People with disabilities are especially vulnerable to reductions in Medicaid spending; typically, they require more health services and often long-term supports as well. Fifteen and a half million Americans with disabilities depended on Medicaid as a source of health insurance in 2009, including 6.0 million seniors and 9.5 million nonelderly people with disabilities.⁵⁴  Medicaid -

• Covers almost two-thirds (63.6%) of public nursing home costs and virtually all costs of intermediate care facility services to people with intellectual and developmental disabilities (ICFs/I-DDs);
• Pays 44 percent of Medicaid home and community-based service costs, thereby helping more than 3 million seniors and people with disabilities to avoid institutionalization;
• Compensates millions of home health aides, attendants and other personal care workers. Existing shortages among such workers would be greatly exacerbated by reductions in Medicaid spending, especially in the face of a projected 79 percent increase in the number of elderly citizens between 2010 and 2030;
• Offers financial protection to husbands and wives who have spouses living in nursing homes, and provides support to family members who care for loved ones at home;
• Helps many of the estimated 52 million family members who furnish informal services and supports to seniors and people with disabilities, thus allowing them to hold jobs, care for their families, and manage the physical and emotional stresses of caregiving; and
• Is a primary source of income for approximately 15,700 nursing facilities and 33,000 providers of home-based care across the nation. In addition to the millions of Americans employed in these facilities, Medicaid also saves U.S. businesses an estimated $33 billion annually in absenteeism and lost productivity by workers with home caregiving duties.