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The federal government should permit states to opt out of Medicaid estate recovery. 

The federal government should require all states to implement medically needy programs for people who need LTSS in all settings. 

The federal government should increase the minimum PNA for Medicaid participants in nursing facilities and residential care settings.

Programs that link Medicaid eligibility to the purchase of long-term care insurance (LTCI) should not limit the availability of Medicaid benefits for people with low incomes who need long-term serv

Partnership programs should require LTCI policies to provide comprehensive benefits and strong consumer protections, particularly regarding non-forfeiture, inflation protection, and premium stabili

Programs should require those selling partnership policies to educate consumers to make informed decisions about whether a partnership policy is right for them.

Program participant cost-sharing for either community or institutional services should be modest. It should not favor one type of service over another.

Some tax revenues for a new LTSS program should be earmarked to an LTSS trust fund. This would build adequate reserves to cover later generations.

The federal government should create a public social insurance benefit that provides coverage for LTSS. It should be within Medicare or in a new public program.