When economic conditions permit, states should accumulate budget reserves adequate to maintain services during recessions.
Deficit-reduction efforts should avoid cuts in programs that serve low- and moderate-income populations.
The federal government must strive for long-term fiscal balance.
At the federal level, there are two categories of budgetary expenditures: entitlement and discretionary spending.
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 bas
The cost of a new social insurance LTSS program should be paid for with premiums, individual contributions through cost-sharing requirements, and general revenues.
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 some type of public social insurance benefit.
Until a comprehensive national LTSS program is implemented, intermediate steps should be taken: