Guam Lawmakers Highlight Need for Medicaid Waiver for Assisted Living Facilities

The 38th Guam Legislature convened on July 29, 2025, to address pressing issues regarding assisted living facilities on the island. The meeting highlighted ongoing concerns about the lack of Medicaid coverage for these facilities, which has significant implications for residents in need of assisted living services.

One of the primary topics discussed was a bill developed in collaboration with the Guam Economic Development Authority (GEDA). The bill aims to address the urgent need for assisted living options on Guam. However, it was noted that without public health actions to secure a waiver for Medicaid coverage, any proposed assisted living program would not be financially accessible to many residents. Currently, assisted living services are not covered under Medicaid or the Medical Indigent Program (MIP), leaving individuals to bear the costs out of pocket.

The public guardian and other stakeholders emphasized that this situation creates a false promise for those seeking assisted living, as they are led to believe that services will be available without understanding the financial implications. The discussion referenced a commitment made by the Department of Public Health in 2022 to pursue a waiver or amend their state plan to include assisted living coverage, which has yet to materialize.

Concerns were also raised about the impact on hospital operations, as patients who do not require acute care are unable to transition to facilities like Saint Dominic's due to the lack of coverage. This has created a bottleneck in patient care, with the public guardian reiterating the urgent need for action from public health to seek the necessary waiver.

The meeting concluded with a call for continued advocacy and follow-up on the status of the waiver request, underscoring the importance of addressing these healthcare gaps for the residents of Guam.