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Referred to the Committee on Education and Workforce, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Introduced April 24, 2025 by Brian K. Fitzpatrick · Last progress April 24, 2025
Creates federal grant programs to grow and train the direct care workforce serving older adults and people with disabilities, and establishes a new Senior Care Cost Reduction Program to provide monthly payments to low-income seniors living in state‑approved assisted living facilities as a less expensive alternative to institutional care. States apply for allotments and must provide eligible residents $1,000 per month at program start, with annual increases tied to inflation, while the Departments of Labor and Health and Human Services will fund training and certification for direct care workers in assisted living. The bill defines assisted living and direct care services, sets eligibility rules for recipients, authorizes the Secretary to issue program regulations, and permits use of recovered or returned funds from federal COVID‑related provider relief programs to carry out the law. It aims to expand workforce capacity, reduce long‑term care costs, and shift some long‑term care spending away from more expensive institutional settings.
The United States population is aging rapidly: about 10,000 Americans turn 65 each day; in 2034 the Nation will have more people over age 65 than under 18; persons age 85 and older are projected to grow 198 percent by 2060.
The Department of Health and Human Services estimates 70 percent of Americans over 65 will require some form of long-term care in their lifetime; by 2050, the number needing paid long-term care services will increase from 8,300,000 to 27,000,000.
According to 2020 Census data, more than 40 percent of baby boomers have no retirement savings; a National Council on Aging report found up to 80 percent of older adults could not afford 4 years in assisted living or more than 2 years in a nursing home; 47,000,000 Americans aged 60 or above do not have the financial resources to cover future care.
Caring for the aging population will be the single most expensive domestic priority and is projected to deplete Federal and State Medicaid budgets; the United States spent over $400,000,000,000 on long-term care in 2020 (about 10 percent of national health care spending).
State and Federal programs accounted for 71.4 percent of all long-term care spending in 2021; Medicaid and Medicare together accounted for 64.1 percent of all spending. Medicaid spent approximately $135,800,000,000 in 2020 and is projected to reach $466,000,000,000 by 2050.
Who is affected and how:
Seniors (65+): Low‑income older adults living in State‑approved assisted living facilities are the primary beneficiaries; eligible individuals receive monthly payments intended to make assisted living more affordable and reduce transfers into institutional care.
Direct care workers and the health care workforce: Workers in assisted living and similar settings could see expanded training, certification opportunities, and potentially stronger career pathways and wages if grant programs support employer‑side training and credentialing.
State governments and agencies: States must apply for program allotments, set up enrollment and payment systems, verify eligibility, and oversee participating assisted living facilities—creating new administrative work but also potential Medicaid savings if institutional admissions decline.
Medicaid and public payers: If the program helps keep seniors in assisted living rather than nursing homes, it could reduce Medicaid long‑term care expenditures; the magnitude depends on program uptake and funding levels.
Federal agencies (HHS/HRSA, Department of Labor): Responsible for grant design, awarding funds, and issuing implementing regulations; success depends on agency capacity to deliver timely guidance and oversight.
Risks and limits:
Expand sections to see detailed analysis
Referred to the Committee on Education and Workforce, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Introduced in House