Opinion: WA Cares could continue to change, despite promises

Elizabeth Hovde states that the theme about WA Cares has been constant since 2019 when lawmakers passed this misguided law that takes more of workers’ wages for a benefit many will never see.

Elizabeth Hovde states that the theme has been constant since 2019 when lawmakers passed this misguided law that takes more of workers’ wages for a benefit many will never see

Elizabeth Hovde
Washington Policy Center

A theme continued in the latest meeting of the state commission overseeing WA Cares, the state’s new long-term-care program that most workers in Washington are forced to fund. The theme has been constant since 2019 when lawmakers passed this misguided law that takes more of workers’ wages for a benefit many will never see and regardless of the benefit’s inadequacy to meet long-term-care needs: Count on nothing, as parameters can change and nothing is set in stone.

The Long-Term Services and Supports Trust Commission is charged with making recommendations to the Legislature annually that might make a bad law less bad. Last week, the commission voted on a new set of recommendations that deal with naysayers’ airing of grievances about WA Cares.

The Legislature, it should be noted, did not pass the recommendations the commission made at the end of 2022. If an initiative trying to gather enough signatures this month to make the WA Cares tax optional is on the ballot in 2024 and passed affirmatively by voters, these past two years of recommendations for the flawed law won’t be as necessary.

Here are a few of the latest happenings that have me reminding Washingtonians that the state’s LTC program is not likely to offer what the state is promising: peace of mind for your personal LTC needs and a solution for the state budget in a graying population.

State budget savings? Probably little, if any

As a commenter and LTC industry leader noted in the meeting on Dec. 12, the savings WA Cares brings to Medicaid is tiny, as little as 1 percent by his calculations. He says the state expresses anticipated Medicaid savings in absolute terms, which can sound like a lot to those watching along and to lawmakers voting on WA Cares. However, when broken down in a percentage, the savings are able to be viewed in better context.

I need to crunch numbers again, but in 2019, the Washington Policy Center (WPC) already knew that Washington state workers were being asked to pay a lot for a little. And in the past three years, we have consistently said WA Cares is not likely to save the state from its mounting LTC costs. Reforming Medicaid, however, could make a good dent. We’ve also pointed out that promises to workers that they should have “peace of mind” about LTC because of WA Cares, as the WA Cares website says, could backfire. It could leave even fewer people planning, saving for or investing in this life need and more people needing taxpayer support.

This new payroll tax, WPC tries to show, hurts workers, especially low-income workers. Income is being taken from them that could have been used for life needs they do have. Instead, it will sometimes be given over to people not in need of taxpayer help. That’s twisted, sister.

Medicaid is a federal-state safety net we already fund with our taxes to help people without means fund end-of-life care or sudden health needs. Instead of strengthening and protecting that safety net, the state created a safety net for people in need and people not in need.

Inflation-adjusted? Maybe

This new safety net, regardless of need, is also insufficient for covering most people’s long-term care.

In the December meeting, a senator on this committee of lawmakers and stakeholders asked a question about the “up to $36,500 benefit” that some workers will now be counting on, even if they can’t. (See a list of hurdles that might get in the way of receiving the money here.) Sen. Curtis King, R-Yakima, asked if that amount rises with inflation automatically or if it is subject to approval of some kind. Well, it turns out approval is needed.

The commission was informed the Office of Financial Management will have a “benefits council” making decisions based on actuarial modeling about “how far up” the benefit can go, but it is capped at the rate of inflation. Another senator expressed worry that the LTSS members wouldn’t have a say in the increased amount. He worried the amount might rise too high to keep the fund solvent. (Solvency of WA Cares is already another maybe.)

A $36,500 benefit for LTC is already considered an inadequate amount for most people’s needs. Since 2019 when the long-term-care law passed, the amount has already fallen behind the actual cost of care. By 2026, it will be even further behind. (See Genworth’s “Cost of Care” survey here.) Good catch, Sen. King.

The answers given and comments made at the latest meeting, as well as a long list of recommendations going to lawmakers to try and fix a broken law that can’t be fixed, reveal that this program and tax continue to be a work in progress, full of maybes.

Count on nothing but lower wages.

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.