Few data exist describing Medicaid's success in providing health care services to people with disabilities. The access to care survey from the Medical Expenditures Panel Survey was used to collect access data from 502 individuals with disabilities in central Missouri receiving Medicaid under fee-for-service reimbursement. Nearly all of the respondents had a usual source of care, but two-thirds reported difficulties obtaining a needed health care service. Dental, optometric, and personal assistance services were most difficult to obtain. Provider non-participation, non-coverage of a service, and coverage restrictions were the most frequently cited barriers to obtaining care. Results suggest that people with disabilities have difficulty accessing needed health care services through the Missouri Medicaid fee-for-service system.