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Decades of policy stalemate have crippled our capacity to sufficiently or equitably finance long-term services and supports (LTSS), leaving large numbers of low-income people at high risk of having unmet LTSS needs or going broke paying privately for LTSS. State and federal budgets also are buckling under increasing costs of their Medicaid programs. Modernizing LTSS financing has been a national priority for decades, but policy makers have failed to achieve significant reform. This article reviews past LTSS financing proposals, objections, and failures to draw lessons to spur policy making.