ACCESS Act
Sponsored By: Senator Marshall, Roger [R-KS]
Introduced
Summary
Medicaid coverage for assisted living services would be expanded to let people who need nursing‑home‑level care get covered services in assisted living when per-person Medicaid costs are no greater than institutional care. The bill would also change the Low-Income Housing Tax Credit to favor projects that shift long-term care out of nursing facilities.
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- Older adults in assisted living: Could receive Medicaid-covered care if they meet state income and resource rules and if the estimated annual per-person Medicaid cost in assisted living is no higher than in a hospital or nursing facility. This change is effective Jan 1, 2027.
- States: The bill designates these assisted living services as a mandatory Medicaid benefit and gives states a delay tied to their next legislative session to avoid noncompliance while they pass any needed laws.
- Developers and affordable housing projects: Low-Income Housing Tax Credit allocations could favor projects that provide non-institutional long-term services and reduce Medicaid long-term services costs. That LIHTC change applies to allocations made after Jan 1, 2027.
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Bill Overview
Analyzed Economic Effects
2 provisions identified: 2 benefits, 0 costs, 0 mixed.
More Medicaid help for assisted living
If you are enrolled in Medicaid and need nursing‑facility‑level care, Medicaid would be able to cover services in an assisted living residence. Coverage would apply only if State law allows those services and the State plan or an approved waiver could pay for them. You must meet your State's income and resource rules. The State must estimate that average Medicaid costs per person in assisted living would not be higher than hospital or nursing facility care. These rules would start January 1, 2027. States that need new laws would get extra time until after their next regular legislative session before being found noncompliant.
Tax credit preference for senior housing
State housing credit agencies would be able to give preference to Low‑Income Housing Tax Credit projects that provide long‑term supports for seniors outside nursing homes. The preference would target projects that lower Medicaid costs by delivering services in a non‑institutional setting. This change would apply to LIHTC allocations made after January 1, 2027. This would likely increase community‑based rental housing with supports for low‑income seniors.
Sponsors & CoSponsors
Sponsor
Marshall, Roger [R-KS]
KS • R
Cosponsors
There are no cosponsors for this bill.
Roll Call Votes
No roll call votes available for this bill.
View on Congress.gov