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Medicaid is a lifeline for millions of Americans, including over 17 million children with disabilities, adults with disabilities, and poor seniors, many of whom need health care and long-term services and supports to address their daily needs. Some have proposed replacing the current Medicaid financing structure with block grants, per capita caps, or both. The price of moving to these types of financing systems is high: millions of Americans could lose access to basic health services and long-term services and supports they need to address their chronic conditions and to live independently in their homes and communities. In addition, states would experience significant cost shifts.