MIECHV runs on $650 million a year. The law funding it ends in 2027.

The Maternal, Infant, and Early Childhood Home Visiting program — MIECHV, jointly run by HHS's Health Resources and Services Administration and the Administration for Children and Families — pays trained nurses, social workers, and parent educators to go into the homes of pregnant women and parents of young children who face real risk: poverty, a history of child abuse, a teen pregnancy.▸ On July 7, 2026, the House Ways and Means Work and Welfare Subcommittee held a hearing on the program and said the quiet part in the room: the law that funds MIECHV runs out on October 1, 2027, and unless Congress reauthorizes it, "these services do not just continue on autopilot or at current funding levels — they stop."

MIECHV's money is mandatory funding written directly into Section 511 of the Social Security Act, not an annual appropriations fight — Congress set the schedule once, in the Jackie Walorski Maternal and Child Home Visiting Reauthorization Act of 2022, and it runs on autopilot through fiscal 2027.▸ For FY2026 that schedule pays out $650 million. Most of it — 87 percent — flows to the 50 states, DC, and five territories through base and matching grant formulas. The rest is reserved by law: 6 percent for tribal entities, awarded through competitive cooperative agreements, and 7 percent split three ways — 2 percent for technical assistance, 2 percent for home-visiting-workforce activities, and 3 percent for research, evaluation, and federal administration — according to the Congressional Research Service's brief on the program.

That reach bought 1 million home visits to 79,000 families in fiscal 2025, per the Ways and Means Committee's summary of HHS data presented at the hearing.▸ That's a fraction of the roughly 285,000 families that the National Home Visiting Resource Center's 2025 Yearbook counted across every home-visiting model operating nationally in 2024, using every funding source combined — MIECHV is the largest single federal stream, not the whole system.

The 2022 reauthorization didn't just extend MIECHV — it changed how states pay for it.▸ Alongside the flat $500 million-a-year base grant, the law created a matching-grant pool that starts at zero and climbs every year, at a 75 percent federal / 25 percent nonfederal match rate (three federal dollars for every one a state, locality, or private partner puts up). In FY2023 states owed nothing to draw the matching money. By FY2027, the final year of the current authorization, the matching-grant appropriation alone reaches $300 million — meaning states must line up roughly $100 million in new nonfederal money just to draw down the full federal match, on top of whatever they were already spending.

Iowa's MIECHV director put a number on what happens if the reauthorization doesn't come through: "If MIECHV funding went away, over 800 families would go unserved" in that state alone, she told the committee.▸ Multiply that kind of exposure across 50 states, DC, and five territories and the October 2027 deadline stops being a bureaucratic date on a spreadsheet.

The people MIECHV pays to do this work are not well paid for it.▸ In a national survey of the home-visiting workforce fielded for HHS, home visitors reported a median annual salary of about $36,000, against $48,000 for their supervisors — per the Administration for Children and Families' Office of Planning, Research and Evaluation. Turnover tracks with that pay. Urban Institute's analysis of federal Head Start program data — covering Early Head Start's home-based option, one of two dozen models states use to deliver MIECHV-funded visits — found the average program-level turnover rate for teachers and home visitors combined was nearly 20 percent in 2019 and jumped to 29 percent by 2022. Home visitors specifically left at a 19 percent rate in 2019, with higher pay elsewhere the single biggest reason cited. Staff vacancy rates over the same stretch nearly quadrupled, from just over 2 percent to almost 9 percent. A family that loses its home visitor mid-relationship doesn't just lose a scheduling slot — the same body of research on family engagement ties staff turnover directly to families dropping out of the program altogether.

Family-count and funding figures come from three separate sources spanning FY2022–FY2025 data and are not directly interchangeable across years; the turnover and vacancy figures are specific to the Early Head Start home-based option, one of MIECHV's delivery models, not the full national home-visiting workforce.