,i  #aai? ,,congress  #a/ ,session  ,h4 
,r4 #bjhb  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,m>* #aa1 #bjbe,mr4   
,suozzi 7= himself & ,mr4 ,mool5a>7     
introduc$ ! foll[+ bill2 :i* 0 ref]r$ to
 ! ,committee on ,ways & ,means  ,a     
,,bill  ,to am5d title ,,ii ( ! ,social 
,security ,act to provide = long-t]m c>e
 insurance b5efits1 & = o!r purposes4   
#a4 ,%ort title ,?is ,act may be cit$ z 
! ,well-,be+ ,insurance = ,s5iors to be 
at ,home ,act or ! ,,wi% ,act4  #b4     
,f9d+s2 purpose  7a7 ,f9d+s ,congress   
f9ds ! foll[+3 7#a7 ,m ?an half (       
,am]icans ent]+ old age today w h a     
long-t]m s]vices & supports 79 ?is      
section ref]r$ to z ,,ltss7 ne$1 av]ag+ 
#bih1jjj co/s p] p]son = ab\t #b ye>s ( 
s]i\s self-c>e disability1 & m ?an half 
w be out-(-pocket1 accord+ to ! ,u4,s4  
,dep>tm5t ( ,heal? & ,human ,s]vices 79 
?is section ref]r$ to z ,,hhs74  7#b7 ,!
 population age #he or old] 7:i* is a   
proxy = ! numb] ( eld]s ne$+ ,,ltss7 w  
d\ble betwe5 #bjbb & #bjce1 & ne>ly     

triple by #bjej4 ,?is ag+ w outpace !   
numb] ( work+-age p1 includ+ family     
memb]s1 :o c help s5iors f9ancially or )
 unpaid c>e4  7#c7 ,rese>* has %[n t mo/
 ,u4,s4 s5iors c\ld only af=d less ?an a
 ye> ( nurs+ home c>e1 assi/$ liv+ c>e1 
or ext5sive home c>e us+ _! f9ancial    
res\rces4 ,"s c get by us+ unpaid       
7family7 c>e1 b mo/ rely on a comb9ation
 ( paid & unpaid c>e4  7#d7 ,m ?an #a 9 
#e middle-income s5iors w end up        
impov]i%$1 ,m$icaid eligible1 & mo/ly   
us+ ,m$icaid to cov] _! ,,ltss co/s4    
7#e7 ,millions ( old] ,am]icans--#a 9   
#e--w ne$ ,,ltss = m ?an #e ye>s1 ) a   
price tag t w\ld impov]i% ne>ly all     
,am]ican h\seholds if !y fac$ t ne$4    
,,hhs projections %[ t old] adults :o   
ne$ ,,ltss = m ?an #e ye>s incur ne>ly  
half ( all ,,ltss exp5ses & #fj p]c5t ( 
,m$icaid's ,,ltss sp5d+4  7#f7 ,only #a 
9 #aj ,am]ican adults 7#aa p]c5t7 h any 
private cov]age = ,,ltss exp5ses1 leav+ 
almo/ all middle-class ,am]ican families
 to exhau/ _! ne/-eggs & become         

impov]i%$ be=e qualify+ = ,m$icaid4     
7#g7 ,! ,nation urg5tly ne$s to create  
me?ods = ord9>y ,am]icans to be able to 
take responsibility to plan = ! risk ( a
 sub/antial p]iod ( disability dur+     
retirem5t ye>s4  7#h7 ,giv5 t ,am]icans 
move & "w across ,/ate l9es s frequ5tly1
 ,/ate-bas$ ,,ltss plans enc\nt]        
difficult adm9i/rative issues4 ,!re=e1 a
 solution to address ,,ltss ne$s =      
s5iors mu/ be an*or$ 9 a ,f$]al         
insurance plan4 ,additionally1 s9ce ! "t
 j aft] onset ( disability is m         
pr$ictable & manageable1 a ,f$]al       
insurance plan %\ld cov] ! risk (       
especially long p]iods ( long-t]m c>e1  
leav+ ! e>ly p]iod ( ne$ to p]sonal     
responsibility4  7#i7 ,^? me?ods mu/    
also responsibly support ! work=ce      
provid+ supports & s]vices4  7b7        
,purpose ,! purpose ( ?is ,act is to    
enable mo/ ,am]icans to make plans t    
protect !mselves & _! families1 to      
enable disabl$ old] adults to support   
!mselves 9 _! communities dur+ p]iods ( 

