HARRISBURG, Pa. – The GOP health bill now in the U.S. Senate would be especially harmful to seniors and people with disabilities, according to a new report. With the per-capita cap on Medicaid spending that would be imposed under the American Health Care Act, states would be forced to make cuts. And, according to Judy Solomon, the vice president for health care policy at the Center on Budget and Policy Priorities, Home- and Community-Based Services (HCBS), which allow seniors and people with disabilities to get the care they need in their homes, would be at the top of the list. “Most HCBS are what Medicaid considers ‘optional’ services – in other words, states don’t have to provide them, in contrast to care in a nursing home, which is mandatory and states must provide,” she explains. The report says more than 90,000 Pennsylvanians participate in Medicaid-funded HCBS, and capping Medicaid could force many into much more expensive nursing-home care.Marty Ford, the senior executive officer for public policy of the Arc, says the impact of a cap on Medicaid would be devastating for people with intellectual and developmental disabilities. She claims it would undo decades of work by states to move people out of institutions and into the community, as federal law requires.”It would be a major step backward and a violation of the U.S. Supreme Court’s decision in Olmstead. And based on the Americans with Disabilities Act, unnecessary segregation is discrimination.”In some states, people with disabilities already spend eight to 10 years on waiting lists for home- and community-based services,” she says. David Certner, legislative policy director for AARP notes that seniors and people with disabilities now account for 60-percent of Medicaid spending. He says caps would shift costs to states, state taxpayers and to families who can’t afford to pay for care without this additional support.”The end result would be dramatic cuts to program eligibility, program services or both, ultimately harming some of our nation’s most vulnerable citizens,” Certner says. Nationally, nearly three million people rely on HCBS to receive care at home instead of nursing homes or other institutions.