Seniors in nursing homes need a cost-of-living raise, too
*Boston Globe
By The Editorial Board
November 4, 2026
Imagine trying to get by on $72.80 a month for shoes, clothes, and a cell phone plan.
Over time, the cost of goods and services goes up. That’s why wages increase, Social Security pays more each year, and pensions have cost-of-living increases. But for one population in Massachusetts, the amount of money they have to live on each year stays exactly the same, regardless of inflation: seniors with Medicaid coverage living in nursing or rest homes.
Under state law, seniors in rest homes and nursing homes can keep $72.80 of their monthly income (which often means their Social Security payments) while the rest of their money goes to Medicaid to pay for their care. So in 2026, although Social Security payments had a 2.8 percent cost-of-living increase, a nursing home resident’s monthly income (officially called their personal needs allowance) remained $72.80 — just as it has been every year since 2008. That’s just $873.60 a year.
That system is fundamentally unfair, since it means seniors’ purchasing power declines annually. They have less money to buy shoes, clothing, a cellphone plan, or a grandchild’s gift.
An effort by Dignity Alliance Massachusetts, an advocacy group for seniors, to have the Legislature raise the personal needs allowance to $113 a month — the amount it would be today if the 2008 figure were indexed to inflation — with annual increases after that, has stalled. Although the cost in forgone revenues to MassHealth, an estimated $10 million to $12 million, is a pittance compared to the $22 billion MassHealth budget, harsh federal Medicaid cuts leave little legislative appetite for anything that would drain revenue from MassHealth.
Paul Lanzikos, cofounder of Dignity Alliance Massachusetts, said the organization now plans to lobby for a smaller change — indexing the increase to the personal needs allowance to Social Security’s cost-of-living increase. If that policy had been in effect in 2026, seniors would have gotten $74.84 a month. Lanzikos estimates this would cost MassHealth less than $1 million a year to help an estimated 22,000 to 24,000 seniors.
The Massachusetts Senior Care Association (which represents nursing homes), AARP, the Disability Law Center, and health care workers union 1199SEIU all support increasing seniors’ personal needs allowance. There does not appear to be organized opposition.
Lawmakers should act soon to increase the money that seniors in nursing and rest homes have to live on as the cost of living rises.
The amount of money involved is small to MassHealth but impactful to seniors.
Just ask Patrick Lyman, who lives at Rockridge rest home in Northampton. On a podcast taped by Noah Daube-Valois, a Vassar College junior from Northampton who volunteered at Rockridge, Lyman said his glasses arm broke, and he repaired it with a Band-Aid for months until his scheduled eye exam, because he didn’t want to spend $3 on round-trip bus fare to get them repaired.
Daube-Valois told the editorial board he was inspired to tape the podcast after he took a group of residents for ice cream and saw one woman get upset after she accidentally dropped hers. “I could tell from the look in her eyes she wouldn’t be able to afford another cone,” Daube-Valois said.
While MassHealth’s payments to nursing homes and rest homes cover room and board and medical or personal care assistance, residents need money to pay for things like personal hygiene products, clothes, shoes, books, and cellphones. State Senator Pat Jehlen, a Somerville Democrat who chairs the Joint Committee on Aging and Independence, said one rest home in her district held a clothing drive to get residents winter coats. “People don’t realize what an austerity budget it already is for old people,” Jehlen said.
Federal law says states can set the personal needs allowance anywhere between $30 and $200 a month. A study using 2024 data found that nationally, Massachusetts ranks near the middle of states, with a national average allowance of $70.
In New England, Massachusetts, New Hampshire, Connecticut, and Rhode Island all had similar allowances, between $73 and $75 (rounded to the nearest dollar). Vermont’s was higher, while New York’s and Maine’s were lower. Florida, with its high portion of elderly residents, had one of the country’s highest allowances, at $160.
But Massachusetts also has one of the highest costs of living in the country, so a senior’s haircut or coat may cost more.
The Healey administration hasn’t taken a position on raising the allowance. MassHealth spokesperson Stacey Nee told the editorial board that the administration is concerned about making life more affordable for residents, but at the same time, MassHealth is facing significant federal funding cuts. “We recognize concerns about the personal needs allowance and are evaluating options to continue supporting MassHealth members while navigating these financial pressures,” Nee said.
Paul Shafer, associate professor and codirector of the Medicaid Policy Lab at Boston University School of Public Health, told the editorial board that raising the personal needs allowance for seniors is about providing basic dignity and small niceties. “If they don’t have family members who can chip in to help with those things, they’re counting pennies every month, literally, to have the things they need and want,” Shafer said. Let’s give these seniors the dignity they deserve.