The Affordable Care Act includes many new provisions for long-term services and supports (LTSS). Among these are several new options, improvements, and incentives within Medicaid to balance service systems and expand access to home and community-based services. In addition, the Affordable Care Act authorizes the establishment of a new voluntary national long-term care insurance program, the Community Living Assistance Services and Supports (CLASS) Program. This article discusses some of the major provisions and implementation. It also examines how the major principles of rehabilitation counseling are central to advancing LTSS policy and how rehabilitation counselors can play a key role in ensuring quality LTSS services for persons with disabilities.