the first and second-largest public payers, accounting for a combined 64.1 percent of all spending. Medicaid is by far the largest single funding source for long-term care, spending approximately $135,800,000,000 in 2020, a figure that is projected to reach $466,000,000,000 by 2050. (6) A 2023 report by AARP, indicates that at least 9 percent of seniors in skilled nursing nationwide have low-acuity levels that do not warrant high skilled care, but are forced into a skilled nursing home where assets can be depleted, and Medicaid can become the primary payer. The report by AARP indicated that this number is 20 percent in 5 States. (7) In 2021, the Department of Veterans Affairs testified to Congress that if veterans in need of long-term care services could choose assisted living instead of a nursing home, $69,101 per veteran per year would be saved by the Department of Veterans Affairs. (8) Strengthening cost-effective models of long-term care services, providing incentives for Americans to better afford their care costs, and developing the workforce needed to care for the Nation’s aging population will reduce Federal and State Medicaid spending. (9) Congregate care models of long-term care services, such as assisted living, are half the cost of nursing homes, and less than a third of round the clock home health aides. (10) Assisted living provides 24/7 personal care, chronic disease management, nutrition, room and board, and socialization. If assisted living were not an option, as many as 61 percent of senior residents may be forced into far-costlier skilled nursing facilities at a cost of $43,400,000,000 per year. (11) The senior living industry lost approximately 400,000 jobs between 2020 and 2022, leaving the workforce far below prepandemic employment levels. In order to care for the United States aging population, the senior care industry will need to fill more than 20,200,000 jobs by 2040. 3. Addressing the long-term care workforce crisis (a) Workforce programs (1) Expansion of DOL workforce programs The