Housing affordability is a global concern although its impacts are not experienced equally across society, disproportionately impacting people with disability. Housing affordability is an important social determinant of health and living in unaffordable housing is associated with physical and mental ill-health, reinforcing systemic health inequalities for people with disability. In 2008 the Australian Government committed to ensuring equal access to affordable housing under the UN Convention on the Rights of Persons with Disabilities and this has been outlined as a policy priority in Australia's Disability Strategy. To date, there is no evidence to monitor whether Australia is meeting these commitments. This study analysed 20 years of data from the Household, Income and Labour Dynamics in Australia Survey to examine trends in housing affordability inequalities between people with and without disability. We found from 2003 to 2022, people with disability in Australia experienced persistent and significant inequalities in housing affordability for every year during the 20-year period with no evidence of improvement in either absolute or relative inequalities over time. People with disability were between 1.8 and 2.5 times more likely to experience unaffordable housing than people without disability. This pattern was consistent across age and sex stratifications. The persistence of these inequalities indicates there is a housing affordability crisis for people with disability in Australia and this is a critical public health concern. Without targeted, structural reforms, people with disability will continue to experience both housing and health inequalities during the ongoing global housing crisis and for the foreseeable future.