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Washington State Enacts Public Long-Term Care Insurance

The first-in-the-nation law will help workers afford a wide range of services

Washington Governor Jay Inslee signs a bill


Editor's note: This article was updated to reflect the bill being signed into law.

En español | Washington Gov. Jay Inslee Monday signed into law a bill making the state the first in the nation to create a state-run long-term care insurance benefit to help its residents afford the high cost of services ranging from assistance at home to nursing home stays.

The Long-Term Care Trust Act will provide a lifetime benefit of $36,500, indexed annually for inflation. Workers would be able to access their benefits once they’ve paid into the program for 10 years. As the program gets going, some employees may be able to access benefits if they have worked continuously for three of the last six years. Starting in 2022, employees would have just over one half of 1 percent deducted from their wages to pay for the insurance. The benefits will be available to active employees and retirees starting in 2025.

AARP’s Washington state office has been working with a coalition of organizations to convince lawmakers to take this historic step. “We saw a real challenge as baby boomers are aging and millennials are coming in right behind them. They haven’t saved for retirement or for their long-term care needs,” says Cathy MacCaul, AARP’s Washington’s advocacy director. The median retirement savings for people over 65 in Washington is $148,000, she says, while for those who need care the lifetime cost averages $266,000.

“Within 10 or 15 years when this program is fully up and operational we will look back at this and realize we met a huge demand and we filled a gap that existed and really helped people age with purpose and dignity,” MacCaul says.

The insurance will cover such services as personal aides providing care at home, outfitting a home with such supports as a wheelchair ramp, adult day care, nursing home care and such residential options as an adult family home or assisted living facility. Beneficiaries can also use the benefit to provide financial support to family caregivers.

To be eligible, residents have to show they need help with at least three routine activities, such as dressing, bathing and other personal hygiene needs, eating and cognitive issues.

“This is a true breakthrough piece of legislation in long-term care,” says Elaine Ryan, AARP vice president of state advocacy and strategy. “Washington becomes a great template for other state legislatures to look at how to do this. Other states will be watching how it is implemented.”

Howard Gleckman, a senior researcher at the nonpartisan Urban Institute, who specializes in long-term care issues, agrees that the state level is where the action is going to be for now. “We’re certainly in a situation now where on the federal level it’s unlikely we’re going to get any steps forward in terms of public long-term care insurance.” Washington state, he said, “is going to be a very interesting experiment.” Gleckman said other states, including Minnesota, Illinois and Michigan, are looking at a variety of public and private proposals, and California is considering a ballot initiative on a public long-term care program.