THE 140,000 disabled people in NSW will be guaranteed care and support within five years after the federal and NSW governments reached a $6 billion deal to implement the national disability insurance scheme by 2018 - and the federal opposition vowed to honour the deal if it was elected.
But the scheme will come at a cost with the Prime Minister, Julia Gillard, warning of severe budget cuts to find the billions of dollars the federal government will need to find each year to pay its share.
''I'm being clear about it because I want people to understand it. We will be asking people to make some hard choices to get this done,'' she said.
The federal opposition, if elected next year, will also be forced to find the savings to meet its promise to honour the deal struck in Canberra on Thursday between Ms Gillard and the Premier, Barry O'Farrell.
On Monday, as Tony Abbott described himself as ''Doctor Yes'' when it came to the scheme, his shadow treasurer, Joe Hockey, warned that a Coalition government would support the scheme only when the budget was strong enough.
''Under us, you will get a full NDIS when we can afford it, and Australia at the moment cannot afford it,'' he said.
But on Thursday, the opposition spokesman on disabilities, Mitch Fifield, committed the Coalition to the 2018 timeline. ''We support the agreement reached,'' he said.
The NSW deal will increase pressure on other states to sign up but will proceed regardless of how many are on board.
In NSW, the federal government will pay $3.32 billion in 2018, or about 51 per cent of the funding needed, and the state will pay the rest, $3.13 billion.
NSW sources said the state would not have to find extra money because it already spent more than $2 billion a year on disability support in its Stronger Together program and this contribution would be indexed to $3 billion by 2018.
''We're confident that within the Stronger Together program, we can fund this proposal,'' Mr O'Farrell said.
The Commonwealth now contributes about $500 million to NSW for disability services, so it will face the greater pressure to find the extra money.
Ms Gillard warned that no other state would receive such generous federal assistance as NSW because it already spent more per head on disabled people.
The other states, she said, would have to increase their spending rather than rely on the Commonwealth to do the heavy lifting.
It is estimated the states and Commonwealth will have to find an extra $8 billion a year among them by 2018.
''Some states have got a bigger journey to travel than NSW because their disability services are not at the same starting point,'' Ms Gillard said.
Others, including South Australia and Queensland, are insisting the Commonwealth pay all the extra funding.
The Productivity Commission, which designed the scheme, will reassess the costs in 2018.
Pilot schemes, which were funded in the May budget with $1 billion over four years, will begin on July 1 in NSW, Victoria, Tasmania, SA, and the ACT.
In 2016, the pilot scheme in the Hunter region will start expanding to be statewide by 2018.
Ms Gillard will use the deal with NSW to pressure the other state and territory leaders at Council of Australian Governments meeting in Canberra on Friday.
The government hopes all states will sign an intergovernmental agreement pledging support but so far, Western Australia and Queensland are holding out.
The former NSW Labor minister and now disability advocate, John Della Bosca, urged the rest of the nation to agree.