Short-term Medicaid MFP and Spousal Impoverishment Bill Approved

Legislation | January 22, 2019 | by Andrea Price-Carter

The Senate supports short-term Medicaid Extenders Act to extend the Medicaid Money Follows the Person Rebalancing demonstration, and to extend protections for Medicaid recipients of home and community-based services against spousal impoverishment.

On January 17, 2019, the Senate passed the Medicaid Extenders Act of 2019 (H.R. 259) which provides short-term funding for the Money Follows the Person (MFP) Demonstration Grants that helps states rebalance their Medicaid long-term care systems. The Act also includes a short-term extension of protections for Medicaid recipients of home and community-based services (HCBS) against spousal impoverishment. This is the same bill that the House of Representatives passed on January 8, and it now heads to the White House, where it is expected to be signed into law.

The MFP Rebalancing Demonstration Grants, which became effective in 2005, have helped over 75,151 Medicaid beneficiaries with chronic conditions and disabilities to transition from nursing homes to community-based settings. While eight state MFP programs already have exhausted their funding, the remaining 36 were expected to exhaust their funding by December 31, 2018. Medicaid Extenders Act includes three months of funding for MFP that states have until September 30, 2019 to spend. has a list of states participating in MFP.

The Medicaid Extenders Act’s extension of the spousal impoverishment protections for Medicaid beneficiaries receiving HCBS is modeled after similar protections already available under Medicaid law for spouses of Medicaid beneficiaries living in nursing homes. A provision of the Affordable Care Act that requires state Medicaid programs to apply such rules to HCBS long-term care expired on December 31, 2018.

While efforts to pass longer reauthorization bills during the last Congress were unsuccessful, Rep. Debbie Dingell (D-MI), a lead cosponsor on the MFP Demonstration Program and the spousal impoverishment protections for seniors on Medicaid legislation, has vowed to continue to work for a permanent solution during the 116th Congress. LeadingAge will continue to work with members of Congress on Medicaid solutions to ensure that beneficiaries are able to access the services they need in the settings of their choice.