Disability is a gendered issue, with women in the United States experiencing relatively higher rates of disability than men.1 Disabled women face significant headwinds due to the pressures of the COVID-19 pandemic and political factors, such as the expansion and contraction of safety net programs. Specifically, the pandemic disproportionately affected disabled people, particularly those living in congregate spaces such as group homes and carceral settings.2 From the beginning of the pandemic in early 2020, disabled people have been dying at higher rates.3 More people have also become disabled,4 with women more likely than men to contract long COVID.5
The good news is that disabled women have seen moderate employment gains during the economic recovery from COVID-19, with employment rates for disabled women ages 16–64 reaching record highs in 2023.6 Yet disabled women continue to face a stubborn pay gap and experience unacceptably high poverty rates.7 Disabled women are important to the U.S. economy and are disproportionately working on the front lines in health and service occupations when compared with the general population. 8
Occupational segregation negatively affects disabled women’s employment participation and outcomes.9 So, too, do sexism and ableism.10 Further, disabled women of color and multimarginalized disabled women experience disproportionately worse outcomes because of intersecting forms of discrimination such as racism.11 Unsurprisingly, a 2022 poll found that disabled women are most concerned about high cost of living and their family income not being able to meet expenses.12 With disability on the rise and expected to continue to climb with the aging of the U.S. population13—alongside the implications of long COVID14—it is imperative that federal and state policymakers prioritize closing gaps in employment and wages for disabled women to improve their economic security and grow the U.S. economy.
This chapter of the “Playbook for the Advancement of Women in the Economy” details the economic challenges disabled women face and how improving their economic security would benefit the U.S. economy overall. The chapter closes with detailed policy recommendations for federal and state policymakers, including eliminating the subminimum wage and ensuring employers provide adequate workplace accommodations.
The problem
Disabled women are less likely to be employed and more likely to experience poverty than disabled men and people without disabilities. This adversely affects their ability to obtain economic security.
Employment gaps
Disabled women face employment gaps in comparison to both the general population and disabled men. In 2023, disabled women’s employment rate was a record high 20.5 percent yet substantially lower than that of the general population, at 60.3 percent, and that of disabled men, at 24.8 percent.15 The labor force participation rate of disabled women, at 22 percent, also lagged behind that of both disabled men with and without disabilities, at 26.7 percent and 73.8 percent, respectively, as well as women without disabilities, at 62.6 percent in 2023.16
Fortunately, between 2019 and 2023, the employment rate increased for disabled women compared with pre-pandemic rates.17 Working-age disabled women reached an average employment rate of 36.1 percent in 2023—a record high.18 Many gains that disabled women have experienced in the economic recovery were in employment with telework options, according to the National Bureau of Economic Research.19
But there are concerns that some of the increases in employment among disabled people, including disabled women, may be due in part to the increase in the number of disabled people.20 A general push to undo telework accommodations that particularly affected disabled women’s employment could reduce their ability to continue working and perhaps undo progress made.21
More needs to be done to close labor force participation rate gaps and ensure disabled women can continue to access both in-person and telework employment.
Wage gaps
Much research documents women’s wage gaps. (see Chapter 5) Adding disability to the equation widens the gender wage gap. The top 10 occupations in which disabled women work pay $15,800 less, on average, than the top 10 occupations for nondisabled men.22 Even worse, some disabled people receive below the federal minimum wage due to a Section 14(c)23 exception in the Fair Labor Standards Act.24 This exception was intended to help disabled people get jobs, but the aftereffects have left disabled people trapped in poverty while working in segregated workplaces.
The disabled women’s wage gap slightly decreased in 2020 because many of the lowest-wage workers in leisure and hospitality were temporarily out of the workforce, but disabled women experienced nearly the same wage gap in 2021 compared with nondisabled men as they did in 2008.25 While higher education does help increase the likelihood of a disabled person finding work, wage gaps between disabled workers and nondisabled workers actually widen at higher levels of education.26
Disabled people with a high school degree earned on average 22 percent less than nondisabled people with a high school degree in 2011.27 With a master’s degree, disabled people earned an average of 24 percent less than nondisabled people during the same year.28 Other contributing factors to the wage gap include:
- Unpaid medical absences29
- Difficulty finding consistent child care30
- Lack of accessible transportation31
- Denial of workplace and other accommodations32
These are all barriers that can keep disabled women from being able to maintain stable employment and earn livable wages. Narrowing the wage gap for disabled women compared with both disabled and nondisabled men could significantly help pull disabled women out of poverty.
