For all the talk about Medicare, the race for the White House may have a greater impact on Medicaid, which many with disabilities rely on for everything from in-home care to health coverage.

Under President Barack Obama’s signature health care reform law, Medicaid is slated to expand dramatically over the next several years. Up to 17 million new beneficiaries could be added to the program which already covers more than 60 million Americans.

Should Mitt Romney win the presidency in November, however, the future of Medicaid may look very different. He’s pledged to repeal the health care law and supports converting the program to a block grant system whereby states would receive a set amount of money for Medicaid and would be able to control eligibility and spending on their own terms.

The election outcome could have huge implications for people with disabilities and older Americans who account for about half of Medicaid spending. One recent estimate found that block grants may lead to as many as 27 million people losing coverage, reports The New York Times. To read more click here.