s]i\s disability1 to support ! work=ce  
provid+ direct s]vices to eld]s liv+ )  
disabilities1 & to r$uce :at is n[      
necess>y reliance on ,m$icaid4  #c4     
,long-t]m c>e insurance b5efits  7a7 ,9 
g5]al ,title ,,ii ( ! ,social ,security 
,act 7#db ,u4,s4,c4 #dja et seq47 is    
am5d$ by add+ at ! end ! foll[+3  #bce4 
,long-t]m c>e insurance b5efits  7a7 ,9 
g5]al ,e individual :o-- 7#a7 has atta9$
 retirem5t age 7z def9$ 9 section       
#baf7l77#a772  7#b7 has fil$ an         
application = long-t]m c>e insurance    
b5efits2  7#c7 is insur$ = long-t]m c>e 
insurance b5efits 7z det]m9$ "u         
subsection 7c77 at ! "t su* individual's
 application is fil$2 &  7#d7 has a     
cont9ual s]i\s functional disability 7z 
def9$ 9 subsection 7d77 &1 at ! "t su*  
individual's application is fil$1 has _h
 su* disability = a sub/antial p]iod (  
"t 7z det]m9$ "u subsection 7e771  %all 
be entitl$ to a long-t]m c>e insurance  
b5efit = ea* mon? beg9n+ ) ! #a/ mon? 9 
:i* ! individual meets ! crit]ia        

specifi$ 9 p>agraphs 7#a7 ?r\gh 7#d71 & 
end+ ) ! e>li] ( ! mon? 9 :i* !         
individual dies or ! #a/ mon? 9 :i* !   
individual no long] has a cont9ual s]i\s
 functional disability 7z s def9$74  7b7
 ,b5efit am\nt ,su* individual's        
long-t]m c>e insurance b5efit = ea* mon?
 %all be an am\nt equal to ! product (--
 7#a7 an e/imate1 to be det]m9$ by !    
,secret>y ( ,heal? & ,human ,s]vices 9  
consultation ) ! ,dep>tm5t ( ,labor1 ( !
 m$ian co/ ( #f h\rs p] day ( paid      
p]sonal assi/ance 9 ! ,unit$ ,/ates1    
index$ to wages 9 ! long-t]m c>e sector1
 multipli$ by  7#b7 ! ratio 7n great]   
?an #a7 ( ! numb] ( qu>t]s ( cov]age !  
individual has dur+ ! applicable base   
p]iod 7z def9$ 9 subsection 7c77#b77 to 
#dj4  7c7 ,def9ition ( insur$ /atus     
7#a7 ,9 g5]al ,= purposes ( subsection  
7a71 an individual %all be insur$ =     
long-t]m c>e insurance b5efits 9 any    
mon? if ! individual has #f qu>t]s (    
cov]age dur+ ! applicable base p]iod4   
7#b7 ,applicable base p]iod ,= purposes 

