There are a lot of areas in American politics and society that are worrying. Just look around and you can probably rattle off at least five major things that aren’t going well. But there are bright spots if you look in the right places. One of those places is in new technologies that help people with disabilities. Some of these innovations are nothing short of miraculous.
Ray-Ban Meta smart glasses with AI assistance are helping blind people read menus, get dressed, and prepare meals. AI-powered bionic arms are more usable and continuously improves in its ability to recognize a user’s movement patterns. Gene therapy is improving the hearing of children with a rare genetic condition that causes hearing loss. Patients with debilitating diseases like progressive supranuclear palsy (PSP) are now able to train AI-based voice assistants and continue communicating well even after they’ve physically lost the ability to speak. These are just a few of the many new amazing technologies that are helping people with disabilities. I want you to stop and read each of those examples again and think about what they mean for the people involved. These are miracles happening right in front of us. We humans are doing this. We are the miracle makers.
There’s a cost-of-living connection here. These kinds of innovations could significantly reduce healthcare expenditure for people with disabilities and they also help them be better able to live independently, thus avoiding often very costly assisted living situations – not to mention all of the dignity benefits there too. In addition to those cost-of-living benefits, these technologies help people with disabilities live fuller, richer lives. When I think about the blend of technological advancements and progressive values that drives so much of what I believe in, it is these kinds of technologies that I have most in mind.
The real question then is “How do we do this faster? What policy reforms can accelerate the development of technologies for people with disabilities?” There are a number of answers one could give on that but I want to focus on a particular one here: regulatory sandboxes.
Current Regulatory Barriers to Miracle Abundance
The technologies that I described above do not come to market in a regulatory vacuum. They face a maze of overlapping federal agencies, each with their own approval processes, timelines, and requirements. For AI-powered medical devices, companies have to navigate the FDA's complex software classification system. A bionic arm that learns from user behavior doesn't fit neatly into traditional medical device categories, which creates regulatory uncertainty that can delay market entry. Those gene therapies for hearing loss face a multi-stage approval process through the FDA's Center for Biologics Evaluation and Research requiring extensive clinical trials that can cost tens of millions of dollars and take many years. The current system prioritizes avoiding any risk over enabling life-changing benefits, which makes sense for some medical interventions but creates unnecessarily high barriers for breakthrough disability technologies.
Cross-agency coordination problems make things worse. AI-based voice-training may need approval from the FTC for privacy practices, the FDA for medical claims, and state insurance commissioners for coverage, with no single agency taking responsibility for ensuring these technologies quickly reach the people who need them. As a result, miracle technologies often remain on laboratory shelves while people with disabilities wait for bureaucratic processes to catch up with scientific possibility.
What Regulatory Sandboxes Are
A regulatory sandbox is essentially a controlled testing environment where companies can pilot innovative products and services under relaxed regulatory requirements for a limited time period. Think of it as a "testing ground" where regulators and innovators can experiment together without the full weight of existing rules that weren't designed for breakthrough technologies. As the State Policy Network points out, “While some restrictions are lifted, regulatory sandboxes are not a free-for-all. Regulations that impact public health, safety, and consumer protection remain in place, all other regulations are suspended. After businesses explore their concepts for one year without regulations, lawmakers will evaluate what’s working and what isn’t—namely, what regulations the business needs to follow once it transitions out of the “sandbox.”
The concept originated in financial services, where the UK's Financial Conduct Authority created the first regulatory sandbox in 2014. Since then, regulatory sandboxes have spread globally and across industries. Singapore uses them for autonomous vehicles, the Netherlands is using them for AI innovations, and several U.S. states have them too.
Here's how they could work in practice for disability tech. A company could apply to participate with a specific innovative product or service. Regulators could then review the application and, if approved, grant temporary relief from certain regulations, maybe waiving standard clinical trial requirements or allowing provisional insurance coverage or permitting cross-state licensing. The company would then test their innovation with real users under close regulatory supervision, collect data on safety, efficacy, etc. At the end of the testing period, regulators use this real-world evidence to craft better regulations around this new innovation that could help get it to market faster while maintaining appropriate safety standards.
The key insight is that sandboxes let regulators learn alongside innovators rather than trying to regulate technologies they don't fully understand. Instead of saying "prove this works within our existing framework," sandboxes say "let's figure out together how to make this work safely."
How Regulatory Sandboxes Can Help These Technologies
Disability-focused regulatory sandboxes could address the specific challenges facing assistive technologies in ways that traditional approval processes simply can't. For AI-powered devices like smart glasses or bionic arms, regulatory sandboxes could allow for iterative improvement during the testing period with the understanding that machine learning systems get better with use rather than requiring them to be perfect before launch.
With regards to gene therapy for hearing loss, a regulatory sandbox could enable expedited compassionate use programs for children with progressive conditions, allowing them to access experimental treatments while researchers collect real-world safety and efficacy data. Instead of waiting a decade for full FDA approval, families could access these therapies in partnership with their doctors within specialized medical centers participating in the sandbox.
For insurance coverage barriers, regulatory sandboxes could include temporary reimbursement agreements. Medicare or state Medicaid programs could pilot coverage for promising assistive technologies, tracking both health outcomes and cost savings over a two-year period. This could help patients and also help government healthcare programs by helping them better understand which of these new technologies are most cost-effective.
Perhaps most importantly, disability-focused regulatory sandboxes could prioritize user feedback in ways traditional regulatory processes often don't or can’t. People with disabilities could participate as co-designers throughout the testing process, ensuring these technologies actually meet their needs rather than what engineers think they need. This user-centered approach would likely produce better outcomes and faster adoption once technologies graduate from the sandbox to full approval.
Disability Doesn’t Have to Mean Diminished Possibilities
The economic case for accelerating these technologies is compelling, but it doesn't capture the full story. Yes, AI-powered assistive devices could potentially reduce healthcare costs. Smart glasses that help blind people navigate independently reduces, or maybe even eliminates, the need for costly mobility training. Gene therapies that restore hearing prevent a lifetime of specialized education expenses. Bionic arms that continuously improve mean fewer revision surgeries and rehab sessions.
But behind every cost saving is a human story of expanded possibility. A child who receives gene therapy for hearing loss doesn't just save the healthcare system money, they get to hear their parent's voice clearly for the first time. A person using an AI-trained voice assistant after losing their ability to speak doesn't just avoid expensive communication devices, they get to keep telling jokes with friends and saying goodnight to their children.
This is what abundance looks like: technologies that don't just make life cheaper but make it richer and more dignified. Regulatory sandboxes can help us deliver these miracles faster.
-GW