Washingtonians for a Responsible Future

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.

2018 Legislation: House Bill 2533 and Senate Bill 6238

The Long-Term Care Trust Act: The Solution to Washington’s Long-Term Care Financing Crisis.

Most people will need long-term care during their lives.  

  • Most Washingtonians over 65 will eventually need long-term care services, including help with bathing, dressing, toileting, and eating.[i]

Most people are unable to afford the long-term care they need.

  • Median retirement savings for people over 65 is just $148,000[ii] while the lifetime cost of care averages $260,000.[iii]
  • Medicare covers only limited long-term care for skilled nursing care or rehabilitation, leaving most people uninsured for their long-term care needs.
  • The private LTC Insurance market is broken – 90% of adults are uninsured and there are increasingly limited options and expensive plans.


Doing nothing will impoverish families and our State’s Medicaid budget.

  • Unless we act, Washington’s spending on Medicaid-funded long-term care will skyrocket up 91% to 4.01 billion per year. [iv]
  • Without action, countless more middle-class families will be forced to spend down their life savings to pay for care. Once impoverished, they can access long-term care through the Medicaid program.
  • Over 850,000 Washingtonians provide unpaid caregiving to a family member. Nationally, family caregivers spend an average of 20 percent of their income on out-of-pocket costs related to caregiving.[v] To provide this care, many caregivers quit or reduce time at their jobs and lose income, social security credits or other benefits like health insurance.

The Long-Term Care Trust Act would create a public long-term care benefit for Washingtonians.  

Washingtonians for a Responsible Future is working to pass legislation that embodies these guiding principles:

  • Affordable for the individual and the State – Individuals vest into the program through a modest payroll premium (0.49% premium). The State would save millions of dollars because this benefit reduces the number of people using Medicaid to pay for long-term care.
  • Accessible to all – Vesting through a payroll deduction gives access to a significant portion of the population (W2-Employees). Self-employed individuals would be eligible to opt-in to access this insurance.
  • Flexible and meaningful benefits – the 2018 Trust Act would provide 365 days of a $100 per day benefit coverage to eligible and vested individuals. Families would choose the care setting or the services that meets their loved ones’ needs.  Coverage can be used on in-home care aides, adult family homes, assisted living, skilled-nursing facilities and many others or to purchase emergency alert devices and services including but not limited to home modification, transportation or meal preparation.
  • Actuarially sound and fiscally responsible – the 2018 proposal was actuarially sound for 40 years into the future and modeled significant savings to the State’s Medicaid budget.

Washingtonians for a Responsible Future is a broad-based coalition of aging and disability advocates, businesses, long-term care providers, labor, consumer rights organizations, and families working to start this important conversation.

[i] 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

[ii] 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

[iii] Ibid

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

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


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