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S 3020Medical Services

Human Services - Medical Assistance - Long-Term Care Service and Finance Reform - Assisted Living Community Medicaid Rates

This bill requires the state to automatically increase Medicaid payments to assisted living facilities every year based on inflation.

Introduced
Population
Affected
15
Email Legislator
Introduced Mar 5, 2026Committee Senate Finance

Plain-English Summary

This legislation mandates an automatic annual cost-of-living adjustment (COLA) for Medicaid reimbursement rates paid to assisted living communities. Beginning July 1, 2026, the Executive Office of Health and Human Services must increase these rates based on the Consumer Price Index for the Northeast Region. This adjustment applies to all rate tiers and occurs automatically without requiring annual legislative approval, ensuring that state payments to these facilities rise in accordance with inflation to cover increasing operational costs.

For younger readers

This bill helps places where older people live, called assisted living communities. Sometimes, the government pays for people to live there using a program called Medicaid. Right now, the price of things like food and electricity goes up (this is called inflation), but the money the government pays doesn't always go up to match it. This bill says that starting in 2026, the government must automatically give these places a little more money every year to help cover those rising costs, so they can keep taking care of the people living there.

Who & Where It Applies

Impacted groups
Assisted living facility ownersMedicaid recipientsElderly residentsTaxpayersHealthcare workers
Impacted communities
All

Constitutional & Fiscal Check

None Likely

Estimated cost
Amount unknown
Estimated revenue
None

Bill Analysis

Both viewpoints
For Progressives
  • Ensures consistent funding for assisted living facilities, which helps maintain housing security and care standards for low-income seniors and people with disabilities relying on Medicaid.
  • Prevents the erosion of care quality caused by inflation, ensuring that facilities do not have to cut corners on staffing or services due to stagnant reimbursement rates.
  • May help stabilize the workforce in these facilities by providing owners with predictable revenue increases that could potentially support wage adjustments for care workers.
  • Mandates increased payments to facility owners, who may be private or for-profit entities, without explicitly requiring that the extra funds be passed down to workers in the form of higher wages.
  • Creates an automatic budget increase that ties up state funds, potentially limiting the legislature's flexibility to allocate resources to other urgent social programs or education needs during tight budget years.
  • Relies on a general inflation index (CPI-U) which may not accurately reflect the specific rising costs of healthcare delivery, potentially over-subsidizing or under-subsidizing the actual needs of the community.
For Conservatives
  • Provides business owners in the assisted living industry with financial predictability and stability, allowing for better long-term business planning and investment.
  • Reduces the need for annual lobbying and legislative bureaucracy by automating the rate adjustment process, streamlining government operations.
  • Supports the private sector's ability to provide care for the elderly, reducing the pressure on the state to run or manage public care institutions directly.
  • Creates a permanent automatic spending increase (entitlement) that bypasses annual legislative appropriation and oversight, reducing fiscal control.
  • Guarantees increased government spending regardless of the state's economic health or tax revenue intake, potentially leading to future tax hikes to cover the costs.
  • Removes the government's ability to negotiate lower rates or freeze spending during economic downturns without passing new legislation to repeal this mandate.

Votes

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Full Bill Text

Changes to existing Rhode Island law · 19 additions

SECTION 1. Chapter 40-8.9 of the General Laws entitled "Medical Assistance — Long- Term Care Service and Finance Reform" is hereby amended by adding thereto the following section: 40-8.9-10. Assisted living community Medicaid rates -- Annual cost-of-living adjustment.

(a) Beginning July 1, 2026, and annually thereafter, the executive office of health and human services (EOHHS) shall apply an automatic cost-of-living adjustment (“COLA”) to the Medicaid reimbursement rates paid for assisted living services provided pursuant to this chapter.

(b) The annual COLA shall be equal to the percentage increase, if any, in the Consumer Price Index for All Urban Consumers (CPI-U), Northeast Region for the most recently completed calendar year, as published by the United States Bureau of Labor Statistics.

(c) The COLA adjustment shall be applied uniformly across all Medicaid-assisted living rate tiers including, but not limited to, acuity-based or service-level rate categories.

(d) The COLA required under this section shall be applied automatically and shall not be subject to annual appropriation approval, rate rebasing, or discretionary adjustment by the executive branch, except as otherwise expressly provided by law.

(e) Nothing in this section shall be construed to prohibit the general assembly from authorizing additional rate increases or rate restructuring beyond the COLA provided in this section.

(f) The EOHHS shall promulgate any rules and regulations necessary to implement this section, including alignment with federal Medicaid requirements and state plan amendments, if required.

SECTION 2. This act shall take effect upon passage and shall apply to Medicaid assisted living rates effective July 1, 2026.