S. 4479: Assisted Living Affordability, Choice, Community, Empowerment, Savings, and Support Act

This bill, titled the Assisted Living Affordability, Choice, Community, Empowerment, Savings, and Support Act or ACCESS Act, proposes changes aimed at improving support for individuals living in assisted living facilities, particularly focusing on Medicaid and low-income housing tax credits.

Medicaid Coverage for Assisted Living

The bill seeks to amend Medicaid regulations to include services provided within assisted living residences. Specifically, it aims to:

• Enable Medicaid reimbursement for services in assisted living facilities for individuals who would typically require nursing home or hospital-level care, provided these services comply with state laws.
• Ensure that the costs for care in assisted living do not exceed what would be spent if those individuals were receiving care in a hospital or nursing facility, thereby maintaining cost-effectiveness for the Medicaid program.

Mandatory Coverage Inclusion

The bill designates the assistance and services provided in assisted living facilities as a mandatory benefit under Medicaid. This change will require states to include these services in their Medicaid plans without exception.

Effective Date for Medicaid Changes

The modifications concerning Medicaid coverage for assisted living will take effect on January 1, 2027. The bill also allows for a potential delay in implementation in states that require additional legislation to comply with the new provisions.

Low-Income Housing Tax Credit Adjustments

In relation to the Low-Income Housing Tax Credit program, the bill proposes adjustments to the allocation plan criteria. It aims to encourage projects that are designed to:

• Reduce the costs associated with Medicaid’s long-term care services by offering those services in non-institutional settings like assisted living communities.

Effective Date for Housing Tax Credit Changes

The changes related to the low-income housing tax credit will be applicable to allocations made after January 1, 2027.

Relevant Companies

• CHE - Companies involved in providing assisted living services may be impacted as they may see changes in funding availability from Medicaid, influencing their service models.
• SNF - Skilled nursing facilities might see changes in patient care dynamics and reimbursement strategies, potentially affecting their business operations.