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There are numerous federal Medicaid programs and policies that improve access to home and community based services (HCBS) and encourage states to fund and expand HCBS and decrease Medicaid’s bias towards institutional care.

Medicaid’s “spousal impoverishment protections” make it possible for an individual who needs a nursing home level of care to qualify for Medicaid and receive long-term services and supports, while allowing their married spouse to retain a modest amount of income and resources to pay for rent, food, and medication. Congress extended this protection to eligibility for HCBS in all states beginning in 2014, providing married couples the same financial protections whether or not care is provided in a facility or in the community. However, this extension is not permanent.

If these protections were to expire, people who are now eligible for HCBS could be forced to leave their spouse and loved ones and move into more costly institutional care against their wishes. The effect would be to stall, or even reverse, the progress states have made in helping older adults and people with disabilities remain at home and in the community.

Read more about the importance of the HCBS spousal impoverishment protections and why they should be made permanent in our fact sheet.

The Medicaid Money Follows the Person (MFP) Program helps older adults and people with disabilities move out of institutions and into the community and is a common-sense way to fund Medicaid Home and Community-Based Services that improve the quality of life for people and families and save federal dollars that would otherwise be spent in more costly institutions.

Read more about our MFP advocacy in partnership.

Letters from 60 National Aging & Disability Organizations Urging the House and Senate to Extend Spousal Impoverishment Protection and Reauthorize Money Follows the Person (March 2019)

Letter from 126 National, State, and Local Aging & Disability Organizations Urging Congress to Pass Long-Term Extensions of Medicaid Money Follows the Person Program and HCBS Spousal Impoverishment Protections (October 2019)

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