The ADA at 36: Honoring the Workers Who Make Its Promise a Reality
Thirty-six years ago, on July 26, 1990, the Americans with Disabilities Act (ADA) was signed into law, a landmark declaration to ensure equal opportunity for—and prevent discrimination against—people with disabilities in all aspects of American life. Nine years later, the Supreme Court’s Olmstead decision gave that declaration force, affirming the rights of people with disabilities to live in their communities, not institutions.
Rights on paper become realities through the lived experience and contributions of people across the country. A large and growing number of Americans with disabilities self-direct their own services, with vital contributions from care workers, personal care aides, and direct support professionals. Long before the ADA, the independent living movement established a defining principle: people with disabilities should control the services they receive. Today, more than 1.5 million people self-direct their services through programs in every state, recruiting, hiring, training, and supervising their own workers—deciding who provides their support, and how.
Self-direction only works, however, when there are workers to hire. The same is true of every home and community-based service the ADA and Olmstead made possible: their promise depends on a stable, respected workforce.
An Undervalued Workforce
The workers who support people with disabilities are part of the nation’s direct care workforce of nearly 5.4 million. Direct care workers earned a median wage of just $17.36 in 2024, and nearly half rely on public assistance to make ends meet.
Direct support professionals, who work primarily with people with intellectual and developmental disabilities, face these same conditions, yet remain largely invisible in federal data, which still lacks a distinct occupational category for their role.
When poor job quality drives workers away, the consequences fall on people with disabilities: services delayed or denied, waiting lists that stretch for years, self-directing clients who cannot fill their positions, and the risk of institutionalization that the ADA and Olmstead were meant to end.
A Promise Under Pressure
This anniversary arrives at a precarious moment. Federal Medicaid cuts enacted under H.R. 1 are beginning to take effect, and because home and community-based services remain an optional Medicaid benefit, they are among the most exposed as states weigh difficult budget decisions, even though research has shown that they cost less than institutional alternatives.
Medicaid is the primary funder of these services, and therefore of the jobs and self-directed budgets that sustain community living. When funding is cut, wages stagnate, the workforce becomes less stable, and people who direct their own care cannot offer what it takes to effectively recruit and retain workers. A person with a disability who loses their worker also loses what the ADA has promised.
Honoring the ADA Means Investing in Care
The surest way to honor the ADA is to invest in the people who bring it to life: protecting and strengthening Medicaid; improving compensation, training, and career pathways for direct care workers; supporting the immigrant workers who are essential to this field; defending labor rights; strengthening self-direction; and building systems that make direct care a sustainable, respected profession.
The ADA endures because generations of advocates, led by people with disabilities themselves, refused to accept exclusion. Sustaining that legacy means investing in them and in the direct care workers who support their right to live fully and independently.