( ?is subsection1 ! t]m applicable base 
p]iod means ! p]iod t beg9s ) ! #a/     
qu>t] ( #bjbf4  7d7 ,def9ition (        
cont9ual s]i\s functional disability ,= 
purposes ( subsection 7a71 an individual
 %all be consid]$ to h a cont9ual s]i\s 
functional disability if ! p]son is a   
*ronically ill individual 7z det]m9$ "u 
section #ggjb;,b7c77#b7 ( ! ,int]nal    
,rev5ue ,code ( #aihf7 & is expect$ to  
rema9 a *ronically ill individual 7z s  
det]m9$7 = at lea/ #a ye> or until !    
individual's dea?4  7e7 ,def9ition (    
sub/antial p]iod  7#a7 ,9 g5]al ,=      
purposes ( subsection 7a71 a sub/antial 
p]iod ( "t means-- 7,a7 9 ! case ( an   
individual :o1 at ! "t describ$ 9       
p>agraph 7#c71 has av]age index$ mon?ly 
e>n+s = long-t]m c>e equal to or less   
?an ! doll> am\nt repres5t+ ! #dj?      
p]c5tile 9 ! table e/abli%$ "u          
subsection 7f7 = su* cal5d> ye>1 #ab    
mon?s2 &  7,b7 9 ! case ( an individual 
:o1 at su* "t1 has av]age index$ mon?ly 
e>n+s = long-t]m c>e great] ?an su*     

doll> am\nt1 #ab mon?s plus #a          
additional mon? = ea* #a4be p]c5tile    
int]val above ! #dj? p]c5tile = :i* !   
individual's av]age index$ mon?ly e>n+s 
= long-t]m c>e w\ld atta9 7z specifi$ 9 
su* table74  7#b7 ,table ( e>n+s  7,a7  
,9 g5]al ,! ,commission] ( ,social      
,security %all e/abli% a table1 = ea*   
cal5d> ye> beg9n+ ) cal5d> ye> #bjbf1   
sett+ =?-- 7i7 ! doll> am\nt repres5t+ !
 #dj? p]c5tile among ! av]age index$    
mon?ly e>n+s = long-t]m c>e 7z det]m9$  
"u subp>agraph 7,b77 ( ea* individual :o
 has atta9$ age #fb & ^: prim>y         
insurance am\nt is fir/ comput$ dur+ su*
 cal5d> ye> 7or1 = cal5d> ye> #bjcf1    
dur+ any previ\s cal5d> ye>72 &  7ii7 ! 
doll> am\nts repres5t+ p]c5tiles ov] #dj
 7increas+ l9e>ly f #dj 9 int]vals (    
#a4be7 among ! av]age index$ mon?ly     
e>n+s = long-t]m c>e 7z s det]m9$7 ( ea*
 su* individual4  7,b7 ,det]m9ation (   
av]age index$ mon?ly e>n+s = long-t]m   
c>e ,= purposes ( ?is subsection1 !     
av]age index$ mon?ly e>n+s = long-t]m   

c>e ( an individual %all be det]m9$ "u  
section #bae7;b7 7z 9 effect on ! date (
 enactm5t ( ?is ,act7 z if su* section 7
 am5d$-- 7i7 9 p>agraph 7#b77;,a71 by   
/rik+ r$uc$-- & all t foll[s ?r\gh ! end
 & ins]t+ r$uc$ by ! numb] ( b5efit     
computation ye>s = :i* no wages 7 paid 9
 & no self-employm5t income cr$it$42 &  
7ii7 9 p>agraph 7#b77;,b77ii71 by /rik+ 
#aiej & ins]t+ #bjbe4  7#c7 ,"t (       
calculation ,! "t describ$ 9 ?is        
p>agraph is-- 7,a7 9 ! case ( an        
individual :o has #dj qu>t]s ( cov]age  
dur+ ! applicable base p]iod 7z def9$ 9 
subsection 7c77#b77 prior to becom+     
entitl$ to old-age insurance b5efits1 ! 
"t at :i* ! individual's prim>y         
insurance am\nt 0 fir/ comput$ ) respect
 to ! individual's application = su*    
b5efits2 &  7,b7 9 ! case ( any o!r     
individual1 ! "t at :i* ! individual    
files an application = long-t]m c>e     
insurance b5efits "u ?is section4  7f7  
,provision ( in=mation relat+ to obta9+ 
long-,t]m c>e ,! ,commission] ( ,social 