Poverty
In 2022, 26.2 percent of disabled women lived in poverty compared with 10.7 percent of nondisabled women and 21.6 percent of disabled men.33 This is much higher than most other demographic groups such as children (15 percent), older adults (10.2 percent),34 and Black women (16.6 percent) or Latinas (16.8 percent).35 While extra costs continue to bury disabled women in debt, they often are forced to survive on less money.
This is because employers are allowed to pay disabled workers subminimum wages, as well as due to conditions such as inaccessible workplaces and a social safety net that reinforces poverty among disabled people. Not only are wages affected, but disabled women also face disparities when receiving Social Security Disability Insurance36 and are slightly more likely to utilize Supplemental Security Income.37 This is due to numerous factors, including participating in unpaid labor and experiencing long periods of not participating in paid labor. Administrative burdens, such as asset and income limits, set up a system that creates a perverse choice between access to essential health services and supports for disabled people and savings and financial stability.38
Reproductive health
The reproductive health needs of disabled women have historically been an afterthought of the reproductive health movement.39 With recent high-profile court cases bringing attention to disabled women’s reproductive freedom, which underpins economic freedom and mobility, the time is ripe to bring disabled women into the forefront of these policy discussions.40
Disabled women face significant harms due to systemic ableism, along with racism41 and xenophobia,42 all of which undermine their right to bodily autonomy. Policies such as guardianship laws43 and forced sterilization44 deny disabled people’s basic civil rights. Disabled people also significantly face discrimination in accessing general reproductive health care, including being unable to get gynecological examinations45 due to inaccessible clinics and being unable to afford contraceptives46 because of current Medicare restrictions. This has led to higher rates of complications and mortality during pregnancy and childbirth47 and higher mortality rates from reproductive-related cancers48 among disabled women compared with nondisabled women.
The effects of reduced access to reproductive care have implications for women’s employment, including reduced labor force participation,49 fewer hours worked,50 and increased leave taking needs.51 When disabled women are less able than nondisabled women to access these services, it becomes not only an ethical issue, but also a problem of economic security. It is imperative that disabled women’s reproductive needs be taken into consideration when addressing reproductive health access policies—a necessary part of enabling disabled women to continue contributing to the economy.
The economic benefits
Women are more likely than men to have a disability. According to the Centers for Disease Control and Prevention, 28.8 percent of women reported having some type of disability in 2021, compared with 25.6 percent of men.52 At the same time, as explained above, disabled women are less likely to participate in the labor force—suggesting disabled women could have real potential to fill gaps in the U.S. labor force.53 One study from 2018 showed that if just 1 percent more disabled people joined the labor market, U.S. gross domestic product could “get a boost up to $25 billion.”54 Not only would this benefit the general economy, but it would also help lift disabled women and their families out of poverty, and many others, beyond disabled people, would be lifted out of poverty with the ability to increase financial security through work.
Employing women with disabilities can have a positive impact on individual companies. Research shows that employing disabled women increases company loyalty and retention rates because disabled people are more likely to stay at a company.55 Many employers have the false impression that workplace accommodations are too expensive, but a report citing 720 employer survey responses showed that almost half of those providing accommodations said it cost them nothing.56 Of those who did have to spend money, 43.3 percent only had a one-time expense with a median cost of $300.
The median cost of repeated annual expenses was $3,750. That contradicts the myth around accommodations and shows that employing disabled workers often requires little financial investment. In turn, that positive impact benefits both the company and individual workers, as employed disabled people report having more confidence, an increased social network, and overall increased sense of community and self-worth.57
Lastly, increasing the employment of disabled women who want to work can help reduce stress on social safety net programs. Slight changes in administrative burdens, such as lifting asset limits on Medicaid, can significantly increase disabled people’s ability to work, reducing their reliance on other financial programs. Research shows that disabled people in states with Medicaid expansion were more likely to be employed because they were able to enter the workforce and increase their earnings, without the risk of losing coverage that enabled them to access required care.58
The policy recommendations
Past policy measures, such as the passage of the Americans with Disabilities Act in 199059 and Medicaid expansion in many states, resulted in significant progress in helping disabled women achieve economic security—but inequities persist. Federal and state lawmakers have a crucial role to play in bridging gaps in work and pay by increasing wages, eliminating asset limits, and protecting worker rights by ensuring employers provide adequate workplace accommodations. Robust health and social support are also needed to help disabled women fully access the labor market.
