President signs Medicaid bill reauthorizing coordinated care programs important to counties

On August 6, President Trump signed into law the Sustaining Excellence in Medicaid Act (P.L. 116-39), a legislative package containing measures to improve care coordination within Medicaid. The legislation builds on similar bills passed earlier in 2019 to boost funding for the Money Follows the Person (MFP) Medicaid demonstration from $132 million to $254.5 million and extend protections for recipients of home and community-based services against spousal impoverishment.

Important to counties, the MFP program enhances federal support for state Medicaid programs transitioning individuals in long-term care facilities back into community-based settings. Since it was first enacted, MFP has enabled 43 states and the District of Columbia to develop the infrastructure to help older adults and people with disabilities live in the settings of their choice, while achieving lower institutional admission rates and cost savings in the Medicaid program.

The additional flexibility provided under MFP has been shown to enable counties to fill coverage gaps and provide wraparound services to residents. Although Medicaid operates as a federal-state program, counties play a central role in financing and administering Medicaid services to residents. NACo supports Medicaid coverage of community-based long-term care.

The bill also extends several smaller programs, including the Community Mental Health Services (CMHS) demonstration in the Medicare program, Family-to-Family Health Information Centers and a provision to reduce wholesale costs for new drugs.

President Trump’s approval of the Medicaid minibus follows the short-term reauthorization of the MFP demonstration in April 2019, as well as efforts to pass a similar legislative package toward the end of the 115^th Congress. 

For more NACo resources on the Medicaid program, please see the following links:

• President signs Medicaid minibus reauthorizing coordinated care programs important to counties
• NACo Policy Brief: Enhance Counties' Ability to Prevent and Treat Mental Illness and Substance Use Disorders
• NACo Legislative Presentation: Medicaid and Counties: Understanding the Program and Why It Matters to Counties