Medicaid pays for most of the 1.4 million people in nursing homes. It covers 20 percent of all Americans and 40 percent of poor adults. On Thursday, Senate Republicans joined their House colleagues in proposing steep cuts to Medicaid, part of the effort to repeal the Affordable Care Act. Conservatives hope to roll back what they see as an expanding and costly entitlement. But little has been said about what would happen to older Americans in nursing homes if the cuts took effect.