There are about 550 nursing homes in Texas with a Medicaid population of 70 percent or higher, Graves said. Texas ranks 49th in the nation in Medicaid reimbursement rates to nursing homes.

The almost 125,000 Texans in home- and community-based care programs are also in jeopardy. A 10 percent cut would mean some agencies could barely afford to pay workers minimum wage; others would be forced to close their doors, said Anita Bradberry, executive director of the Texas Association for Home Care & Hospice.

The fallout threatens to topple a well-balanced long-term care system that has helped residents stay in their homes and stabilized growth among nursing home populations, she said. The cost per person in a community-care program is a third to half that of a nursing home resident.

John Gabbert, CEO of the home health care agency Red River Health Care Systems in Denison near the Oklahoma border, is optimistic that the cuts won't happen, predicting that "sanity will prevail before it all shakes out."

"But if they do cut, we're in chaos," Gabbert said. "All bets are off."

In Corsicana, Angels At Home administrator Jennie Baird said the Medicaid reduction could force her to cut employee benefits and pay, which isn't much more than minimum wage now. "I feel passionate that we've got to be able to find a solution," she said. "Our patients don't have any other options."

To contact your legislators about plans to cut spending on long-term care, call 1-888-633-3650 toll-free.

Kim Krisberg is a freelance writer living in Austin, Texas.