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The promise of health care as a right has all too often proved hollow for people with disabilities. In this article, we argue that the understanding of health care as a human right, as found in the CRPD, fails to provide the theoretical machinery for responding to the pressing challenges of health care costs. These challenges are real and potentially devastating. We develop instead an account of health care as a civil right. What this right requires is dependent on the context and resources of the time, so long as all have meaningful access to the benefits provided. The ACA includes some provisions that may prove antithetical to this nondiscrimination standard.