Lawmakers Push to Keep Seniors at Home with Newly Introduced Bills

A bipartisan group of U.S. lawmakers has introduced two new pieces of legislation aimed at making it easier — and more financially secure — for seniors and individuals with disabilities to receive care at home.

The move is yet another recent example of the high-priority position home-based care has developed on Capitol Hill as America’s baby boomers age and health care costs skyrocket.

On Monday, Reps. Debbie Dingell (D-Mich.), Fred Upton (R-Mich.) and Brett Guthrie (R-Ky.) simultaneously introduced the Ensuring Medicaid Provides Opportunities for Widespread Equity, Resources (EMPOWER) and Care Act, along with the Protecting Married Seniors from Impoverishment Act.


Among its provisions, the EMPOWER Care Act reauthorizes the federal Money Follows the Person (MFP) demonstration program for five years. More than 88,000 individuals have used the MFP program to receive care in their own homes since its creation more than a decade ago. Specifically, the program allows certain Medicaid users, including older adults, to more seamlessly transition from a nursing home or institutional care back into the home — but only if they desire to do so.

Dingell and Guthrie previously attempted to reauthorize the MFP program with similar legislation in March 2018.

A different group of lawmakers likewise attempted to reauthorize the program in 2017.


Overall, the MFP program has saved the federal government hundreds of millions of dollars since 2005, according to U.S. Department of Health and Human Services statistics.

“The EMPOWER Care Act will do just that: Empower people with disabilities to decide where to receive care,” Guthrie — who last year helped lead legislative efforts to delay the implementation of electronic visit verification (EVV) requirements — said in a statement. “This program does not force patients to leave a facility if they don’t want to; rather, it allows individuals to decide what is best for them.”

Meanwhile, the Protecting Married Seniors from Impoverishment Act permanently extends spousal impoverishment protections for Medicaid beneficiaries receiving long-term care in home- or community-based settings.

Under current mandates, spousal impoverishment protections in Medicaid prevent unnecessary financial harm in cases where one spouse needs long-term care in a nursing home or institutional care facility.

But protections for care at home or in the community — less costly and less disruptive for families – can potentially expire.

“The long-term care system in this country is broken,” Dingell said in a statement. “Seniors, families, and caregivers are often desperate, stressed, and don’t know where to turn.”

Both pieces of legislation are backed by several long-term care stakeholders, including the Partnership for Medicaid Home-Based Care (PMHC), currently chaired by Bayada Home Health Care Chief Government Affairs Officer David Totaro.

“PMHC applauds the reintroduction of this important legislation which will ensure that individuals who could be helped by MFP to live in their homes and communities will not be forced into an institution instead, and it’s for that reason that we will be proud to advocate for its passage,” Totaro said in a statement. “Despite the program’s well-documented value, states have been facing the dire risk of running out of funds to operate with the program only receiving a short three-month extension passed by Congress earlier this year.”

Leaders from the National Council on Aging and LeadingAge have also voiced support for the legislation.

The introductions of the EMPOWER Care Act and the Protecting Married Seniors from Impoverishment Act come a week after the Centers for Medicare & Medicaid Services (CMS) Office of the Actuary released its latest round of long-term health care spending projections.

National health expenditure growth is expected to average 5.5% per year through 2027, reaching nearly $6 trillion by 2027. Based on those projections, health care’s share of GDP would climb from 17.9% in 2017 to 19.4% in 2027, a trend that should make supporting home-based care and other cost-saving measures a necessity, experts argue.

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