Public assistance programs are important sources of support for working-age people with disabilities in the United States. Using a variety of information sources, the authors estimate that the federal government spent $226 billion in 2002 on working-age people with disabilities, including both cash and in-kind benefits. These expenditures account for about 2.2 percent of the nation’s gross domestic product (GDP) and 11.3 percent of all federal outlays. States contributed an additional $50 billion under federal-state programs. The bulk of these expenditures provided income support and health care to working-age people with disabilities who were not employed or had very low earnings. The authors provide a detailed accounting of the expenditures and question whether the distribution of expenditures is properly aligned with the evolving disability paradigm.