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The Republican war on Medicaid would institutionalize millions. Today, roughly 4.5 million people use Medicaid-funded HCBS as an alternative to institutionalization; the waivers help pay for home healthcare workers, durable medical equipment, career coaching, case management and other services. No one claims that the program is perfect—but most criticism has come on the basis of shortfalls, not overspending. More than half a million disabled people remain on waitlists for HCBS, often waiting yea
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