Approximately 800,000 Massachusetts residents live with some form of disability.2 Among them, 335,000 households (about 12% of all Massachusetts households) include someone with an ambulatory disability, defined as a condition that substantially limits one or more basic physical activities such as walking, 9 climbing stairs, or carrying items. 3 These households often require specific accessibility features in their homes, such as no-step entries, wider doorways, and accessible bathrooms.
Despite the clear and growing demand, accessible housing in Massachusetts is in short supply. Data from Housing Navigator Massachusetts reveals that there is only one accessible and affordable unit for every 63 renters earning below 80% of the area median income (AMl). 4 Less than 5% of all housing units nationwide are accessible for people with mobility impairments, and only 1 % are fully wheelchair accessible. 5 This means that thousands of Massachusetts residents are unable to find housing that meets even their most basic physical needs. As of the most recent statewide data, there are approximately 10,246 fully accessible and affordable housing units, with a limited pipeline of additional units.6
Accessible housing is not just about mobility features. Disability and access needs are highly individualized and often change over time. Some people may require zero-step entryways and roll-in showers, while others may need proximity to public transit, lower countertops, or smart-home technology for remote control of lighting and temperature. Individuals with developmental disabilities have distinct needs that are often not addressed by state or federal accessibility requirements. The lack of flexibility in housing design and regulations often fails to accommodate this diversity.
There is also a wide range of regulatory frameworks governing accessibility, which can be confusing for developers and residents. For example, federal standards under the Americans with Disabilities Act (ADA) and the Fair Housing Act intersect with state building codes and local zoning ordinances in ways that are not always aligned. In practice, this patchwork of requirements often results in inconsistent implementation and unclear accountability.
Cost Burden and Poor Housing Fit
People with disabilities are significantly more likely to face housing instability and cost burden. 41% of households in Massachusetts with a disability are renters, compared to 36% of the general population. 7 These households are also more likely to experience poor housing conditions, including inadequate heating, mold, and inaccessible layouts.
People with disabilities who rely on long-term services and supports are especially vulnerable. They often face severe cost burdens and limited housing choices. For individuals who rely on federal benefits like Supplemental Security Income (SSI), housing is often entirely unaffordable: there is no housing market in the U.S. where SSI alone can cover rent.8
The Joint Center for Housing Studies at Harvard found that 6.8 million U.S. households report difficulties navigating or using their homes nationwide. Of those, 2.9 million report difficulties with both mobility and functionality.9 Entryways, kitchens, and bathrooms are the most common problem areas. Households with annual incomes below $30,000 reported 3x the rate of housing fit problems than households earning $75,000 or more.
Challenges in Development and Policy
Developers often cite the high cost of incorporating accessibility features as a barrier yet cost estimates for doing so vary widely. In many cases, integrating universal design or adaptable elements from the outset can be relatively inexpensive, especially compared to retrofitting later. Depending on the market, making too many units fully accessible can lead to a lower unit yield for a building or lower demand for market-rate rent. Without clear cost data or revenue offsets, accessibility improvements beyond minimum requirements are often dismissed as prohibitively expensive.
Additionally, the permitting and zoning process often does not prioritize accessibility. lnclusionary zoning policies may require a certain percentage of affordable units, but few require accessibility beyond federal minimums. Rigid building codes can further complicate the construction of accessible units.
For the purpose of this report, "accessible units" generally refers to dwelling units that are fully usable by individuals with physical disabilities at the time of initial occupancy - including features such as no-step entries, accessible routes, widened doors, grab bars, and accessible kitchens and bathrooms, as defined in 521 CMR 9.00. By contrast, "adaptable units" are designed so that accessibility features can be easily added or adjusted later (for example, installing grab bars or improving access to sinks by removing base cabinets), allowing the unit to be modified to meet the needs of a future resident with a disability. As this report recommends, these terms can also take on a more expansive definition as we update our regulations and language to encompass the full set of accessibility needs that exist today.