The Affordable Care Act and long-term care: marginal advancement on the status quo

The purpose of this analysis is to evaluate the sufficiency of the Long-Term Services and Supports (LTSS) provisions contained within the Patient Protection and Affordable Care Act (ACA). Beyond the ambitious but fatally flawed Community Living Assistance Services and Supports Act, the ACA's LTSS changes represent only marginal advances over the status quo. Moreover, the impact of the ACA's strategies varies with the extent to which the federal and state governments opt to invest in them, through funding, implementing, and enforcing the modest changes enacted. The ACA's LTSS provisions, while welcome, are unlikely to result in the major changes necessary to meet both current and future demand for care.