Request Information on Challenges in Addressing Housing for Those Requiring Long-Term Care

Text of Letter (PDF)

WASHINGTON – Today, Congresswoman Ayanna Pressley (MA-07), a Co-Chair of the House Task Force on Aging and Families, led her Task Force colleagues in requesting the Centers for Medicare and Medicaid Services (CMS) to provide data on housing needs for Medicaid beneficiaries and feedback on challenges the agency is having in covering housing support for people requiring home and community-based services (HCBS).

The information requested by the lawmakers will help inform Congress’ efforts to better address housing as the social determinant of health that it is. Joining Rep. Pressley in sending the letter, which was endorsed by the Service Employees International Union (SEIU), are Representatives Debbie Dingell, Lloyd Doggett, John Larson, Doris Matsui, Mark Pocan, and Jan Schakowsky.

“As policymakers, we recognize that there are many avenues to deliver lifesaving care to our constituents, and we are deeply grateful for the unprecedented steps taken by the Biden-Harris Administration in expanding housing supports through Medicaid. These actions are crucial in ensuring that those requiring long-term services and supports (LTSS) and their caregivers are able to remain in their communities,” the lawmakers wrote in their letter to CMS Administrator Chiquita Brooks-LaSure. “As the Centers for Medicare and Medicaid Services (CMS) considers state waiver demonstrations relating to social determinants of health, we respectfully request that you provide information regarding the agency’s current ability to address housing-related needs.”

The vast majority of aging adults and individuals with disabilities prefer to receive care and support within their own homes and communities. Home and community-based services (HCBS) are essential in allowing these individuals to age in place or manage a disability, providing care that ranges from home modifications and caregiver support to transportation and employment assistance. However, it is becoming increasingly difficult for people, especially those managing complex medical needs, to afford to live in their own communities to begin with as housing costs soar across the country.

In their letter, the lawmakers praised the Biden-Harris Administration for recognizing the role social determinants of health play in public health disparities, but acknowledged that CMS may be facing obstacles in delivering long-term housing support to Medicaid beneficiaries requiring HCBS.

The lawmakers requested CMS provide the following information so that Congress may facilitate the agency’s ability to address housing needs:

• From FY2012 to FY2023, what states, disaggregated by year, have requested waivers for housing-related services?
• From FY2012 to FY2023, how many Section 1115 demonstration waiver requests reference long-term services and supports?
• Please provide any research conducted by the agency on the impact of housing instability on health outcomes.
• In states where housing-related services have been covered through Medicaid, how have the health outcomes among their Medicaid beneficiaries changed?
• What statutory barriers exist that prevent CMS from addressing long-term housing-related needs for Medicaid beneficiaries requiring HCBS?

A copy of the letter can be found here.

Congresswoman Pressley has fought to affirm housing as a human right and support older Americans and people with disabilities.

• In November 2023, she delivered a floor speech in which she slammed House Republicans for advancing a housing appropriations bill that excluded critical funding for The Pryde, an affordable housing development for LGBTQ+ seniors in the Massachusetts 7th.
• In October 2023, she joined her delegation colleagues on a letter supporting a component of Governor Healey’s Medicaid 1115 Waiver request to address the migrant housing crisis.
• In March 2021, she led her colleagues on a letter with 107 of their colleagues to President Joe Biden and Vice President Kamala Harris calling for an historic investment of $450 billion in home- and community-based services (HCBS) in the Build Back Better infrastructure package.
• In early 2020, she worked with advocates to challenge Massachusetts Governor Charlie Baker’s crisis standards of care and release updated guidelines with input from the disability community.
• In June 2020, Rep. Pressley and Senators Elizabeth Warren (D-MA) and Ed Markey (D-MA) wrote to Governor Baker requesting an independent investigation into the outbreak of COVID-19 at the Chelsea Soldiers’ Home (CSH).

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