11 - Making “Meaningful Access” Meaningful: Equitable Healthcare for Divisive Times

Summary

Meaningful access to social participation sets a standard for repairing harms imposed by disability discrimination. To be meaningful, access must secure more for people for whom opportunity has been arbitrarily proscribed than merely ushering them through a newly unbolted door only to confront further barriers impelled by bias. Meaningful access to a social process is diminished or denied when individuals, due to disability, are prevented from achieving the benefits that generally motivate individuals to participate in that process. Yet interpreting the meaningful access standard has proved elusive for courts. An influential early decision made the illusory affirmation that the door was open to people with disabilities receiving Medicaid because they had the same fourteen days of eligibility for hospital care as others, even though they disproportionately required longer hospital stays to achieve similar care goals.