Washington State’s Public Option for Long-Term Care Costs — What It Means for Aging in Place

As long-term care costs continue to climb, with home care and assisted living expenses rising dramatically, families across the country are searching for better ways to protect their savings and help loved ones remain at home. Washington State has launched a pioneering public program that offers a new tool in that fight: the WA Cares Fund, the nation’s first state-run long-term care insurance program.  I first discussed this option in my 2019 article, "Washington State May Be First State With Payroll-Funded Long Term Care Insurance Benefit."

What Is WA Cares?
Enacted in 2019 and beginning to pay benefits in 2026, the program is funded by a modest payroll tax (currently 0.58%) on Washington workers. Qualifying residents can receive a lifetime benefit (up to approximately $36,500, adjusted for inflation) to help cover a wide range of long-term care needs, including:

• In-home personal care
• Adult day care
• Assisted living
• Nursing home care
• Other supports that help people remain independent.

Importantly, these benefits can be used to pay family caregivers in many situations, providing real support for the unpaid family members who do the majority of caregiving in America.Why This Matters for Aging in Place
For those of us who advise families on staying in their homes as long as possible, programs like WA Cares are encouraging because they:

• Reduce the financial pressure that often forces premature institutionalization.
• Provide a baseline of support that can be combined with private savings, long-term care insurance, or Medicaid planning.
• Recognize the value of home- and community-based services rather than defaulting to nursing home care.

However, the benefit cap means most people will still need additional planning. A $36,500 lifetime benefit is helpful but, for example,  will not cover years of 24/7 care. Lessons for Families Everywhere
Even if you don’t live in Washington, this development is worth watching. Several other states are studying similar programs, highlighting the growing recognition that the current reliance on Medicaid spend-downs and family sacrifice is unsustainable.
Proactive steps you should take:

• Understand Your State’s Landscape: Know what public programs (if any) exist and their limitations.

• Layer Protections:  Deploy long-term care insurance, short- and long-term disability plans.   If you purchase annuities or life insurance, look for those that offer bonuses, benefit acceleration, or a waiver of surrender fees.   If you or your spouse is a veteran, investigate eligibility for the Aid and Attendance Benefit, a non-service disability pension available to vets who served during wartime (even if they never served in combat or overseas).   Shop Medicare Advantage Plans for home care and/or disability benefits.  Don't forget to consider Medicaid Asset Protection Trusts (MAPTs), hybrid life/long-term care policies, and proper asset titling.

• Plan for home care explicitly:  Document preferences for aging in place in advance directives, designate caregivers, and build a realistic budget that accounts for gaps in public coverage.

• Review powers of attorney and trusts: Ensure documents are robust enough to handle long-term care coordination and asset protection.

The Bottom Line
Washington’s WA Cares Fund is an innovative step forward, a public option that can ease the burden on middle-class families without requiring complete asset depletion. It won’t solve every problem, but it reminds us that creative solutions are possible and that waiting until a crisis hits is far more expensive than planning ahead.
If you’re concerned about how long-term care could affect your family’s ability to age in place, now is the time to act. A comprehensive plan tailored to your state’s rules and your family’s needs can provide peace of mind and preserve dignity and independence.