There is a great disparity in home and community based services available to the disabled. Medicaid block money is sent to each state to provide community-based or institutional care for the disabled. Unfortunately, there is a stark difference in services available depending on which state that you reside. If a person is able to obtain services, then has to relocate to another state, there is no guarantee that the same services will be available. If available, frequently there is a waiting list for the services.
Data demonstrates that institutional care is 3-4 times more expensive than the community services model. Like the ACA, nationalizing this area would afford portability to the disabled and save tax dollars being used in some states for costly institutional care.