WA Cares: Research

In 2019, Washington became the first state to pass legislation creating a public long-term care insurance program. In doing so, we are leading the way in addressing a nationwide crisis: an aging population in which the vast majority lack the financial resources to pay for the care they need as they age.

Passage of the Act required five years of in-depth study and analysis. There was agreement early on that a primary goal was to avoid individuals spending down assets into poverty before they could get care. The stakeholders advocating for adoption included groups with widely varying interests, including assisted living, adult family home and nursing home providers; labor unions; area agencies on aging; businesses; the AARP, and more. Many of these stakeholders had divergent interests, so benefit design required intense negotiation to maintain actuarial soundness while providing benefits that would be useful in an operational system.

Read on for more information about the background and history of creating the WA Cares Fund.

Long-Term Services and Supports (LTSS) Trust Commission

The Long-Term Services and Supports Trust Commission comprises legislators, administering agencies, and stakeholder representatives. The Commission makes recommendations regarding criteria for determining who is a qualified individual, minimum provider qualifications, service payment maximums, actions needed to maintain Trust solvency, and monitoring of agency expenses.

Washington Long-Term Care Trust Fund: A Campaign Explained

From academics at the University of Southern California:
"The passage of the Long-Term Care Trust Act led by Washingtonians for a Responsible Future gives hope to families struggling to afford to care for their loved ones. We were truly inspired by this impressive win and how it provides the nation a vision of what is possible. Our hope is that this report portrays the collective experience of those who played a part in making the Long-Term Care Trust Act a reality, and that it celebrates their hard-won victory. And, we hope that sharing the Washington story will help other coalitions and states advance systems of care that are dignified and sustainable for the workforce, and are more supportive and accessible for all families."

The Future Of WA Cares: A Response To Warshawsky

From Health Affairs, the leading journal of health policy thought and research:
"Medicaid covers LTSS for people with meager income and assets and accounted for 42.9 percent of all spending on long-term care. Medicare covers limited home or institutional care for people after they have spent three or more days in a hospital and accounted for 20.5 percent of LTSS spending. Private long-term care insurance plans covered only about 5 percent. Much of the rest is paid out of pocket by individuals or charitable organizations. All of these coverage options are fragmented and flawed in various ways."

Office of the State Actuary

The Office of the State Actuary is responsible for providing recommendations to the Long-Term Services and Supports Trust Commission and the Legislature on actions necessary to achieve and maintain trust solvency.

This webpage provides readers with actuarial studies about the fund's solvency, Milliman, or LTSS Trust Commission supporting the WA Cares Fund.

• OSA Reports & Resources
• Milliman Actuarial Studies/Reports
• LTSS Trust Commission Risk Management