Federal policy recommendations
Federal policymakers have a range of policy options to improve the economic security of disabled women, including:
- Increase home- and community-based services funding: Congress must significantly increase funding for home- and community-based services to ensure access to personal care for disabled women so they can live and participate in their communities.60 This funding should support increased wages for care workers, expand the care workforce, and provide vocational services for disabled workers. (see Chapter 4)
- Reform asset limits and earned income caps: Reforming or eliminating asset limits in government income support programs is necessary to provide financial security for people with disabilities.61 Raising earned income caps on Supplemental Security Income and Medicaid would allow disabled people to work without losing their benefits.
- Eliminate subminimum wages: (see Chapter 5) Section 14(c) of the Fair Labor Standards Act still operates based on the ableist notion that disabled people’s work is less worthy, creating nonintegrated workplaces that require dull, repetitive labor.62 Disabled people can still make only $3.50 per hour, which traps many below the poverty line.63 Policymakers need to continue to phase out the subminimum wage for disabled contractors.64
- Raise the minimum wage: (see Chapter 5) Increasing the federal minimum wage to at least $17 per hour would help disabled women in the U.S. workforce.65
- Pass universal paid family and medical leave: (see Chapter 6) Ensuring paid leave would enable disabled workers to address medical concerns and caregiving without contending with whether they have to leave their jobs.66
- Increase funding for the U.S. Equal Employment Opportunity Commission (EEOC): (see Chapter 7) The EEOC needs more funding to hire additional staff that can address disability-related complaints.67
- Ensure access to workplace accommodations: Accommodations should be accessible, require less paperwork, be well communicated to employees, and be in full compliance with the Americans with Disabilities Act.68
- Strengthen misclassification and labor law protections: (see Chapter 9) Addressing worker misclassification will prevent people from being underpaid,69 and passing the Protecting the Right to Organize (PRO) Act will bolster the ability of workers to unionize.70
- Strengthen workplace standards to create healthy environments for workers: The COVID-19 pandemic showed just how important improved air quality is to reducing the spread of highly transmissible viruses. The Occupational Safety and Health Administration should create workplace air quality and ventilation standards to protect all workers, particularly those most vulnerable to illness and death.71
- Pass comprehensive health policies that protect reproductive health: (see Chapter 1 and Chapter 2) Reproductive health is an important part of disabled women’s health care that requires direct investment and protection.72 Federal policymakers must pass statutory protections and issue executive orders that protect abortion rights,73 repeal the Hyde Amendment, and have the U.S. Department of Health and Human Services and the U.S. Department of Justice adopt accessible medical equipment standards.74
State policy recommendations
It is critical that state policymakers also step up to support disabled women’s employment outcomes. Specifically, they need to:
- Expand Medicaid: Ten states still have not adopted Medicaid expansion under the Affordable Care Act.75 Access to health care is absolutely essential for disabled women, particularly low-wage workers, to be able to work; Medicaid expansion is a lifeline for working disabled women and those who need home- and community-based services.
- Make state changes to home- and community-based services permanent: Many states utilized their public health emergency powers during the COVID-19 pandemic to boost home- and community-based services,76 including allowing for virtual video evaluations, paying family caregivers and increasing pay for nonfamily caregivers, expanding the eligibility pool, and waiving prior authorizations. Those changes should be made permanent.
- Implement supported decision-making: Guardianship laws should be replaced with supported decision-making laws that give disabled people back their right to make decisions and provide support to help make those decisions.77
- Pass paid leave legislation: (see Chapter 6) States can pass their own paid leave standards, ensuring disabled women can take medical or family leave without losing out on wages.
- Eliminate subminimum wage laws and raise the minimum wage: (see Chapter 5) Twelve states have essentially eliminated subminimum wages for disabled people, and five are phasing it out.78 More states should eliminate subminimum wage laws for everyone and increase the minimum wage to $17 per hour or higher in the absence of federal action.
Conclusion
Across the United States, little policy attention has been paid to disabled women. Yet women are much more likely to have a disability and live in poverty. Investing in disabled women and helping them join or stay in the labor force and increase their buying power will continue to help them, the communities in which they live, and the economy as a whole.
The authors would like to thank Sara Estep, Rose Khattar, Lily Roberts, Will Roberts, Andrea Ducas, Jill Rosenthal, Sabrina Talukder, and Amina Khalique for their assistance.