Policymakers should retain estate and inheritance taxes as important components of our tax structure.
Federal and state estate and inheritance taxes should affect only the largest transfers.
Deficit-reduction efforts should avoid cuts in programs that serve low- and moderate-income populations.
States should not tie essential spending programs to unstable revenue sources.
The federal government must strive for long-term fiscal balance.
Federal policymakers should develop a comprehensive system for financing Long-Term Services and Supports (LTSS) that includes a new social insurance program to provide a basic level of LTSS.
Ideally, the federal government should finance LTSS through a universal, comprehensive, and publicly administered program such as Medicare or similar social insurance program of shared risk.
States should require adequate numbers of appropriately trained staff to ensure a high quality of care.
Quality measures: Participant preferences and satisfaction should be used as key quality measures.
The federal government should assume a much stronger role in ensuring the quality of services paid for by Medicaid in residential care settings.