If you ask Argentum CEO James Balda to characterize the year ahead as it relates to senior living and the federal government, he’ll tell you that 2025 will be a “year of change.”
Senior living operators and owners have faced a wave of uncertainty since the election of President Donald Trump, from federal policy changes to the Centers for Medicare and Medicaid Services (CMS) and potential regulation of senior living at the state level to immigration and its effects on the workforce.
“If you asked me what was going on in prior administrations, I’d say, ‘What day is it?’ Now, I say, ‘What time is it?’,” Balda said in a recent interview with Senior Housing News.
Current Trump administration rhetoric on immigration has led to the deportations and revoking green card status and detention of foreign-born students. Research consistently shows deportations harm the U.S. labor market and could lead to worsening conditions for U.S.-born workers, according to the Brookings Institution, a nonprofit think tank that researches education and social sciences.
Nonpartisan organization the Baker Institute cataloged a number of potential impacts on the U.S labor market, citing that the country’s gross domestic product (GDP) could decline between 2.6% and 6.2% over the next 10 years if mass deportations are carried out as initially outlined by the Trump administration.
It’s been a common talking point in the senior living industry in calling for more access to bring foreign-born workers into the U.S. to fill the ongoing caregiver and licensed care staff roles, but Balda said, those prospects appear highly unlikely under the Trump administration’s current tact.
“I don’t get there’s any really strong appetite at this point for broad-based immigration reform,” Balda said as it relates to the senior living industry. “I just don’t see that being a priority anytime soon.”
But given the context of the recent funding and job cuts action by the Department of Government Efficiency (DOGE) led by controversial billionaire entrepreneur Elon Musk, Balda sees fiscal conservatism in Washington, D.C. as an opportunity for the senior living industry to present itself as a dynamic options capable of meeting increased health care needs and demographic trends skew older in the years to come.
“The magic of assisted living is the combination of both health care and models based around the social determinants of health,” Balda said. “Anything that inhibits the ability for the industry to ultimately meet demand long-term is problematic.”
In the months ahead, Balda said Argentum would continue to advocate on Capitol Hill for Congressional leaders to preserve Medicaid support for low income housing tax credits to further affordable senior living options nationwide.
After years in which the industry was fighting against negative media coverage, based around resident safety and affordability, 2025 is shaping up for the next act in the industry’s “really intensive education battle,” said Argentum Senior Vice President of Public Policy Maggie Elehwany.
In a nod to further value-based care adoption occurring in senior living in the coming years, Balda said the Trump administration’s so-far favorable outlook for Medicare Advantage (MA) adoption could lay the groundwork for a popular tool used by senior living operators and their primary care groups.
“The pace of adoption of value-based care within communities does seem to be increasing and what is driving that change is occupancy as there’s bandwidth for operators to focus on other fronts,” Balda said.
Given the context of the Republican-led House budget resolution calling for $880 billion in Medicaid cuts, Balda said there were many pathways ahead and each is uncertain, on whether cuts could come from cuts to direct care for older adults, the Affordable Care Act (ACA) marketplace; or come from “broad interpretations of what fraud and abuse are.”
“Regardless of where the cuts come from, it’s going to leave states trying to figure out how to balance their budgets as it relates to Medicaid,” Balda said. “It almost doesn’t matter where the cuts come from, because states are still going to have to figure out how to make up for any shortfalls.”
To improve access to affordable senior housing, Balda said Congressional leaders “need to preserve Medicaid,” specifically through sustaining the low income housing tax credits, while also working on a caregiver tax credit along with a middle market housing tax credit in repurposing vacant properties into affordable senior housing.
“This is where the industry needs to continue to engage in the coming years to ultimately move the needle but we’ve got to have those conversations now to be able to have an impact,” Balda said.
