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For one Texas voter, casting a ballot in the March primary took weeks of coordination, multiple phone calls, two applications and help from several people just to meet the deadline.
“As a multi-disabled, homebound senior living in a rural area … there are a number of barriers I have to overcome just to cast my ballot by mail,” he said in a written account to Texas Public Radio.
The voter requested anonymity due to pending litigation with the state of Texas.
Without regular care at home, even basic steps depend on others. Living on a county road without mail delivery, the voter relies on a post office box and a volunteer who can only pick up mail occasionally.
“I get my mail once a month,” he said.
After requesting a ballot by mail in January, delays meant the application did not reach election officials for several weeks. Then another problem came up.
“County election staff called me that day and told me I had failed to choose a party preference, as required under Texas law, so I would not get a ballot for the primaries,” he said.
He said local county election officials were helpful and did what they could within the limits of the system.
With the deadline approaching, he had to start over. A second application was picked up, delivered and returned on the final day. Even then, retrieving and returning the ballot required coordination with a volunteer and a case manager to ensure it arrived on time.
“The lack of regular home care and volunteers, not as easy to find as you might think, is the greatest obstacle to voting,” the voter said.
Barriers beyond the ballot
Advocates and researchers say this experience reflects a broader pattern that may pose added challenges with two elections scheduled in May: The May 2 municipal elections and the May 26 primary runoffs.
For many voters with disabilities, the biggest barriers are not the ballot itself, but the systems people rely on to navigate the process on time, including gaps in home care, transportation and access to assistance.
While the right to vote is protected under federal law, the support services many people rely on to cast a ballot are governed by separate systems that are often underfunded and inconsistent.
Some election officials and advocacy groups are working to address those gaps, though access to those solutions remains uneven.
Isaac Gutierrez, a San Antonio artist who lives with low vision, said he has faced similar challenges. Medically retired, he said the lack of in-home support can make even basic civic participation difficult.
“You should be able to say you need home assistance of some kind because of your disability,” Gutierrez said. “Or at least have someone come in, some type of caseworker, to identify what your needs are … what are my actual needs in order for me to get around my home?”
Gutierrez said he also ran into problems when Texas changed its rules requiring voters to reapply annually for a mail-in ballot.
“So when it came time for elections, I couldn’t get one,” he said. “When I tried to get one, it wasn’t going to arrive in time.”
Angie Collier, a teacher at Poth ISD, said her adult son Jacob, who lives with schizophrenia, faces a different set of barriers. His condition makes complex tasks like researching candidates or navigating the voting process difficult without assistance.
“If he wanted to know how to register, where to vote, getting to the voting facility, because he can’t drive, everything would be really complicated,” Collier said. “The illness really does a number on him as far as any kind of planning.”
Collier said Jacob’s insurance covers limited home health services, but not the kinds of support that would help him participate in elections.
“Things like driving him to appointments or helping him obtain information, those aren’t covered,” she said. “Voting wouldn’t be covered either.”
Gaps in services
The Texas voter who shared his experience with TPR said he has been without in-home health care services for 10 years. He said even a small amount of weekly assistance could have made the process easier.
“If I had 10 hours per week of in-home care,” the voter said, “someone could have handled the mail in a more timely way.”
Lydia Nunez Landry, a coordinator with REV UP Texas, said the barriers described are common across the state.
Home and community-based services in Texas have more than 340,000 people on waiting lists, she said, with some waiting up to 20 years.
“So, a lot of people actually die before they receive those services,” Landry said.
She said those gaps affect far more than medical care, shaping whether people can carry out everyday tasks, including participating in elections.
“Without those services, people rely on family, friends or volunteers for things like transportation, paperwork or even just getting out the door,” Landry said. “Voting becomes one more thing that depends on whether someone is available to help.”
Advocates say the shortage of caregivers and long waitlists can leave many people without consistent support, especially those who live alone or in rural areas.
Transportation challenges
Landry said transportation is another major hurdle, especially in areas without accessible public transit.
“My area, and I’m in a suburb of Houston, but the MetroLift doesn’t come to where I’m located,” she said.
Anna Gray, executive director of Prosumers International, said gaps are often compounded in rural areas, where basic logistics require advance planning.
“Rural transportation, many times, is something you have to schedule a month in advance,” Gray said.
She said for voters who rely on others for rides, even small delays can mean missing key deadlines for early voting or mail-in ballots.
“When every step takes that much coordination, it discourages people before they even get started,” Gray said.
Gray said the challenges are not limited to rural communities. Even in urban areas, limited routes, long wait times and accessibility issues can make getting to polling places difficult.
Advocates say transportation can be especially challenging for people who rely on scheduled rides or assistance. Even during early voting, those voters may have only limited opportunities to get to a polling place. Small delays can mean missing that window altogether.
