Opinion: Recertification, portability and other recommendations are in the making for state’s long-term-care law

Elizabeth Hovde of the Washington Policy Center still believes the new law should be repealed and not just fixed

Elizabeth Hovde
Washington Policy Center

When the Long-Term Service and Supports Trust Commission met this week to discuss various tweaks to Washington state’s long-term-care law, it was a good reminder that the law should be repealed, not “fixed,” as lawmakers have suggested can be done.

Subcommittees are working hard to come up with legislative recommendations that would make the law better for some, but it would still be unfair to most. The law lowers workers’ wages, takes away choice and penalizes work. Solvency concerns also remain, and the law’s messaging erroneously discourages private plans for long-term care.

Here are some highlights from the meeting:

Portability

Portability options were discussed. A subcommittee is trying to find a way to allow people who pay into the WA Cares Fund, the program created by the law, to receive a benefit if they move out of state. Right now, any earned benefit disappears at the state line.

WA Cares director, Ben Veghte, said it is feasible to provide portability in the ways the subcommittee is proposing. That is the first time I have heard that.

This change would be good. It would remove one of the hurdles set up to keep people from benefits that the program falsely promises. Then again, the options being considered introduce new fairness concerns. And one of the options only allows people who move before they have paid the payroll tax for 10 years to continue paying taxes.

Veghte says an advantage of this option is that “not everyone would elect to keep their benefits portable by continuing to pay in. And so you would have a smaller number of people getting full benefits once they left the state.”

Another option would provide significantly reduced benefits to people who paid in and then moved out of state. However, this option would likely have administrative costs that are unattractive, Veghte explained. Watch the meeting to learn more about portability options in consideration.

Recertification for those already exempt

The Workgroup on Recertification and Rescinding Private LTC Insurance Exemption advises requiring recertification of those exempted because they had private long-term-care insurance. Recertification would be required not more than once a year and no less than every three years. It would begin in Dec. 2024. The workgroup also wants to give people who initially opted out of WA Cares the option to get back in. That could improve the solvency of the program, a workgroup member says.

Sen. Curtis King, R-Yakima, rightly worries that requiring recertification rewrites the law and treats this exemption population poorly. He also stated his belief that if you are going to be changing the law, it should change to allow others who can find better, private options to be exempted from WA Cares.

Sen. Karen Keiser, D-Des Moines, expressed concern about the idea that people who are already exempted would be allowed to opt back in. Right now, these people have been told there is no re-entry into WA Cares.

Other matters

Health criteria for eligibility was discussed and should be a red flag for all those hoping to benefit from the social program someday. You might get a benefit, if you vest enough years paying 58 cents on every $100 of earnings and if you need the care that is outlined. Health criteria attached to private long-term-care insurance is more generous.

Next up, even proponents of the long-term-care law expressed concern that a program meant for late-life care goes too far and wide. It will also serve as a disability program of sorts. The law says WA Cares is available to anyone who has vested (meaning they have paid the payroll tax enough years) and needs help with three or more daily life activities. The person could be young or old, and other state programs could be available to them.

Supplemental insurance that wraps around WA Cares was discussed, and the commission is rightly involving insurance providers and their knowledge in the discussion. For most people who need long-term care, $36,500 won’t be enough, making a seamless product for private LTCI desirable. People who exhaust the WA Cares benefit and their own savings, of course, will head to Medicaid, an outcome WA Cares was created to try and prevent.

A bright spot at Tuesday’s meeting was discussion about changing a vesting requirement from 10 years “without a gap of five or more consecutive years” to just 10 years over your career. I have been writing about the problem with that provision in the law for a year. The “without a gap of five or more consecutive years” requirement would impose a particular hardship on those who choose to take time away from formal work to raise a family or care for elderly relatives — some of the very people WA Cares is supposed to be helping. Solvency watchers said this change would be negligible.

Repeal the law

The commission had a lot of work to do, and it is doing it. Instead of spending all its time on potential legislative “fixes,” I wish it could make the recommendation that the state repeal the law and get out of the long-term-care-insurance business.

Read my full policy brief to learn more.

Elizabeth Hovde is a policy analyst and the director of the Centers for Health Care and Worker Rights at the Washington Policy Center. She is a Clark County resident.