,security %all provide to ea* individual
 entitl$ to a long-t]m c>e insurance    
b5efit "u ?is section1 z soon z         
practicable foll[+ ! fir/ day ( ! fir/  
mon? ( su* entitlem5t1 in=mation        
describ+ ! /eps ! individual may take to
 obta9 long-t]m c>e1 includ+ an         
explanation ( ! s]vices 7includ+ c>e    
plann+1 c>e managem5t1 & adm9i/rative   
s]vices = hir$ c>e provid]s1 by ref]ral 
or 9-h\se1 = a fee7 provid$ by1 & !     
appropriate contact in=mation =1 ! ,ag+ 
& ,disability ,res\rce ,c5t]s describ$ 9
 section #bjb7;b77#h7 ( ! ,old]         
,am]icans ,act ( #aife & ! area ag5cies 
on ag+ 7z def9$ 9 section #ajb7f7 ( su* 
,act74  7g7 ,provision ( b5efici>y      
in=mation by any p]son ,any p]son may   
submit applicable in=mation ) respect to
 an individual's application = long-t]m 
c>e insurance b5efits1 an annual /atem5t
 describ$ "u subsection 7i77#b71 or any 
o!r in=mation requir$ to be submitt$ by 
! individual "u ?is title1 includ+1 z   
applicable1 ! individual's              

repres5tative1 or any family memb] or   
o!r appropriate p]son4  7h7 ,treatm5t ( 
long-,t]m c>e insurance b5efit paym5ts  
,a long-t]m c>e insurance b5efit paym5t 
%all n be reg>d$ z income & %all n be   
reg>d$ z a res\rce = any mon?1 =        
purposes ( det]m9+ ! eligibility ( !    
recipi5t 7or ! recipi5t's sp\se or      
family7 = b5efits or assi/ance "u any   
,f$]al program or "u any ,/ate or local 
program f9anc$ 9 :ole or 9 "p ) ,f$]al  
funds4  7i7 ,additional requirem5ts     
7#a7 ,relat+ to wages & )hold+ rules ,an
 individual entitl$ to a long-t]m c>e   
insurance b5efit = a mon? dur+ a cal5d> 
ye> %all1 9 any case 9 :i* su*          
individual hires an employee :o is n a  
family memb] to provide paid p]sonal c>e
 to ! individual dur+ su* mon?1 comply )
 all applicable ,/ate & ,f$]al laws     
relat+ to-- 7,a7 ! paym5t ( a m9imum    
wage2 &  7,b7 ! )hold+ ( payroll taxes &
 o!r employm5t-relat$ taxes4  7#b7      
,annual /atem5t ,an individual entitl$  
to a long-t]m c>e insurance b5efit = a  

mon? dur+ a cal5d> ye> %all submit a    
/atem5t to ! ,commission] ( ,social     
,security at lea/ once dur+ su* cal5d>  
ye>1 z direct$ by ! ,commission]-- 7,a7 
affirm+ t ! individual-- 7i7 cont9ues to
 h a cont9ual s]i\s functional          
disability 7z def9$ 9 subsection 7d772 &
  7ii7 is 9 compliance ) ! laws describ$
 9 p>agraph 7#a72 &  7,b7 specify+ !    
c\ntry ( resid5ce ( ! individual4  7#c7 
,nonpaym5t ( b5efits 9 c]ta9 cases ,no  
long-t]m c>e insurance b5efit %all be   
payable to an individual = any mon?--   
7,a7 ) respect to :i* ! individual fails
 to satisfy any ( ! requirem5ts describ$
 9 ! prec$+ p>agraphs ( ?is subsection2 
or  7,b7 beg9n+ aft] ! fif? consecutive 
ye> ) respect to :i* ! individual has   
report$1 9 ! annual /atem5t requir$ "u  
p>agraph 7#b71 a c\ntry ( resid5ce o!r  
?an ! ,unit$ ,/ates 7includ+ any        
t]ritory ( ! ,unit$ ,/ates74  4  7b7    
,e/imates ( b5efits ,section            
#aadc7;a77#b7 ( ! ,social ,security ,act
 7#db ,u4,s4,c4 #acbj;b-#ac7 is am5d$-- 

