The ongoing debate around how much governmental oversight of assisted living is appropriate and necessary may soon have new fodder. A bipartisan group of four U.S. Senators, including Elizabeth Warren (D-Mass.), is pushing for a review of how state and federal authorities oversee assisted living facilities that care for residents on Medicaid.

Medicaid is jointly funded by states and the federal government, and while the program writ-large is not designed to be a major assisted living payer, some AL residents are covered. This is through waivers—such as Medicaid home- and community-based waivers, and comprehensive demonstration waivers—as well as through state plans, the letter notes.

“Given the growth in federal Medicaid spending for long-term care services and expected program growth caused by the aging and expansion of the population and program, information to understand federal and state spending and oversight of care provided in these settings is needed,” the Senators wrote in their letter, dated July 8.


Specifically, they are requesting that the Government Accountability Office (GAO) gather this information and produce a report on it.

In addition to Sen. Warren, the letter signatories were Sens. Susan Collins (R-Maine), Orrin Hatch (R-Utah) and Claire McCaskill (D-Mo.) Collins is chairman of the Special Committee on Aging, McCaskill is the ranking member, and Warren and Hatch are members.

Warren’s doggedness on matters of consumer protection makes her a particularly notable signatory. She was instrumental in the formation of the Consumer Financial Protection Bureau and has become such a high-profile legislator that it has spurred talk of a presidential run in 2016.

Written by Tim Mullaney