WA Cares can provide long-term insurance benefits, director says

PORT ANGELES — It's a misconception only low-income people need long-term care insurance, WA Cares Director Ben Veghte told individuals from the Olympic Area on Aging and local caregivers at the Port Angeles Food Bank.

Sooner or later, most of us will, he said.

Veghte was in town on Tuesday to promote and answer questions about the nation's first long-term care insurance program that was created by the Legislature in 2019 and began collecting revenue in 2023. The failure of an initiative on the November ballot that would have allowed Washington workers to opt out of the program has renewed interest in how it works, what it does and how much it costs.

The program is administered by the state Employment Security Department and the Department of Social and Health Services and provides up to $36,500 in benefits that can be used to pay for expenses, such as residential health assistance, transportation to medical appointments, medical equipment and residential and nursing home care.

It's funded with a 0.58 percent payroll tax collected by employers. Self-employed individuals can opt into the program, as well.

Veghte said workers will pay far less into the program than what they will get out of it. For example, someone with an annual salary of $56,000 would pay $290 a year, a total of $8,700 over 30 years.

To access benefits, workers must contribute for at least 10 years. They also can access benefits if they contributed for three of the past six years at the time they applied.

Individuals like baby boomers — people born before 1968 — who are near retirement can earn lifetime access to 10 percent of the full benefit amount for each year they contributed.

The goal is to alleviate the need for people to drain their savings or spend down their assets to qualify for Medicaid in order to pay for the care they need, Veghte said.

"It is a resource that we all pay into it, but then when we need it, we have it," he said. "It gives us resources to meet the need however we choose."

WA Cares has been criticized for placing a financial burden on low-income workers and making them pay into a program that many may never dip into.

Veghte emphasized that the plan does not just benefit the individuals who paid into the program, but it eases the financial burden on family caregivers — most of whom are women — who may have to take time off from their jobs to take care of an aging or ill parent or partner. The insured can use his or her benefit to pay for that care.

"There is a misconception that only low-income people need it," Veghte said. "Middle class struggle to pay for care."

While the $36,500 benefit maximum has been criticized as not being nearly enough to cover long-term care expenses, Veghte called it "not meaningless."

"It's more than nothing," he said. "It gives the resources to meet the need, whatever that looks like. It provides a more dignified path to give people choices for home care, get meals delivered."

Only 10 percent of Washington residents can afford to pay for private long-term care insurance or pay for care out of pocket, he said.

"WA Cares spreads the cost of care across all of us," he said. "It's a more equitable way to spread the burden."

Veghte said the Long-Term Services and Supports Trust Commission, which oversees the program, has been working with the Legislature and insurers to develop a market for private supplemental long-term insurance that would allow people to use their WA Cares benefit as a deductible for a private policy.

"We realize the WA Cares benefit doesn't take care of everyone's needs; that is going to be considered by the Legislature in the next session," he said.

Unlike private long-term care policies, WA Cares guarantees care regardless of preexisting conditions and does not disqualify individuals prescribed certain medications, Veghte said. There are no deductibles and it doesn't require individuals to file claims. A number of wrinkles in the program have been ironed out, he said, such as making it portable so workers can access benefits even if they no longer live in Washington.

Veghte pushed back on claims that WA Cares is not financially sustainable. He said last year the state collected $1.4 billion in WA Cares revenue — more than had been anticipated. Right now, most of the funds are being invested by the Washington State Investment Board; benefits from the fund won't start being paid out until 2026.

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Reporter Paula Hunt can be reached by email at [email protected].