Changes to the WA Cares Fund expand long-term care support - Insurance News | InsuranceNewsNet

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May 21, 2025 Health/Employee Benefits News
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Changes to the WA Cares Fund expand long-term care support

By Press Release

OLYMPIA — Washington Gov. Bob Ferguson signed a new law expanding Washingtonians’ options for accessing long-term care support through the WA Cares Fund. The law creates opportunities for Washingtonians to purchase affordable supplemental long-term care coverage from private insurers in the future, allows workers who have a private insurance exemption to join the program and simplifies the 10-year contribution requirement to qualify for benefits.

“These changes will allow more Washingtonians to access WA Cares benefits and pave the way for insurers to offer affordable options to workers who want additional coverage,” said WA Cares Director Ben Veghte. “For most Washington families, the high costs of long-term care for a loved one can be devastating. As our population ages, there’s a growing need for resources like WA Cares that make families more resilient when a loved one needs care.”

Supplemental private long-term care insurance

The law creates new standards for private supplemental long-term care insurance policies designed to work alongside WA Cares. This structure is very similar to how Social Security and Medicare work. The public insurance provides a foundation of financial security for everyone, and private options are available for those who want more coverage.

Because WA Cares benefits will cover the deductible, insurers would be able to offer supplemental plans that are much more affordable – increasing access to long-term care coverage for Washingtonians.

The new supplemental policies must provide at least 12 months of coverage after WA Cares benefits are exhausted and allow people to keep their current care providers when transitioning between programs. The policies must also include options to reduce benefits rather than lose coverage if someone becomes unable to pay increased premiums, and they must cover care provided by qualified family members.

Opportunity for exempt workers to participate

The law also provides an opportunity for everyone who has a private long-term care insurance exemption to cancel their exemption and join the program. WA Cares has received more than 6,500 inquiries from customers who want to cancel their exemptions. Many customers said they were interested because of program updates such as partial benefits for near-retirees or the ability for workers who leave Washington to continue participating in the program and access benefits in the future.

The Employment Security Department will contact workers with approved private long-term care insurance exemptions to provide more information after this part of the law takes effect on Jan. 1, 2026.

Simplifying 10-year contribution requirement

To qualify for benefits, workers must meet the contribution requirement through one of three pathways. The lifetime access pathway, which most Washingtonians will use to qualify for benefits, previously required workers to contribute for at least 10 years without a break of five or more consecutive years.

Under the new law, this requirement is simplified to apply to all workers who contribute for at least 10 years. Workers who leave the workforce for an extended time will not have to restart their progress toward earning 10 qualifying years once they return. This will increase protection and improve access to benefits for those who stop working to care for children or older loved ones.

Workers who haven’t contributed for 10 years can also meet the requirement if they have contributed for at least three of the last six years at the time they need care. Workers born before 1968 earn pro-rated benefits for each year they contribute.

Additional changes

Other program updates in the law include:

  • Automating annual inflation increases to keep workers’ benefit amount growing over time – even after they stop working and contributing.
  • Creating an optional exemption for active-duty service members working civilian jobs in Washington (spouses of active-duty service members will continue to have access to their existing exemption option).
  • Allowing the program to pay benefits to a small group of eligible individuals before benefits become widely available in July 2026, ensuring administering agencies can pilot all systems and processes involved in paying benefits and address any issues in advance.

 

How the program works

Starting in 2026, WA Cares will begin paying benefits to eligible Washington residents who need help with daily activities like bathing, eating or taking medications. Workers earn benefits by contributing 0.58% of each paycheck to the program – about $24 per month for the typical worker. Workers who leave the state can choose to continue participating in the program starting in July 2026 and access benefits outside Washington starting in July 2030.

For more information about WA Cares and the new changes, workers can visit wacaresfund.wa.gov.

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