Sponsors (2)
The bill expands options for community‑based, home‑like long‑term care (including LIHTC‑linked supportive housing) and could reduce Medicaid costs for states, but it creates administrative burdens, state-by-state access disparities, and financial pressures on some providers and public subsidies.
Medicaid beneficiaries, seniors, and people with disabilities: gain access to home-like assisted living and housing-based non‑institutional long‑term care instead of nursing homes, allowing more community-based care and support.
State governments and Medicaid programs: may reduce Medicaid spending by shifting eligible long‑term care from higher‑cost institutional settings to community-based assisted living and LIHTC‑linked services when per‑capita costs are equal or lower.
Low-income seniors: increases development of LIHTC‑funded affordable housing projects that include on‑site supportive, non‑institutional services, expanding integrated housing options that support independence and quality of life.
State Medicaid and housing agencies: will incur additional administrative, planning, verification, and monitoring costs to estimate per‑capita Medicaid costs, amend plans, and oversee service claims.
Medicaid beneficiaries: access could be uneven or denied depending on state laws, eligibility rules, or cost‑comparison results, producing geographic disparities in who can get assisted living coverage.
Providers and institutional facilities: assisted living providers may face reimbursement or eligibility constraints and hospitals/facilities may lose revenue if funding shifts to housing‑based services, potentially reducing provider capacity or availability.
Based on analysis of 2 sections of legislative text.
Requires Medicaid coverage of assisted-living services where state law permits and costs no more than institutional care, and lets LIHTC award points to projects that reduce LTSS Medicaid costs.
Introduced May 4, 2026 by Max Miller · Last progress May 4, 2026
Adds assisted living residence services to the statutory list of Medicaid "medical assistance" when state law permits and when the average Medicaid cost per person in assisted living would not exceed that of hospital or nursing facility care, and gives states time to change their laws if needed. Also lets state housing credit agencies award low-income housing tax credit points to projects that reduce Medicaid costs for long-term services and supports by providing services in non-institutional settings. Both changes take effect January 1, 2027, with transitional timing for state law changes.