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Passing responsibilities down to lower levels of government should be undertaken primarily to place services closer to the people being served and to maximize administrative

DeficitThe amount by which annual expenditures exceed annual revenues.

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

The cost of a new social insurance LTSS program should be paid for with premiums, individual contributions through

Program participant cost-sharingThe share of insurance-covered costs that a person pays ou

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:

The federal and state government should conduct regular, thorough, and consistent oversight.