In cases alleging disability discrimination in the provision of state and local government services, courts frequently hold that plaintiffs’ claims depend on the question whether, despite the disadvantage that government actions impose, the plaintiffs nevertheless receive meaningful access to the government services. Whether people with disabilities actually have meaningful access is in reality a factual question, one on which social science and other empirically supported facts should matter. But courts frequently ignore evidence about the nature and level of access that people with disabilities have to government programs when decisions regarding those programs are being challenged. This essay catalogues judicial decisions that bypass, or conversely, engage in the empirical inquiry. The essay considers several types of cases, including those concerning limits on government medical assistance, an issue of particular salience in the current political climate. The essay draws the conclusion that the better reasoned decisions are those that take social science and other relevant evidence seriously in determining whether meaningful access is afforded.