The state of hospital website accessibility, 2026

Of the 99 health-system homepages we tested, the homepage alone showed:

• 66% had at least one serious accessibility failure (a critical or serious WCAG issue), about two in three.
• 35% had at least one critical issue: more than a third, and the kind that can hard-block a screen-reader user.
• Only 12%, about one in eight, passed every automated check.
• The median site had 8 detectable issues on its homepage; the worst had 75.

An automated scan only sees detectable failures, so treat these as a lower bound. The sample is large, well-known health systems chosen by hand, which is not every hospital in the country.

We ran an identical scan over 90 online stores earlier this year, which lets us compare two sectors on the same yardstick. Healthcare came out ahead on every headline measure:

• At least one serious failure: 66% of hospitals vs 81% of stores.
• At least one critical issue: 35% vs 49%.
• Passed every automated check: 12% vs 8%.
• Median issues per homepage: 8 vs 17, roughly half.

Our best guess at the reason: health systems tend to run on institutional content platforms with in-house web teams, and unlike most retailers they have a sector-specific reason to care about access. We did not test that directly. Either way, a third of these homepages had a critical barrier on the first page a patient sees.

Ranked by the share of tested sites affected, the recurring WCAG problems were:

• Colour contrast (28%) — text that does not meet the 4.5:1 ratio, WCAG 1.4.3. As with the stores, this was the single most common WCAG failure, and our figure includes text on CSS gradients that most scanners skip.
• Touch target size (12%) — controls smaller than the 24×24px minimum, WCAG 2.5.8.
• Buttons with no accessible name (12%) — usually icon-only buttons, WCAG 4.1.2.
• ARIA elements missing required children (11%) — custom menus, tab sets, and listboxes that are wired up incorrectly, WCAG 1.3.1. This one showed up more on hospital sites than on stores, and it tends to sit on the interactive widgets that matter most here: appointment finders, provider search, portal menus.
• Images missing alt text (9%) — WCAG 1.1.1.
• Links with no discernible text (9%) — usually icon-only links, WCAG 2.4.4 / 4.1.2.

Structural best-practice issues were more widespread than any single WCAG failure: content not contained in landmarks showed up on 52% of sites, and out-of-order headings on 29%. Those are advisory rather than WCAG success-criterion failures, so we have kept them separate from the figures above, but they make a page harder to navigate by screen reader.

A checkout you cannot use costs you a sale. A hospital site you cannot use can stand between someone and their care, and the people most likely to depend on assistive technology are, disproportionately, the people who need healthcare.

Healthcare also carries obligations most sectors do not. In 2024 the US Department of Health and Human Services adopted WCAG 2.1 Level AA as the accessibility standard for the websites and mobile apps of providers that receive federal funding, under Section 504. An interim final rule in May 2026 moved the compliance dates back a year, to May 11, 2027 for recipients with 15 or more employees and May 10, 2028 for smaller ones (both the HHS and ADA Title II dates are here). Section 1557 of the Affordable Care Act separately bars disability discrimination by those same programmes. We are not offering a legal reading of any particular site here. The point is only that for hospitals, the machine-checkable issues above sit on top of a standard that is already named in a rule.

The median hospital homepage also had 15 items flagged as "needs human review", cases an automated test cannot decide, like whether alt text is accurate or whether a custom appointment widget works from the keyboard. That is far more than the government and bank sites we scanned later (2 each), which fits the widget-heavy pages hospitals build: provider search, location finders, booking tools.

Automated testing covers roughly a third of WCAG success criteria, according to independent research, so the failure rates above understate what patients actually run into. Scoring better than stores on automated checks means hospitals trip fewer of the traps a machine can see. It does not show their sites are easier to use.

We are not saying any health system is breaking the law, and we name none. Automated failures are not a compliance verdict. The finding is that a sector with a specific rule and a specific reason to get this right still ships serious failures on most homepages, and they are ordinary front-end problems: contrast, alt text, button and link names, widgets built without the right ARIA structure.

Fixing them means changing the markup of those widgets and pages. Run the free scan on your own patient-facing pages, or add the CLI and GitHub Action to your release pipeline to catch regressions.

• Sample: homepages of 99 US health systems, scanned in June 2026. We attempted 101; 2 were excluded because they returned bot-protection or error pages instead of the real homepage. This is a curated sample of large, recognisable providers, not a random or traffic-ranked one, so read it as a snapshot of major health systems rather than a statistical census of all hospitals.
• Engine: the axe-core rules for WCAG 2.x Level A and AA, plus our own resolution of colour contrast over CSS gradients. The same engine and settings we used for the stores report, so the two are directly comparable.
• Scope: homepages only. Patient portals, provider search, and appointment booking flows often fare worse, and are where the interactive-widget failures above tend to concentrate.
• As loaded: pages were scanned as they rendered, including any cookie or consent overlays, which can both add and mask issues.
• Not a compliance audit: detectable WCAG failures are not a legal determination, and automated testing does not cover the criteria that need a human. We have reported aggregate figures only and named no individual provider.