If you dig into his 2016 budget proposal, you will find that President Barack Obama has suggested some broad policy changes that could affect how and where services would be delivered to seniors and those with disabilities.

Specifically, the proposed budget would expand the Money Follows the Person (MFP) Rebalancing Demonstration Grant, giving states more flexibility to deliver long-term Medicaid services in home-based and community-based settings, instead of institutions (e.g., nursing homes).

Since Medicaid’s creation 50 years ago, long-term services and support were only available to beneficiaries if they were delivered in a nursing home. State funding of home- and community-based care is available, but it requires additional federal approval.

A new pilot program in the president’s budget proposal would improve and extend the MFP initiative and allow up to five states to determine the best, most cost-effective setting for a person to receive care and services. Participating states would receive additional money from the federal government to support the eight-year project.

Although the pilot program would require congressional approval, Forbes contributor Howard Gleckman believes it could come to pass. “Many Republican lawmakers back both additional state flexibility under Medicaid and site-neutrality under the program,” Gleckman writes in his post about the possible policy changes.

A move away from nursing home-based Medicaid services would be a dramatic shift that could benefit seniors of all economic circumstances.

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