What the data show
A 2024 report from Rutgers University, Voting Experiences Since HAVA: Perspectives of People with Disabilities, found that about 20 million people with disabilities voted in the 2024 election.
Doug Kruse, a co-author of the study and a professor of labor studies and employment relations, said that reflects strong participation, but also persistent gaps.
“We do see lower turnout among people with cognitive impairments and people with more severe disabilities,” Kruse said. “But even then, about half still voted.”
The study found that 21% of voters with disabilities who cast ballots in person reported difficulties. Among voters with vision impairments, the challenges were more pronounced.
More than half, about 52.5%, of voters with vision impairments who voted in person reported some type of difficulty, and nearly 40% said they had trouble reading or seeing the ballot.
Lisa Schur, a co-author of the study, said those challenges reflect barriers faced by people with a range of disabilities in both rural and urban areas.
“Urban voters can face long lines, which make it difficult for people who can’t stand for extended periods,” she said. “But rural voters often face distance and access issues.”
Policy and access
Schur and Kruse also served as expert witnesses in legal challenges to Texas Senate Bill 1, a sweeping voting law passed in 2021 that added new identification requirements for mail-in ballots and limited how voters can receive assistance.
Supporters of the law said the changes were intended to prevent voter fraud, including practices sometimes referred to as “ballot harvesting,” in which third parties collect and return ballots.
“A federal judge found the law had a disproportionate impact on voters with disabilities,” Schur said.
Gaps in support services persist despite federal requirements under Olmstead v. L.C., a U.S. Supreme Court decision interpreting the Americans with Disabilities Act that requires states to provide services to people with disabilities in community-based settings whenever possible.
Advocates say addressing those gaps will likely require broader changes beyond election policy, including expanding Medicaid-funded home- and community-based services, strengthening the caregiving workforce and reducing long waitlists for in-home care.
These services are the backbone of daily support for many people with disabilities, from help with transportation, paperwork and basic tasks at home.
While some states have expanded services or raised pay for caregivers, advocates say Medicaid cuts under the Trump administration are moving in the opposite direction. Staffing shortages and long waitlists continue to limit access.
Luke Sikinyi of the Alliance for Rights and Recovery said states often scale back these services when funding is uncertain.
“Because home- and community-based services are optional for states, they’re often some of the first to be cut,” he said. “That’s where people get help with daily living, so when those services go away, it affects everything else.”
Many people remain on waitlists for years or rely on family members and volunteers to fill the gaps.
Those broader gaps often shape how accessible voting is in practice.
Researchers say voting access can vary widely depending on how states and local jurisdictions structure their policies.
Kruse said broader access measures, such as expanded vote-by-mail options, tend to improve participation.
“We see turnout improve in states that take steps to make voting easier,” he said.
What’s helping, and where it falls short
Broader access measures, such as expanded vote-by-mail, have helped increase participation among voters with disabilities, Kruse said.
In Bexar County, voters with certain disabilities can access an electronic ballot system known as OmniBallot, which works with screen readers and allows voters to fill out a ballot digitally before printing and mailing it.
Wendy Walker of the National Federation of the Blind of Texas said the system can help, but it still requires multiple steps.
“You fill it out digitally, but then you still have to print it, sign it and mail it back,” she said.
Texas law also allows curbside voting at polling places for voters with disabilities, though awareness and implementation can vary.
Tools like those can make a difference for voters who are blind or have low vision, particularly when they are set up correctly and paired with clear instructions.
Voters who make errors on mail-in ballots may also have opportunities to correct them, but that process can require follow-up and access to assistance.
Access still out of reach for many
Kruse said accessibility has improved since the passage of the Help America Vote Act in 2002. The share of voters with disabilities reporting problems at polling places has dropped from about 30% in 2012 to around 20% in 2024.
But significant challenges remain.
“The biggest problems are for people with visual impairments,” he said. “They are far more likely than others to report difficulties, both with voting by mail and in-person.”
Some solutions are relatively simple, Schur said, like providing seating at polling places or ensuring poll workers are trained on accessible voting equipment.
Others require broader systemic changes.
In practice, those challenges often mean voters still rely on personal support to navigate the process.
San Antonio artist Jenny Salinas, who also lives with low vision, said she relies on her sister to vote.
Accessible voting machines are required at polling sites, but Salinas said she has never been able to use one successfully because poll workers were unfamiliar with the equipment.
“So they give me a headset, and it just keeps repeating instructions,” she said. “There’s no keyboard. It’s not set up. My sister ends up helping me again.”
Anna Gray of Prosumers International said the consequences of those barriers go beyond a single election.
She said the impact can shape whether people feel included in civic life at all.
“Not only in the sense that they’re not able to vote, but in the sense that they are a full citizen with civic responsibilities and privileges,” she said. “That discouragement just adds to the message: ‘You don’t belong. You’re not OK.’”
