To provide assisted living assistance through Medicaid and low-income housing tax credit.
- Sponsor
- Rep. Miller, Max L. [R-OH-7]
- Committees
- Energy and Commerce Committee (primary)
- Last action
- May 4, 2026
Bottom line
H.R. 8662 seeks to expand access to assisted living services for low-income seniors through Medicaid and incentivize the development of such housing via the Low-Income Housing Tax Credit.
What it actually does
This bill amends the Social Security Act to include services provided in assisted living residences as a mandatory Medicaid benefit for eligible individuals who would otherwise require hospital or nursing facility care, provided the estimated cost is no greater. It also amends the Internal Revenue Code to add projects that reduce medical assistance costs for long-term elderly services in non-institutional settings as a selection criterion for the Low-Income Housing Tax Credit (LIHTC).
Proponents argue
Proponents would argue that this bill addresses the growing need for affordable long-term care options for the elderly, allowing them to age in less restrictive, non-institutional settings while potentially reducing overall Medicaid costs. It promotes dignity and choice for seniors and leverages existing programs to achieve these goals efficiently.
Opponents contend
Opponents might raise concerns about the potential for increased Medicaid expenditures if cost-neutrality is not strictly maintained or if the number of eligible individuals expands beyond current projections. They might also question the effectiveness of LIHTC as a primary mechanism for expanding assisted living, or argue that it could divert resources from other affordable housing needs.
The bill is very short and can be read quickly, making it accessible for immediate understanding of its core provisions.
Section 1(a), (b), (c)
Mandatory Medicaid Coverage for Assisted Living Residences
This provision amends the Social Security Act to include services provided in assisted living residences as a mandatory part of "medical assistance" under Medicaid. This coverage is for individuals who would otherwise need hospital or nursing facility care and meet state income/resource requirements. Crucially, the estimated annual per capita Medicaid cost for these services in assisted living must not exceed the cost if the individual received care in a hospital or nursing facility. The effective date is January 1, 2027, with a delay for states requiring legislative changes.
Supporters argue
Supporters argue this provision offers a more humane and often more cost-effective alternative to institutional care for seniors, aligning with preferences to age in place. It could reduce overall Medicaid spending by shifting individuals from higher-cost settings.
Critics contend
Critics might express concern that the "cost-neutrality" clause could be difficult to enforce or accurately estimate, potentially leading to unforeseen increases in Medicaid expenditures. They may also worry about the administrative burden on states to implement and monitor this new benefit.
Tradeoffs
The bill balances the desire to provide person-centered care and expand options for seniors with the need to control Medicaid costs. The tension lies in ensuring that the expansion of services truly remains cost-neutral or cost-saving compared to traditional institutional care.
Section 2(a), (b)
Low-Income Housing Tax Credit for Non-Institutional Elderly Care
This provision amends the Internal Revenue Code to add a new selection criterion for Qualified Allocation Plans (QAPs) under the Low-Income Housing Tax Credit (LIHTC) program. State housing agencies would be encouraged to prioritize projects that reduce medical assistance costs for long-term services and supports for the elderly by providing such services in a non-institutional setting. This applies to allocations made after January 1, 2027.