Senator Marshall Introduces Bill to Expand Assisted Living Under Medicaid

Washington - On Thursday, U.S. Senator Roger Marshall, M.D. (R-Kansas) introduced legislation to make assisted living a covered Medicaid benefit for seniors who meet nursing facility level-of-care criteria-aiming to lower federal Medicaid costs while expanding access to community-based care.

The Assisted Living Affordability, Choice, Community, Empowerment, Savings and Support (ACCESS) Act addresses a structural gap in Medicaid, which currently requires coverage for nursing facility care but not assisted living-often leading to higher spending on more intensive care settings.

Medicaid is projected to grow 63% over the next decade, intensifying pressure on federal and state budgets. Supporters argue the bill would realign incentives by allowing states to provide care in settings that better match patient needs-without increasing overall program costs.

"Medicaid spending is on an unsustainable path, and too many seniors are being pushed into higher-cost care they don't actually need," said Senator Marshall. "As a physician, I've seen the consequences of that firsthand. This bill is about giving states the ability to provide the right care in the right setting, while protecting the long-term future of Medicaid."

This legislation is being introduced in the House of Representatives by Congressman Max Miller (R-Ohio).

"Right now, the system is backwards. We're paying more for unnecessary care while more practical options remain out of reach. This legislation fixes that. It's about common sense-giving seniors better choices and making sure Medicaid dollars are spent wisely," said Congressman Miller.

What the bill does:

• Allows for the lower-cost, assisted living option to be a mandatory Medicaid benefit for eligible seniors (as nursing facilities currently are).
• Applies to individuals meeting nursing facility level-of-care criteria.
• Requires cost neutrality relative to institutional care; no new population served.
• Aligns with housing policy to support the development of new supply.

Click here to read the full text of the legislation.

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