So if anything like the proposed cuts come to pass, the impact will be meaningful. In addition to nursing homes, Medicaid may also pay for home- and community-based care for older adults, and H. Stephen Kaye, the director of the Community Living Policy Center at the University of California, San Francisco, recently examined how much less might have been budgeted for those services and others for people with physical and other nondevelopmental disabilities if the House bill’s caps had been in existence from 2001 to 2013. His estimate? Roughly 25 percent, a staggering figure for people who use those services to keep themselves out of nursing homes in the first place.

How does this all trickle down to an individual? First, you need to qualify for Medicaid. This will depend on your income, assets and condition. Each state has its own rules, and a federal website provides links to all of them. In general, you have to be pretty close to destitute, with certain important exceptions related to homes and spouses, among other things.

The most detailed, plain-English guide I’ve found to the rules so far is called “How to Protect Your Family’s Assets From Devastating Nursing Home Costs.” As the title suggests, an entire industry has grown up around helping people qualify for Medicaid while still having something left for spouses and heirs. More than nearly any other important area of personal finance, this one depends a great deal on your state of residence, and many people hire an elder-law attorney to help them navigate the process.

Medicaid must pay for nursing homes, but not every nursing home takes Medicaid patients. Nor do the ones that do accept Medicaid patients have to let in every Medicaid patient who wants an empty bed. That means that people with at least some ability to pay at the beginning of their care may have an advantage getting a bed at their favored nursing home. How much might it cost where you live? Genworth has a good state-by-state estimator for this and other elder-care costs.

But many people don’t want to be in a nursing home at all. They would much rather live in their own residence for as long as possible. This is where things get tricky, and where the various proposals in Congress could make a big difference. Medicaid must cover nursing home care, but state Medicaid plans don’t have to cover community- or home-based care that might allow you to stay out of a nursing home for some period of time or forever.

So how do states handle this in practice? On the federal Medicaid site, a bit of research tells the story. (View it now — this administration has a habit of denying access to bits of useful information.) Alaska, Arizona, Minnesota, New Mexico and Oregon spend more than two-thirds of their Medicaid budgets for long-term care on home- and community-based care. Florida, Indiana, Louisiana, Michigan and Mississippi spend less than 40 percent in that manner.

If state Medicaid administrators have much less money to work with in future years, they will face some unpleasant choices. Do they spread the cuts equally (or at least proportionally) among children, adults with disabilities and seniors? And when billions disappear from budgets for old people who have run out of money and have no family to help them, what will be cut first and most?