WASHINGTON (AP) — There's another Paul Ryan plan for health care, a fundamental change in caring for the poor and disabled that would affect many more people than the Medicare overhaul the GOP vice presidential candidate is best known for.

Under the Wisconsin congressman's Medicaid plan, states would take over the program. At the same time, Ryan's budget would reduce projected federal spending on Medicaid by about $800 billion over 10 years, dramatically shrinking it as a share of the national economy.

Medicaid serves about 60 million people, roughly 10 million more than Medicare. It's a diverse population brought together by need. Most Medicaid recipients are low-income children and their mothers, but the costliest cases are severely disabled people, many of them seniors in nursing homes.