Here's why Washington's long-term care program is a game-changer

As a former competitive rower and a typical Pacific Northwesterner who bikes, skis, backpacks, and kayaks, I consider myself a healthy person. Now that I'm "middle-aged," a common conversation with my peers is the care our parents need. We also discuss how we'd manage if we ever needed help with things like dressing, getting around, and meals. Those who are parents worry about becoming a burden to their children, and those without kids wonder how we'll stay in our homes instead of moving into assisted living facilities.

When I learned that neither health insurance nor Medicare covers long-term care expenses like a home care aide, I applied for private long-term care insurance to protect my retirement savings. I was shocked when I was denied a policy due to a pre-existing condition, despite the fact my rare urological condition was surgically corrected in childhood. The exclusion of people with pre-existing conditions and the exorbitant cost of long-term care insurance premiums (ranging from $2,000-$7,000 or more annually - even after you retire) explains why only 3% of Americans have long-term care insurance policies. (See www.cbsnews.com/news/long-term-care-insurance-costs-by-age.)

From my decades-long healthcare career advocating for patients, I know firsthand the importance of being seen as "normal" and "capable", not someone requiring assistance. But it's a fact of life that most of us will need help at some point, whether due to a disease like multiple sclerosis or cancer, chronic conditions like arthritis or diabetes, limitations from a serious injury or accident, or the normal challenges of aging.

Washington's long-term care benefit ( wacaresfund.wa.gov) will be a game-changer, whether we need care or become a caregiver for loved ones someday. Because it's a public state-backed benefit, it doesn't discriminate against the 50% of us who have some kind of pre-existing condition.

And unlike private long-term care insurance, everyone pays the same low rate, only while working. We can use the $36,500 benefit (which will rise with inflation) for home care aides or even pay a family member to care for us, and it has no daily limits. We can tap it to cover home modifications like ramps and grab bars, or medical equipment like a wheelchair or hospital bed, enabling us to live as independently as possible at home.

But Initiative 2124 ( tinyurl.com/I-2124-details), sponsored by hedge fund billionaire Brian Heywood, threatens this essential safety net. I-2124 is deceptively framed providing a choice to participate or not in the program. However, it's important to understand what initiative backers know and intend: the impact would be to take the benefit away from millions of low and middle-income working families - the very people it was designed to help most.

Independent long-term care and insurance industry experts say making participation optional would effectively kill the program. Like Medicare or Social Security, Washington's long-term care benefit depends on a broad base of contributors in order to keep premiums low and ensure sustainability.

Eliminating Washington's long-term care benefit threatens people like me with pre-existing conditions who have no alternative, and disproportionately harms women, who most commonly leave their jobs to care for family members. If approved, the initiative will put us at the mercy of for-profit insurance companies that routinely delay or deny coverage, refuse to cover people with pre-existing conditions, and habitually increase premiums by 50, 100 or even 300%. It will leave low and middle-income working families with no option but to drain their life savings and sell their assets to qualify for taxpayer-subsidized Medicaid.

In response to the worsening long-term care crisis, Washington's long-term care benefit was pioneering. Many other states, including California, have similar programs in the works. Critics who argue it doesn't solve the problem perfectly should remember that programs like Social Security, Medicare and Medicaid all faced doubts and calls for changes. Today, most of us couldn't imagine life without them. The same will be true of WA Cares in the years ahead.

I am fortunate that my siblings and I can afford to scale back or leave our jobs when my mom needs more help, but not everyone is so lucky. By ensuring everyone is able to access the care and support they need to live with dignity no matter their circumstances, Washington is leading the way in creating a more compassionate society.

Pull Quote

It's a fact of life that most of us will need help at some point, whether due to a disease like multiple sclerosis or cancer, chronic conditions like arthritis or diabetes, limitations from a serious injury or accident, or the normal challenges of aging.