The thing about laws is that it’s easy to forget about them. Even after bills pass through both chambers and receive the executive’s signature, their rules—say, an income tax, or a foam cooler ban—may not take effect for a year, or two, or four. Their passage draws headlines. But their implementation? That’s often less newsworthy.
So perhaps it should come as no surprise that the rollout of Washington’s first-of-its-kind long-term care benefit program, despite receiving plenty of attention upon its 2019 passage in Olympia, has snuck up on many in the Evergreen State. Starting on January 1, 2022, W2-holders will pay 58 cents for every $100 of income they earn until they retire. That money gets dumped into the WA Cares Fund, a trust that provides all eligible workers with a maximum $36,500 lifetime benefit if they need help with at least three activities of daily living—think eating, bathing, and dressing—after qualifying for the insurance. The state estimates that seven of 10 Washingtonians will use it, allowing them to avoid some out-of-pocket costs that hamstring an aging population. “This is a crisis right now as you get older, and really difficult to navigate,” says Ben Veghte, director of the WA Cares Fund at the Department of Social and Health Services.
In 2021, lawmakers added the legislative equivalent of “speak now or forever hold your peace” to the policy. If residents have private insurance as of November 1, they can secure an exemption by December 31, 2022, from the program and its strict terms. To receive any benefits, participants must have worked and contributed to the fund for at least 10 years (without a break of five or more), or three of the last six at the time of applying for the benefit—people retiring in the next year or two won’t see anything. The benefit is not portable, meaning those who move away from Washington can’t use it. And the benefit is capped, so high earners will pay more to receive the same amount of insurance.
Some observers have already weighed in on the fund. Washington Policy Center’s Elizabeth Hovde deemed the $36,500 benefit “a laughably small amount” and called for a repeal in an opinion piece for The Seattle Times. David Donhoff of Leverage Planners Wealth Management has started a website, stopthetaxbleed.com, complete with a countdown clock to opt out and a video explaining the finer points. But in a state that’s long squawked over taxing salaries, this mandatory paycheck clipping has arrived with a whisper rather than a cacophony. “I am really surprised at how few people are aware of this,” says Teresa Wells, managing director and co-lead of Seattle Operations at Tiedemann Advisors.
Those who are have a leg up. Wells has encouraged some of her clients (often “ultra-high-net-worth families”) to seek out private insurance. Even those who aren’t in that category might want to consider it, perhaps those making upwards of $75,000, Wells estimates (Donhoff recommends opting out if you expect to make over $70,000 during your career; another wealth manager puts that number at $104,000). Everyone deliberating will definitely want to hurry up and decide: Wells has heard that insurance companies are inundated with requests, backing up the underwriting process by as much as two months. And if people do want to lock down an exemption, they must file by January 1, 2022 to avoid paying the state’s premium along with their private insurance cost.
Workers with on-the-ball HR departments have alerted their employees. Microsoft, for instance, allowed an insurance carrier and broker to offer employees individual long-term care insurance, though the software giant didn’t sponsor or endorse the coverage, according to vice president of global benefits and mobility Fred Thiele. At Amazon, Washington state employees have the option to opt into a long-term care coverage.
Which raises the question: If affluent tech types are opting out, doesn’t that deplete the WA Cares Fund before it’s even begun collecting? Not so, says Veghte. He doesn’t know how many workers will ultimately seek exemptions, but he says the state figured a significant number of opt-outs into its projections. And when future high earners move to the state, they’ll be automatically enrolled in the program. No wiggling away. “If a few hundred thousand people opt out this year,” says Veghte, “it has a small impact on our finances over a 75-year time frame.”
Veghte has heard the critics bemoaning the fund’s lack of flexibility and final benefit. Some neglect to mention that private insurance industry premiums can last long after retirement, he notes, and that these companies “have an interest in insuring people who are least likely to need care.” People with health problems can get turned away for being high-risk, or have to pay a higher premium, “whereas our goal with the WA Cares Fund is to cover people and cover everyone,” says Veghte.
But is it enough coverage? Veghte acknowledges it’s a modest amount. He adds that the current law isn’t necessarily going to stay the same. The total benefit of $36,500 may increase over time (potentially the premium, too) as the state works with private insurers to provide supplemental coverage. “Ideally, five, 10 years from now, we’ll have a situation where many Washingtonians, almost everyone, has this core program, the WA Cares Fund,” Veghte says. “And then people who want more have purchased more on the private market.”
A group is also exploring ways to address the portability challenge, perhaps working with provider networks in other states. Yet, even as Washington works to make the nascent social insurance program viable for the masses, Veghte feels like some are missing the point of the premium, an irony given our pandemic state. “What bothers me about this is everyone’s looking at it from their own individual perspective,” he says, “and we’re not thinking about the community.”