7#a7 9 subp>agraph 7,d71 by /rik+ & at !
 end2  7#b7 9 subp>agraph 7,e71 by /rik+
 ! p]iod at ! end & ins]t+ 2 &2 &  7#c7 
by add+ at ! end ! foll[+3  7,f7 an     
e/imate ( ! pot5tial long-t]m c>e       
insurance b5efits payable to !          
individual4  4  #d4 ,e/abli%m5t ( ,f$]al
 ,long-,t]m ,c>e ,insurance ,tru/ ,fund 
7a7 ,9 g5]al ,!re is h]eby creat$ on !  
books ( ! ,treasury ( ! ,unit$ ,/ates a 
tru/ fund to be kn[n z ! ,f$]al         
,long-,t]m ,c>e ,insurance ,tru/ ,fund4 
,! ,f$]al ,long-,t]m ,c>e ,insurance    
,tru/ ,fund %all consi/ ( su* gifts &   
beque/s z may be made z provid$ 9       
section #bja7;i77#a7 ( ! ,social        
,security ,act 7#db ,u4,s4,c4           
#dja7;i77#a77 & su* am\nts z may be     
appropriat$ to1 or deposit$ 91 ! ,f$]al 
,long-,t]m ,c>e ,insurance ,tru/ ,fund z
 provid$ 9 ?is section4  7b7            
,appropriation ,!re is appropriat$ to ! 
,f$]al ,long-,t]m ,c>e ,insurance ,tru/ 
,fund out ( moneys 9 ! ,treasury n      
o!rwise appropriat$-- 7#a7 = ea* (      

fiscal ye>s #bjbf1 #bjbg1 & #bjbh1      
#ab1jjj1jjj = ! initial e/abli%m5t ( !  
,long-,t]m ,c>e ,insurance program &    
paym5t ( b5efits dur+ su* fiscal ye>s2 &
  7#b7 #ej1jjj1jjj = public education   
relat+ to ! ,long-,t]m ,c>e ,insurance  
program z describ$ 9 section #f7;a74    
7c7 ,managem5t ( ,tru/ ,fund ,!         
provisions ( subsections 7c71 7d71 7e71 
7f71 7i71 & 7m7 ( section #bja ( !      
,social ,security ,act 7#db ,u4,s4,c4   
#dja7 %all apply ) respect to ! ,f$]al  
,long-,t]m ,c>e ,insurance ,tru/ ,fund 9
 ! same mann] z su* provisions apply to 
! ,f$]al ,old-,age & ,survivors         
,insurance ,tru/ ,fund & ! ,disability  
,insurance ,tru/ ,fund1 except t !      
,manag+ ,tru/ee 7)9 ! mean+ ( subsection
 7d7 ( su* section7 may inve/ su*       
portion ( ! ,f$]al ,long-,t]m ,c>e      
,insurance ,tru/ ,fund z ! ,manag+      
,tru/ee consid]s appropriate 9          
cons]vative m>ket securities4  7d7      
,adm9i/ration ,!re are au?oriz$ to be   
made available = exp5diture1 out ( !    

