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Capitol Correspondence - 09.24.18

Momentum Continues to Build on Money Follows the Person (MFP) Program Renewal

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Ahead of our October Policy Summit and Hill Day, we are sharing with you an article from CQ that covers where the bill is currently at and the climate surrounding it. Asking for the renewal of Money Follows the Person will be one of three asks we will be focusing on for our Hill Day and ANCOR has been leading reauthorization efforts of the program.

“Efforts to fund a Medicaid program that helps older Americans and people with disabilities move out of nursing homes and back into their communities appear to be gaining traction – though paying for it remains a hurdle.

A House measure (HR 5306) to reauthorize the program for one year gained a number of cosponsors recently. The program, known as Money Follows the Person, was one of five bipartisan health care bills the Energy and Commerce Committee advanced last week.

Supporters of the program say the recent movement is encouraging, but its $450 million annual price tag remains a stumbling block, as the bill’s sponsors, Reps. Brett Guthrie, R-Ky., and Debbie Dingell, D-Mich., seek a floor vote. A spokeswoman for Guthrie said this week he believes the House will pass an amended bill with a one-year reauthorization – down from the original version’s five-year funding extension – before the end of the year.

A committee aide said Tuesday that Energy and Commerce leaders are working to get all of the recently committee-approved bipartisan health bills to the House floor as soon as possible.

[…]

Meanwhile, the clock is ticking on the Money Follows the Person program, which has helped more than 75,000 Americans move from institutions like nursing homes and saved states upwards of $1 billion since its start in 2007.

Funding for the program officially expired in 2016, and states have been using reserve funds since then. But all states must stop accepting new participants by the end of this year and can only use remaining funds to help existing enrollees through 2020.                        

First authorized in 2005 under a Republican administration, the program enjoys wide bipartisan support. Evaluations over the years have shown it saves states hundreds of millions of dollars and improves people’s quality of life.

It plays an important role in state efforts to refocus long-term services from typically expensive institutions to more cost-effective care in communities.

But finding a way to pay for it is problematic, in part, because it’s a Medicaid program and lawmakers would likely want any offsets to come from within Medicaid, said Joe Caldwell, director of long-term services and supports policy at the National Council on Aging.

Shortening the extension’s duration to one year, down from the original five years, gives the measure a better shot at passage. But supporters say a short-term solution isn’t ideal.

Some states have had to shutter their programs and may be reluctant to restart them if there’s no guarantee of long-term funding. A one-year extension also makes planning difficult for those with biennial budget processes.

‘One year is definitely better than no years, and it will keep the program going,’ Caldwell said. ‘But I think it’s important to give the states and the health plans some level of certainty about the future of the program.’

Sens. Rob Portman, R-Ohio, and Maria Cantwell, D-Wash., are sponsoring bipartisan legislation (S 2227) that would extend the program for five years. A spokesman for Portman said Monday he’s pleased to see the growing interest that appears to be leading to House action. Portman is also open to a one-year funding extension, his spokesman said.

It’s also unclear which legislative vehicle this year, if any, might carry it. Advocates lobbied without success to get it in the bipartisan budget deal (PL 115-123) or the omnibus spending law (PL 115-141) forged earlier in the year. It’s not a part of the massive opioids package (HR 6) currently being negotiated. 

Still, Caldwell and other advocates remain optimistic that a resolution can be reached before the session ends. He noted the number of cosponsors for the House bill has jumped from roughly 30 to 57 in the past couple of weeks.

‘There’s a lot of momentum there that they want to do it,’ he said. ‘There’s a lot of bipartisan support.’”