The lack of an efficiently financed, well-functioning, and broadly accessible system of long-term services and supports is heavily burdening American families, state and federal budgets, and the economy as a whole. These problems will only worsen in the coming decades as the Boomers age into their 80s and beyond. At the same time, the economic contributions and quality of life of working-age people with disabilities remain unnecessarily limited due to the lack of adequate services. Congress has a range of policy options at its disposal to address the LTSS needs of seniors and working-age people with disabilities.

Social insurance represents a promising approach to meeting the challenges of ensuring broad access to LTSS. A universal and affordable program is necessary to achieve broad coverage, which is particularly important given the nature of the LTSS risk. Many people will not have any need for LTSS; others will need it for a moderate duration; and a small number will face catastrophic expenses. As a result, it is difficult for individuals and families to plan to meet what seems to them to be an uncertain need for LTSS. Yet, the lack of availability of affordable help when LTSS is needed threatens economic and retirement security both individuals and families. A social insurance program would be an efficient way to mitigate the financial risk associated with LTSS. The Academy’s LTSS research will continue to analyze potential policy pathways to using a social insurance framework to achieve universal LTSS.

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