,f$]al ,long-,t]m ,c>e ,insurance ,tru/ 
,fund1 su* sums z may be necess>y to pay
 ! co/s ( ! adm9i/ration ( section #c1  
includ+ />t-up co/s1 te*nical assi/ance1
 outrea*1 education1 evaluation1 &      
report+4  7e7 ,report ,n lat] ?an #e    
ye>s aft] ! date ( enactm5t ( ?is ,act &
 e #e ye>s !reaft]1 ! ,bo>d ( ,tru/ees  
7z def9$ = purposes ( title ,,ii ( !    
,social ,security ,act7 %all submit a   
report to ,congress evaluat+ ! impact ( 
long-t]m c>e insurance b5efits "u       
section #bce ( su* ,act & mak+          
recomm5dations relat+ to pot5tial       
geographical adju/m5ts ( ! am\nt ( su*  
b5efits4  7f7 ,all[+ gifts ,to be made  
to ! ,f$]al ,long-,t]m ,c>e ,insurance  
,tru/ ,fund ,section #bja7;i77#a7 ( !   
,social ,security ,act 7#db ,u4,s4,c4   
#dja7;i77#a77 is am5d$-- 7#a7 by /rik+ 1
 or ! ,f$]al & ins]t+ 1 ! ,f$]al2 &     
7#b7 by ins]t+ aft] 9 su* ,tru/ ,fund7 !
 foll[+3 1 or ! ,f$]al ,long-,t]m ,c>e  
,insurance ,tru/ ,fund e/abli%$ "u !    
,well-,be+ ,insurance = ,s5iors to be at

 ,home ,act4  #e4 ,education & outrea*  
7a7 ,public education plan  7#a7 ,9     
g5]al ,n lat] ?an #ij days aft] ! date (
 enactm5t ( ?is ,act1 ! ,secret>y (     
,heal? & ,human ,s]vices1 9 consultation
 ) ! ,commission] ( ,social ,security1  
%all publi% 9 ! ,f$]al ,regi/] a #aj-ye>
 plan to educate ! public ab\t !        
likelihood ( ne$+ long-t]m c>e1 ! nature
 ( ! exp]i5ce ( long-t]m c>e 9 v>i\s    
situations1 ! co/s ( long-t]m c>e1 !    
availability ( long-t]m c>e insurance   
b5efits1 & ! importance ( plann+ &      
consid]+ private insurance cov]age      
alongside family support & sav+s        
7especially dur+ ! fir/ ye>s ( a s]i\s  
disability74 ,su* plan %all be modifi$ z
 necess>y bas$ on rese>* on !           
effectiv5ess ( v>i\s /rategies &        
modifications ) exp]i5ce4  7#b7 ,fund+  
,!re are appropriat$1 out ( ! ,f$]al    
,long-,t]m ,c>e ,insurance ,tru/ ,fund1 
to ! ,secret>y ( ,heal? & ,human        
,s]vices #ej1jjj1jjj to c>ry out        
p>agraph 7#a74  7b7 ,individual notices 

7#a7 ,9 g5]al ,beg9n+ #a ye> aft] ! date
 ( enactm5t ( ?is ,act & 9 accordance ) 
p>agraph 7#b71 ! ,commission] ( ,social 
,security %all provide to ea* eligible  
individual a notice t specifies-- 7,a7  
7i7 ! av]age index$ mon?ly e>n+s =      
long-t]m c>e t w\ld be calculat$ = !    
individual "u p>agraph 7#b77;,b7 (      
section #bce7;e7 ( ! ,social ,security  
,act if su* av]age index$ mon?ly e>n+s =
 long-t]m c>e 7 calculat$ 9 ! mon? be=e 
! mon? su* notice is provid$2 &  7ii7 = 
purposes ( apply+ su* section to !      
individual1 ! p]c5tile 9 :i* su* av]age 
index$ mon?ly e>n+s = long-t]m c>e ( !  
individual w\ld fall among ! av]age     
index$ mon?ly e>n+s = long-t]m c>e 7z   
det]m9$ "u su* p>agraph 7#b77;,b77 ( ea*
 individual ^: av]age index$ mon?ly     
e>n+s = long-t]m c>e are calculat$ 9 su*
 mon?2  7,b7 ! numb] ( qu>t]s ( cov]age 
! individual has 9 ! mon? be=e ! mon?   
su* notice is provid$ = purposes (      
atta9+ insur$ /atus = long-t]m c>e      
insurance b5efits "u su* ,act2 &  7,c7 9

