A New Chapter of State-Based Solutions to Paying for Long-Term Services and Supports

Written By Allison Cook

The U.S. is at a point where doing nothing to fix our long-term services and supports (LTSS) system exceeds the cost of trying to build a new program. Due to a lack of federal movement, states are increasingly looking at what they can do to build new LTSS financing programs.

This report, a follow-up to Learning from New State Initiatives in Financing Long-Term Services and Supports, explores progress made since 2020 in building new LTSS financing programs in four states: California, Massachusetts, Minnesota, and Washington state. While Washington is the furthest along and starting to implement a new program, the other three states have also made progress, either recently completing or in the process of conducting an actuarial study. The lessons and themes from these states can help illuminate options and next steps for other states, including:

  • The pandemic boosted understanding of the need for, and interest in, LTSS financing reform

  • Actuarial studies are key in supporting policy conversations and consensus-building

  • Consistent stakeholder engagement is essential Setbacks are a normal part of the process

  • Policy development is a multi-year process

  • Workforce considerations are still a work-in-progress

Read the full report.

Allison Cook
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