What happens to disability and long-term-care services?

These services keep running, because Texas already runs them. Long-term care, disability services, and the supports families depend on are administered by Texas today, funded in large part by Texas, and delivered by Texas providers. Independence keeps them, and keeps the people who rely on them covered through the transition.

Texas already administers disability and long-term-care services

The supports that disabled Texans and their families depend on are run in Austin, not Washington. The Texas Health and Human Services Commission administers the Medicaid long-term services and supports that fund nursing homes, community attendant care, the waiver programs for people with intellectual and developmental disabilities, and home and community-based services. The case management, the eligibility, the provider networks, and a large share of the funding are already Texan. The direct-care workers, the group homes, the nursing facilities, and the therapists are all here. Independence does not build this system. Texas already operates it.

The earned piece is protected, the welfare piece is kept

Two different things sit inside "disability services," and both are covered. The earned benefit, Social Security Disability Insurance, is protected exactly like Social Security retirement, portable across borders for citizens and secured by the same totalization tool, addressed in full in the SSDI answer. The means-tested piece, Medicaid long-term care and disability waivers, is welfare Texas already co-administers and funds, counted as a real cost the whole way through. Texas keeps funding it because Texas takes care of its own. Neither the earned check nor the funded service disappears.

Continuity is the design

After a vote, existing arrangements continue through a negotiated transition. A Texan in a nursing home, a family caring for an adult child with a disability, a person on an attendant-care waiver, none of them face a cutoff, because the program serving them is the Texas program. The state agency keeps paying, the providers keep providing, and the supports keep flowing while the larger relationship is settled. The entire premise of independence is government closer to the people it serves, which is incompatible with abandoning the most vulnerable.

A system answerable to Texas

Today the rules and the waiting lists for these services are shaped by federal Medicaid policy set in Washington, and Texas pays to comply whether it agrees or not. An independent Texas sets its own long-term-care and disability policy, designs its own waivers, and funds them from revenue that stops leaving the state, answerable to Texas voters and Texas families. That is more responsive to the real needs of disabled Texans than rules written for fifty states at once.

The honest part

Long-term care is expensive and stretched everywhere, with real waiting lists under the current system, and independence is not an instant fix for that. It is an honest challenge under any flag. What changes is that Texas controls the policy, keeps the funding at home, and answers to the families affected, which is a stronger position to improve these services from than waiting on Washington.

The bottom line

Disability and long-term-care services are administered by Texas, funded in large part by Texas, and kept by Texas. The earned benefits are protected, the funded services continue through the transition, and the policy moves to the people who live with the results.