A new report from the Government Accountability Office (GAO) examines how assisted living services are financed through Medicaid and other federal programs, while highlighting growing concerns about access as demand continues to increase.
The report found that 44 states, including Ohio, use Medicaid to help cover services provided in assisted living settings, most commonly through Home- and Community-Based Services (HCBS) waiver programs. In 2024, federal Medicaid spending on assisted living services totaled at least $3.5 billion, with combined federal-state Medicaid spending averaging about $23,000 per beneficiary receiving services in an assisted living setting. The report also found that most Medicaid beneficiaries receiving assisted living services are dually eligible for Medicare and Medicaid.
Stakeholders interviewed by GAO identified several barriers limiting access, including limited coverage outside of Medicaid, restrictions within Medicaid programs, workforce and provider participation challenges, and growing demand for services amid federal Medicaid funding reductions.
LeadingAge National noted that while the report is primarily informational, it could prompt future proposals to increase federal oversight of assisted living. The association continues to oppose additional federal assisted living regulations, maintaining that licensure and oversight are appropriately administered at the state level.
Read the GAO report on assisted living spending and coverage.