Maybe it's just one recruiter's resume filter. Maybe the company actually has a great medical leave policy, or pays really well, or works on something the OP is super excited by. Or maybe the company is just really, irrationally weird about applicants having gaps on their resume, but is otherwise perfectly normal, and it doesn't matter ever again after OP signs an offer.
Sure, given two offers from otherwise identical companies OP should count this as a mark against, and sign an offer from someone who doesn't care. Given offers that aren't otherwise identical, though, what's it worth? $5k in salary? More? Less?
Maybe a huge amount. If an employer has a negative predisposition towards you, and you already have a small negative signal on your own resume (gap)-- they have the potential to really screw things up for you. The amount of suck you might endure is unbounded, and the probability of your recent experience on your resume becoming worse is too high.
A 5% chance of my house burning down is much more costly to me than 5% of the economic cost of my house burning down. Indeed, there's not really a (reasonable) discounted price I will take for a chance of my house burning down.
Of course, this kind of aggressive avoidance of risk is exactly the thing we are annoyed with the employer for... But most employers do not have their eggs in one basket to the extent that someone returning to their career from a gap does.
$5k this year is small compared to future potential career earnings; not much of a difference in probability of losing those is required to far exceed $5k. Just strict linear expected value could be bad, let alone when one weights the risk and volatility.
So, (eg) if you didn't work all of 2018 and 2019, don't list that time at all, unless you did something relevant to your career.
I certainly wouldn't open with it... nor avoid it. Honesty is the best bet. If it comes up, sure talk about it, but talk about what you did to keep your finger on the pulse, what you researched, etc... just like you would with any talking point in an interview.
Once, early on as a kid I took 12 months off (but wrote an accounting package and some stock market correlation tools), and regularly took a month or six off between gigs.
In my experience, though, it's not that big of a deal. I've been unemployed for over a year in the wake of the dotcom crash, from 2003 to 2004 in my case. I still regret not using that year more productively, and mostly spent it playing Morrowind. Applied for tons of jobs in the mean time, but couldn't even get invited to an interview. Once I did find a job, I found 3 of them. 3 employers were suddenly eager to hire me, and none of them cared that I spent that year mostly playing Morrowind. Sometimes the job market just sucks, and many employers understand that. But your story certainly looks better if you spent that year working on some interesting private or open source project, instead of playing a game.