Debilitating Alexander v. Choate: ‘Meaningful Access’ to Health Care for People with Disabilities

Abstract

Since the 1985 decision of Alexander v. Choate, it has generally been assumed that financially-motivated cutbacks in state-provided health care cannot be successfully confronted as discrimination against people with disabilities. This article first challenges the reading of Alexander as precluding the use of disability discrimination law to object to limitations in state financing of health care. Based on case law interpreting Title II of the ADA, it then elicits an account of "meaningful access" to public services in terms of equality of opportunity to make use of the services. State programs that fail to provide people with disabilities equal opportunity to make meaningful use of health care services can be challenged as disability discrimination. This strategy for debilitating Alexander v. Choate is especially important in light of current cutbacks in state support for public services.