In a report just made public, the General Accountability Office (GAO) said it found that in 2024 federal Medicare and Medicaid spending for services provided in assisted living (AL) facilities totaled at least $12 billion. The report attempted to gauge such spending as AL continues to remain a popular care setting for America’s seniors, GAO said.

In fact, the report said the spending amount is likely an undercount because of data limitations. “For example, assisted living facilities are not a uniformly defined provider type and thus not consistently identified in the data,” GAO said.

Titled, “Assisted Living Facilities: Information on Federal Spending and Medicaid Coverage” (GAO-26-107884), the report also featured these highlights:

• Federal Medicaid spending. GAO identified at least $3.5 billion in federal Medicaid spending for services provided in AL facilities in 2024. State Medicaid programs may cover services, that is, assistance with activities of daily living and other supportive services provided in AL communities, as well as other services such as physical therapy.

  
  

• Medicare spending. GAO identified $8.5 billion in traditional Medicare spending for services provided in AL facilities in 2024. Medicare generally does not cover AL services but may cover other healthcare services such as hospice in AL facilities.

  
  

GAO said other federal programs, like those within the Dept. of Housing and Urban Development and Dept. of Veterans Affairs, may be used by beneficiaries to help cover the costs of certain services, such as room and board, in the AL setting.

The amount of money spent by these programs for such services is unknown.

States Step In

A total of 44 states’ Medicaid programs covered AL services for older adults and people with disabilities as of March 2025, GAO said. More than half of states—29 of the 44—covered these services under Medicaid home- and community-based services waivers. These waivers give states the flexibility to target enrollment to specific populations and to limit the number of participants.

Comments or questions on this article? Contact Patrick Connole at pconnole@parkplacelive.com.