GAO Reports $12 Billion in Federal Medicaid and Medicare Spending for Assisted Living in 2024
The Government Accountability Office reports that federal Medicaid and Medicare spending for services provided in assisted living facilities totaled at least $12 billion in 2024, including $3.5 billion in federal Medicaid spending and $8.5 billion in Medicare spending. Forty-four states cover assisted living services through their Medicaid programs, with 29 states using home- and community-based services (HCBS) waivers as of March 2025. GAO notes the $12 billion figure is likely an undercount due to data limitations, as assisted living facilities are not uniformly defined or consistently identified in program data. Medicare generally does not cover assisted living services but covers other health care such as hospice in these settings.
This GAO analysis quantifies federal spending in assisted living settings and confirms HCBS waivers remain the dominant coverage mechanism for 29 states, affecting MCO long-term services and supports benefit design and network requirements.
LTSS · Long-Term Care · Managed Care
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