Money Follows the Person

December 19, 2019- MFP Receives Short-Term Reauthorization

Today, Congress approved another short-term reauthorization of the Money Follows the Person (MFP) program as part of the minibus spending bill. The deal reauthorizes MFP only through May 22, 2020. While this is not the outcome we had hoped for, there is reason to remain optimistic and we thank everyone for your tireless advocacy that has gotten us to this point.

We understand that the reason Congress chose to pass a five month extension for MFP, HCBS spousal impoverishment protections, and several other extenders is to create pressure for a larger healthcare package before the Memorial Day recess that would include prescription drug pricing and surprise medical billing provisions. This aligns with the bipartisan proposal put forth by Senators Chuck Grassley (R-IA) and Ron Wyden (D-OR) earlier this month that included permanent reauthorizations of MFP and HCBS spousal impoverishment protections, which tied those reauthorizations to cost savings from the its proposed prescription drug pricing provisions.

Had Congress chosen to do a multi-year extension, as it had been considering until recently, this chance for permanent reauthorization of MFP in May would not exist. We will continue in our work to make this vital program permanent and hope you will join us!

The MFP Program has helped more than 91,000 seniors and people with disabilities move out of nursing homes and other institutions and into the community. MFP has improved the lives of older adults and people with disabilities, saved states money, and led to better outcomes. That’s why nearly every state has participated in the program.

Take action and urge Congress to continue to fund MFP!


The Money Follows the Person (MFP) Demonstration – first authorized in the Deficit Reduction Act of 2005 with strong bipartisan support and signed into law by President Bush – was designed to assist states with: (1) supporting Medicaid enrollees who want to transition from nursing facilities back to community-based settings; and (2) developing infrastructure to promote and enhance access to HCBS.

Impact of Money Follows the Person

  • Since its inception, 44 states have participated and over 91,000 individuals have been transitioned back to the community.
  • According to independent evaluations by Mathematica:
    • Participants report significant and lasting improvements in quality of life and community integration after returning to the community.
    • Findings suggest that after individuals return to the community, their overall Medicare and Medicaid expenditures decrease by roughly 20%.
  • States have made significant progress on “balancing” their long-term services and supports system to enhance access for HCBS, due in part to MFP. In FY05, states only spent approximately 37% of their LTSS expenditures on HCBS. According to the most recent data, states now spend over 53% on HCBS.

Need to Continue

  • While states have made progress, more work is needed. Significant variations remain across states and different populations who need HCBS. For example, HCBS accounted for 75% of spending in programs targeting people with developmental disabilities, compared to only 41% of expenditures for programs targeting older people, people with physical disabilities, and people with serious mental illness.
  • Over 50,000 nursing home residents said they wanted to talk with someone about leaving their facility, but never received a referral to a local agency that could help them, according to recent analyses of Nursing Home Minimum Data Set reporting.
  • States have learned lessons and can share promising practices with other states.

What You Can Do

Urge your Members of Congress to extend the Money Follows the Person Program. 


Additional Resources

Letter to Congressional Leaders Regarding Essential Medicare and Medicaid Extender Provisions, Including Permanent Funding of MFP (December 16, 2019)

Letter to Congressional Leaders Urging Permanent Funding of MFP and Permanent Extension of Spousal Impoverishment Protections (December 15, 2019)

Letter to Congressional Leaders Urging Long-Term Extension of MFP (October 2019)

Senate Sign On Letter

House Sign On Letter

Info on Money Follows the Person Program (US Dept of Health & Human Svs.)

Evidence for the Impact of the Money Follows the Person Program (Community Living Policy Center)

Medicaid Spending Drops When Members Transition to Community Care (HealthPayerIntelligence 2018)

Money Follows the Person (MFP) Rebalancing Demonstration: A Work in Progress (National Health Policy Forum)

MFP Demonstration: Overview of State Grantee Progress, January to December 2016 (Mathematica 2017)

Money Follows the Person 2015 Annual Evaluation Report (Mathematica 2017)

Money Follows the Person Demonstration: Overview of State Grantee Progress, January to December 2015 (Mathematica 2016)

Money Follows the Person Demonstration Program: Helping Medicaid Beneficiaries Move Back Home (Kaiser Family Foundation)

EMPOWER Care Act one pager (February 2018)

Congress Should Extend Successful “Money Follows the Person” Demonstration (Center on Budget and Policy Priorities 2018)

MFP Chart February 2018

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