Bill · S. 4479· Senate(119-S-4479)
ACCESS Act
- Introduced
- 4/30/2026
- Last activity
- 4/30/2026 — Read twice and referred to the Committee on Finance.
- Sponsored by
- Roger Marshall
- Cosponsors
- - 2 - 0
- Introduced
- In Committee
What this bill would do
This bill is known as the ACCESS Act. It aims to provide assisted living assistance through Medicaid and the low-income housing tax credit. The bill amends the Social Security Act to include services provided in an assisted living residence under Medicaid coverage. It sets specific cost and care requirements for individuals receiving these assisted living services under Medicaid. Additionally, the bill amends the Internal Revenue Code to include projects that reduce medical assistance costs for the elderly in non-institutional settings into the selection criteria for the low-income housing tax credit. The changes made by this bill take effect on January 1, 2027, with potential delays permitted if a State requires legislation.
Yes· 3 of 9
Would people over 65 be better off under this?+7
The bill expands Medicaid coverage and housing tax credit priorities specifically to support elderly individuals in assisted living settings.
Does this make health care easier to get in general?+6
The bill expands access to care for elderly individuals by allowing Medicaid to cover assisted living services.
Would households on low incomes be better off under this?+5
The bill expands Medicaid benefits which are specifically targeted at meeting state income and resource requirements for low-income individuals.
The opposite
Does this leave more decisions to the states?-2
The bill allows for delays in implementation if states require their own legislation to comply with the new Medicaid requirements.
Who it would affect, and how
Potential Positive Impacts for People
-
Medicaid Coverage for Assisted Living Services: Section 2 adds services provided in an assisted living residence to the definition of medical assistance under Medicaid and makes it a mandatory benefit. This is positive because it helps individuals who need hospital or nursing facility levels of care receive services in an assisted living residence instead, provided they meet state income and resource requirements and cost limits.
-
Housing Credit Support for Elderly Care: Section 3 adds projects that reduce the medical assistance costs of long-term services and supports for the elderly by providing those services in a non-institutional setting to the selection criteria for the low-income housing tax credit. This is beneficial because it encourages the creation of housing projects that help older Americans receive long-term care outside of traditional institutions.
Potential Negative Impacts for People
- Cost Limit Restrictions on Care: Section 2 specifies that Medicaid coverage for assisted living is only available if the estimated annual average per capita total Medicaid cost for the individual is no greater than the cost that would have been incurred in a hospital or nursing facility. This could be viewed as a negative burden if individuals who prefer assisted living are denied access because their specific care costs narrowly exceed the strict institutional cost cap.
Groups and Interests Ranking
Every group the model scored this bill for, from -10 to +10. Hover a score for the reason it gave.
- Demographic And Interest Groups
- Good For Seniors+7Good For Low Income Households+5Good For People With Disabilities+4
- Healthcare
- Improves Healthcare Access+6Increases Medicaid Funding+5
- Social Issues And Justice
- Improves Affordable Housing+5Improves Poverty Reduction+3
- Economy And Finance
- Reduces Government Spending+3Reduces Small Business Taxes+1
- Governance And Ideology
- Increase States Rights-2
- 9/23/2026
- 2 Cosponsors added.
- 4/30/2026
- Read twice and referred to the Committee on Finance.
- Introduced in Senate
One bill Congress.gov lists as related to this one — companions in the other chamber, earlier versions, and bills this one absorbed or was folded into.
Steve DainesRepublican · Montana
Tim SheehyRepublican · Montana