Bills have been reintroduced in Congress that permanently protect Home and Community Based Services (HCBS) recipients against spousal impoverishment.  

Currently, spousal impoverishment protections in Medicaid prevent unnecessary financial harm in cases where one spouse needs long-term services and supports in a nursing home or an institutional care setting. A provision of the Affordable Care Act that required state Medicaid programs to apply these rules to HCBS long-term care settings expired on Dec. 31, 2018. Legislation enacted in January included a three-month extension to protect Medicaid HCBS recipients against spousal impoverishment. This extension expires March 31. 

Ensuring permanent protections for Medicaid recipients of HCBS against spousal impoverishment is crucial to the well-being of older adult recipients of HCBS and those who care for them. Spouses, providers and the Medicaid program will benefit from the certainty that this legislation will provide.