of care and worse health outcomes. Secondary conditions get missed, and preventive care gets skipped.
Drug Pricing and Coverage
Decisions about how drugs are developed, priced and covered land hardest on people with lifelong conditions. Pricing formulas that put a lower value on disabled lives, and opaque practices in the drug supply chain, can put the treatments we rely on out of reach.
Accessible Health Care Environments
As of July 8, 2026, health care providers that receive federal financial assistance from the U.S. Department of Health and Human Services must have at least one accessible exam table and one accessible weight scale.
The requirement comes from HHS’s updated Section 504 rule, which adopts the U.S. Access Board’s standards for accessible medical diagnostic equipment. Under the same rule, equipment those providers buy or lease after July 8, 2024, must be accessible until at least 10% of each type in use meets the standards, or 20% at facilities that specialize in conditions that affect mobility. Staff must be able to operate the equipment and help with transfers.
These requirements can change what a doctor’s appointment looks like for wheelchair users, but only if clinicians and practice managers know about them. We’re working to spread the word, and partners with deep relationships in the clinical community can help.
We also intend to make sure these protections aren’t rolled back. The 2024 rule has already been challenged in court: In September 2026, a federal judge vacated its community integration provisions in Texas v. Kennedy. The medical equipment requirements remain in effect. Read our coalition statement.
Patient Advocacy
For patient advocacy and public affairs teams at health care and life sciences companies, the overlap with our community runs wider than any single diagnosis.
5.5 million
wheelchair users we represent
70,000+
members
40
chapters
100
support groups
450
trained peer mentors
120+
rehabilitation hospital and therapy partners
Three Things To Know
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1Our network reaches people living with the conditions the industry researches and treats.
Through our community support programs, chapters, support groups, peer mentors and hospital partners, we’re in regular contact with people living with spinal cord injury, multiple sclerosis, rare diseases and other mobility disabilities.
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2Our members’ health care needs last a lifetime.
Our community lives with long-term, comprehensive health care needs, often complicated by other diagnoses and secondary conditions.
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3Access barriers make those needs harder to meet.
Inaccessible clinical areas, waiting rooms and equipment, combined with a widespread lack of disability awareness among clinicians, lead to misdiagnosis, lower standards of care and worse health outcomes.
Policy Priorities
Wheelchair users are directly affected by how medicines are developed, priced and covered. These are the federal advocacy and regulatory priorities we’re working on to protect our members’ access to treatment.
Vaccines
Many people in our community are immunocompromised. Access to vaccines must not be hindered, and the development of new vaccines must not be politicized.
QALYs and Most-Favored-Nation Pricing
We oppose most-favored-nation drug pricing. Some of the countries it draws prices from use quality-adjusted life years, or QALYs, to set prices, a metric that discriminates against people with disabilities.
Pharmacy Benefit Managers
Reform of pharmacy benefit managers, the middlemen between drugmakers, insurers and pharmacies, is long overdue. We support current efforts to achieve it.
GLP-1 Medications
We believe anti-obesity medications could be a game-changer for people with limited mobility.
Clinical Indications
We want to ensure access to existing drugs with promising indications for treating conditions that affect wheelchair users of all kinds.
Biologics and Biosimilars
People should keep access to, and choice of, the biologic and biosimilar therapies that work best for them, and policy choices should not curtail the development of new ones.
Therapeutic Areas
These are the therapeutic areas where our members’ health needs and the work of pharmaceutical and life sciences companies most often meet.
Spinal Cord Injuries and Disorders
Traumatic injuries and nontraumatic conditions of the spinal cord.
Bowel and Bladder
Neurogenic bowel and bladder, urology and ostomy care.
Neurological Disorders
Including multiple sclerosis and other conditions that affect mobility.
Autonomic Dysreflexia
A sudden, potentially life-threatening spike in blood pressure that can affect people with injuries at T6 and above.
Spasticity
Involuntary muscle stiffness and spasms, common after spinal cord injury and with MS.
Wound Care
Including prevention and treatment of pressure injuries.
How We Engage the Community
Our advocacy is powered by the people these policies affect most.
Grassroots Advocacy Network
3,000 advocates in nearly every legislative district in the country, mobilized on local, state and federal health access and equity priorities.
Health Access Working Group
Advocates and partners working together to shape and advance our health access agenda.
Federal Agencies
Comments and sign-on letters to the Food and Drug Administration, HHS, the Centers for Medicare & Medicaid Services, the National Institutes of Health and the Administration for Community Living.
Campaigns and Stories
Advocacy campaigns, resources, op-eds and blogs that put wheelchair users’ experiences in front of policymakers, providers and the public.
Partner With Us
Health care, pharmaceutical and life sciences companies have a stake in a health care system that works for wheelchair users. Patient advocacy, public affairs and government affairs teams partner with United Spinal to:
- Help alert clinicians to the new federal requirements for accessible exam tables and scales
- Collaborate on advocacy campaigns and resource development
- Engage our Grassroots Advocacy Network on shared health access and equity priorities
- Take part in our Health Access Working Group
- Sign on to communications to federal agencies
- Co-author op-eds and blogs
Our “Access to Equitable Healthcare” toolkit for providers and people with disabilities was developed with sponsorship from Genentech, a member of the Roche Group.
Coalitions and Alliances
We work alongside patient groups, providers and industry to make sure wheelchair users have a voice in national conversations about drug development, pricing and health system reform.
Health Coalitions and Working Groups
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Health Equity Collaborative
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Coalition for Urologic Patients
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ITEM Coalition
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Multiple Sclerosis CoalitionSteering committee member
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Partnership to Improve Patient Care
Alliance Partners
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AdvaMed
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Biotechnology Innovation Organization
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Pharmaceutical Research and Manufacturers of America
Take Action
Health care gets more accessible when wheelchair users speak up. Here’s where to start.
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1
Join Our Grassroots Advocacy Network
Sign up to represent your district and hear from us when health access issues are on the line.
Join the network -
2
Ask for Accessible Equipment
Hospitals and doctors’ offices that receive federal funding through HHS must now have an accessible exam table and scale. Ask for them at your next appointment. If they aren’t there, tell us.
Email our policy team -
3
Join the Health Access Working Group
Help set our health access agenda alongside other advocates.
Find a working group -
4
Act on Current Campaigns
Send a message to your members of Congress on the issues moving right now.
Visit the Action Center