 any case 9 :i* ! individual has a      
cont9ual s]i\s functional disability 7z 
def9$ 9 section #bce7;d7 ( su* ,act71 ! 
date on :i* su* disability began4  7#b7 
,tim+ ,a notice describ$ 9 p>agraph 7#a7
 %all be provid$-- 7,a7 by mail-- 7i7 to
 ea* eligible individual n lat] ?an #edj
 days ( ! date ( enactm5t ( ?is ,act2 & 
7ii7 to ea* eligible individual 9 ! mon?
 ! individual atta9s age #de1 age #ee1  
age #fe1 & retirem5t age 7z def9$ 9     
section #baf7l7 ( su* ,act72 &  7,b7 =  
ea* eligible individual :o has atta9$   
age #ce1 by mak+ su* notice available on
 ! individual's acc\nt on ! website ( ! 
,social ,security ,adm9i/ration1 to be  
updat$ annually4  7#c7 ,eligible        
individual ,9 ?is subsection1 ! t]m     
eligible individual means an            
individual-- 7,a7 :o has a social       
security acc\nt numb]2 &  7,b7 7i7 :o   
has wages or net e>n+s f self-employm5t2
 or  7ii7 ) respect to :om !            
,commission] has in=mation t ! patt]n ( 
wages or self-employm5t income indicate 

a likelihood ( noncov]$ employm5t4  #f4 
,,gao ,report on ,p]=mance ( ! ,,wi%    
,program ,n lat] ?an #e ye>s aft] ! date
 ( enactm5t ( ?is ,act & e #c ye>s      
!reaft]1 ! ,comptroll] ,g5]al %all      
submit a report to ,congress includ+--  
7#a7 a description ( ! likelihood (     
manipulation ( eligibility crit]ia by   
b5efici>ies or b5efici>y advisors &     
recomm5dations z to ! m]its ( possible  
rem$ies2  7#b7 a description ( !        
likelihood ( f9ancial exploitation or   
eld] mi/reatm5t by o!rs on :om a        
b5efici>y is dep5d5t or o!rwise connect$
 & recomm5dations z to ! m]its (        
possible rem$ies1 includ+ ! m]its (     
impos+ a f9ancial managem5t s]vice or   
fiscal int]m$i>y z has (t5 be5 implem5t$
 by /ates 9 ,m$icaid's ,ca% & ,c\nsel+  
program2 &  7#c7 a description ( !      
m>ketplace & consum] und]/&+ ( long-t]m 
insurance (f]+s & recomm5dations z to ! 
m]its ( possible rem$ies1 includ+ !     
m]its ( /&>diz+ insurance (f]+s to      
improve consum] und]/&+4  #g4 ,report on

 rema9+ long-t]m supports & s]vices ne$s
 ,n lat] ?an #c ye>s aft] ! date (      
enactm5t ( ?is ,act & e #c ye>s !reaft]1
 ! ,secret>y ( ,heal? & ,human ,s]vices1
 act+ ?r\gh ! ,adm9i/rator ( !          
,adm9i/ration on ,community ,liv+ & 9   
consultation ) ! ,commission] ( ,social 
,security1 %all submit a plan to        
,congress t includes-- 7#a7 e/imates ( !
 long-t]m s]vices & supports ne$$ by    
individuals :o are n eligible = b5efits 
"u section #bce ( ! ,social ,security   
,act1 includ+ individuals disabl$ 9     
*ildhood1 individuals liv+ )            
disabilities be=e retirem5t age1 &      
individuals :o are n insur$ = b5efits "u
 su* section2 &  7#b7 propos$ /rategies 
& co/s ( mitigat+ unmet ne$s = su*      
individuals4