The differences on LTC come down to a basic question of whether the Office of Personnel Management would exercise strong central control—as the White House and Capitol Hill Democrats want—or whether a more free-market approach would be used—as congressional Republicans want. The differences are deep but they may yet be overcome because of impatience to act on the issue, especially since long-term care benefits wouldn’t actually be available for at least a year after passage of any law, and probably more like two years.