Federal health officials are reportedly planning to make it optional for states to provide non-emergency transportation for Medicaid beneficiaries, part of a larger bid to reduce fraud and slash $143 billion from the program.

Nursing home advocates, including LeadingAge, said they oppose the policy change, with such rides crucial to getting residents to their doctor and other appointments. Plans to roll back the long-standing Medicaid benefit were unveiled in budget documents, released by administration officials Monday.

“What’s maybe the most concerning is there doesn’t seem to be any sign that some populations [such as those with disabilities or chronic conditions] will be protected,” Tricia Beckmann, adviser to the Medical Transportation Access Coalition, told Bloomberg. “It could be a very broad granting of flexibility to states.”

Medicaid spent about $1.5 billion on such trips in 2013, commonly for services that include substance abuse treatment, dialysis, doctor visits and physical therapy. The benefit has been mandatory since Medicaid started decades ago. Indiana and Iowa currently have waivers that restrict who can use such transportation assistance, as does Kentucky, though its waiver is being challenged in court.