Crafting a viable and robust program to help Washingtonians better prepare for their long-term care needs is critically important for our families and our state. During this legislative session, we have an opportunity to significantly improve the way we pay for care by adopting the Long-Term Care Trust Act (LTCTA).
The LTCTA (HB 1087 and SB 5331), which will be heard in the House on Thursday, would create a state long-term care program, providing Washingtonians with flexible and meaningful benefits that will allow individuals and their families to choose the care setting and services that best meet their needs.
Based on a payroll premium of just over one-half of 1 percent (0.58 percent), vested employees, when eligible, would receive a daily benefit with a lifetime cap of $36,500, which will increase over time with inflation. This benefit, in turn, may be applied to a wide range of care selections such as in-home aides, adult family homes, assisted living, and skilled nursing facilities — as well as other services. It also offers the opportunity for family caregivers to be compensated with a limited amount of training.
When it comes to long-term care, choice is important for our caregiving families, who are the backbone of Washington’s long-term care system. Right now, more than 828,000 family caregivers help their older parents, spouses and other loved ones remain as independent as possible. They assist with bathing and dressing, transportation, medical tasks — from wound care to injections — medication management, and much more. The unpaid care they provide is equivalent to an estimated $10.7 billion annually — five times the amount that Medicaid spends each year on long-term services and supports in the state.
On average family caregivers spend about 20 percent of their income on out-of-pocket costs related to helping their loved ones. Expenses include home modification, medical equipment, in-home aides, and adult day care. Many of these unpaid caregivers are forced to quit or reduce time at their jobs, losing salary, Social Security credits, or other benefits like health insurance.
Yakima resident Stu Seibel took on the role of family caregiver when his wife, Carol, was diagnosed with ovarian cancer. “I can honestly say I was not ignorant about the role of family caregivers, but no amount of knowledge would be adequate preparation for that sudden eventuality,” said Seibel. “If I wasn’t retired, I don’t know what we would have done.”
Some mistakenly believe that Medicare or private insurance will help pay for long-term care. The truth is Medicare only pays for short-term stays in a nursing facility for a maximum of 100 days, and most private insurance covers only a portion of the costs associated with care. Further, access to long-term care insurance is unreachable for 90 percent of older adults as plans are expensive and increasingly limited.
This crisis of affordability and access leaves few choices for those in need. Many will be forced to impoverish themselves to qualify for low-income assistance through Medicaid. This option is not sustainable in the long run.
The LTCTA would alleviate some of the growing stress on the state’s Medicaid budget and could help prevent families from being forced to spend their life savings. By helping people pay for long-term care before they spend themselves into poverty, the LTCTA is projected to save Washington taxpayers $19 million in the first year of operation (2022), $368 million in 2050, and have a net savings of more than $3.9 billion by 2052.
Washingtonians deserve flexible and meaningful options when it comes to long-term care so that when the time comes, they can choose the living environment or services that best meet their needs. While the Long-Term Care Trust Act will not solve all of our challenges, it is a significant step in the right direction.
• Norm Johnson is the former State Representative for Yakima Valley and a sponsor of last year’s Long-Term Care Trust Act bill. Doug Shadel is the current AARP Washington State Director serving more than 965,000 members across the state.