Washingtonians for a Responsible Future

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Long-Term Care Trust Act

Affordable and Accessible Long-Term Care for Washington

The landmark Long-Term Care Trust Act moved even closer to becoming law this year! The 2018 legislation gained bipartisan support and significant momentum in the Washington Legislature. While the bill will not pass into law this year, we continue to push for immediate funding for research to help perfect the policy. We are more committed than ever to fighting to pass this landmark legislation in 2019.

E-mail your legislators to ask them to support work now to position us to pass this landmark policy in 2019.

2018 Legislation: House Bill 2533 and Senate Bill 6238

We face a crisis in long-term care: Most people will not be able to pay for what they need.

  •  Most Washingtonians over 65 will eventually need long- term care services, including help with bathing, dressing, toileting, and eating. 1
  • Long-term care is prohibitively expensive. The average lifetime cost is $260,000. 2
  • Most people have not saved enough to pay for their own care. Median retirement savings for people over 65 is just $148,000. 3
  • Medicare does not cover long-term care services.
  • Nationally, family caregivers spend an average of 20 percent of their income on out-of-pocket costs related to caregiving. 4

Long-Term Care Trust Act would provide long-term care insurance for people employed in Washington.

  • The program provides 365 days worth of coverage.
  • Vested Washingtonians receive benefit of $100 per day.
  • The benefit would cover the complete cost of one year of long-term care for the average Washingtonian who needs in-home long-term care. 5
  • The benefit coverage is financed by a 0.49% (half of one percent) payroll deduction on all workers (an average of $23.30/ month). 6
  • Vesting period is three of the last six years, or ten years total.


Long-Term Care Trust Act would help protect the state budget from increased spending on Medicaid-funded long-term care.

  • Washington now spends $2.1 billion annually on Medicaid-funded long-term service and supports. This spending is projected to increase by 91% in 2040 to $8.02 billion per biennium. 7
  • In its first year, the program would save Washington $19 million in Medicaid spending. 8
  • By the 10th year, it would save the state $70 million every two years (biennium). 9
  •  By 2040, this legislation could save Washington State $1.4 billion per biennium.10
  • Washington now spends $2.1 billion annually on Medicaid-funded long-term service and supports. This spending is projected to increase by 91% in 2040 to $4.01 billion per year.

Long-Term Care insurance coverage would strengthen Washington’s economy.

  • Coverage reduces the burden on family caregivers, enabling them to continue working and save for their own retirement.
  • Family members who leave the workforce to care for loved ones typically lose $300,000 in income and benefits. Women lose the most, an average of $324,044.11.
  • The program would increase workforce and business productivity by reducing the number of family caregivers who must take time off work or quit paid employment.

People would choose how to use their benefits.

  • Under the Trust Act, families would get to choose the care setting that meets their loved ones’ needs. Coverage can be used on in-home care aides, adult family homes, assisted living, or skilled-nursing facilities.
  • Beneficiaries can choose to use their 365 days of coverage consecutively or in smaller chunks, as they need help.

We did the math.

  • The legislature directed Milliman to study and analyze two policy options to help make long-term care more accessible and affordable: a public benefit trust similar to Social Security, paid into by all workers, and a public/private solution to help stabilize the existing private-insurance market.
  • Milliman found the public benefit would have significant and broad impact on both family and state budgets.
  • They also found that reviving the private market would require large state subsidies and risk-sharing to increase the number seniors who could afford meaningful coverage.

Broad Coalition Support

• Alzheimer’s Association
• Caring Across Generations
• Washington Health Care Association
• SEIU 775
• Washington Association of Area Agencies on Aging (W4A)
• Senior Citizens’ Lobby
• LeadingAge Washington
• Long-term Care Ombudsman Program.
• Adult Family Home Council
• A full list of all endorsing organizations is available at http://responsiblefuture.org/about/

Majority of voters in Washington support the LTC Trust Act. A recent statewide poll found that 62% of likely voters support the LTC Trust Act.

1 Favreault, M. (2016). Long-Term Services and Supports for Older Americans: Risks and Financing. U.S. Department of Health and Human Services, Office of the Assistant Secretary of Planning and Evaluation. Retrieved from https://aspe.hhs.gov/basic-report/long-term-services-and-supports-older-americans-risks-and-financing-research-brief

2 Ibid

3 Government Accountability Office. (2015). Most Households Approaching Retirement Have Low Savings (No. GAO-15-419). Washington D.C. Retrieved from https://www.gao.gov/products/GAO-15-419

4 Rainville, C., Skufca, L., & Mehegan, L. (2016). Family Caregiving and Out-of-Pocket Costs: 2016 Report (p. 7, Rep.). Washington D.C.: AARP.

5 Rector (DSHS/ALTSA), Bea-Alise. “Average Monthly Personal Care Hour Utilization. “Average Monthly Personal Care Hour Utilization, 20 Nov. 2017.

6 Washington and U.S. average wages. (2017, August 16). Retrieved December 18, 2017, fromhttps://www.ofm.wa.gov/washington-data-research/statewide-data/washington-trends/economic-trends/washington-and-us-average-wages

7 Report to the Legislature. Feasibility Study of Policy Options to Finance Lon-Term Services and Supports (p. 7, Rep.). (2017). Olympia, WA: Aging and Long-Term Services Administration (DSHS).

8 Report to the Legislature. Feasibility Study of Policy Options to Finance Lon-Term Services and Supports (p. 31, Rep.). (2017). Olympia, WA: Aging and Long-Term Services Administration (DSHS).


10 Mancusco, D. (2017). Washington State Changing Patterns of Long-Term Services and Supports.

11 MetLife Mature Market Institute. (2011). The MetLife Study of Caregiving Costs to Working Caregivers: Double Jeopardy for Baby Boomers Caring for Their Parents.

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