Yesterday, ADvancing States submitted a letter to the Chair of the Senate Finance Committee in response to his request for feedback and recommendations on health reform activities. In the letter, we recommend that the final health reform package support the following goals:

• Maintain coverage and access to Medicaid and LTSS for individuals who require these supports;
• Encourage and promote rebalancing from institutional settings to home and community based services (HCBS) while promoting community integration;
• Provide states with flexibility to deliver person-centered LTSS; and
• Refrain from shifting costs for LTSS onto state governments.

We make a number of specific recommendations for ways that health reform legislation can increase state flexibility and reduce cost-growth while simultaneously improving the experience of participants. Our recommendations build upon the comments we provided to Congress regarding the House health reform bill (the AHCA).