Editorial: Act would help solve looming elder care crisis

By The Herald Editorial Board

One of the bipartisan success stories from last year’s legislative session was the passage of a long-sought paid-family leave law that put Washington state among only five states with such a law.

The legislation provides workers with up to 12 weeks of paid leave for the birth or adoption of a child or a worker’s or family member’s serious medical issue. Modest payments to workers on leave will be supported through payroll deductions, paid by employees and employers, that begin next year Jan. 1.

The state actually had a family leave law on the books since 2007, but the Legislature had never agreed to a funding mechanism. That changed last year, through bipartisan action.

The paid family leave law recognized the importance of work and family, helping families meet expenses when time away from work was necessary, while helping employers retain valued employees.

Lawmakers again, in addressing an issue that almost all families face, now has legislation before them that offers a similar solution.

According to a fact sheet prepared by Washingtonians for a Responsible Future, about 7 in 10 Americans, 65 or older, will need long-term care services, such as in-home or nursing home care, during their lifetimes. But neither Medicare, nor most health insurance plans provide for long-term care, which can include help with bathing, dressing, eating and hygiene. Care is available through Medicaid, but individuals must impoverish themselves to be eligible.

Those care services typically are either provided by family caregivers, through in-home agencies or nursing home care. All involve significant costs to the individual and often the family.

In-home care can annually cost an individual between $12,000 for eight hours of care a week and up to $59,000 for 40 hours of care, based on estimates from a 2015 cost of care survey, while nursing home care can run more than $100,000 a year. The average lifetime cost for long-term care amounts to $260,000, almost double the median retirement savings of $148,000 for those 65 and older.

Those who provide care for family members have to spend an average of 20 percent of their income for out-of-pocket expenses. And that doesn’t count an estimated $300,000 in lost income and benefits — and a significant hit to their own retirement savings — for those who quit work to care for a family member. The average loss is even greater for women, totaling more than $324,000.

And, as the baby boom generation ages — many who had been providing care for their elder relatives — fewer will be available to provide that care to them.

A recent report to the Legislature on long-term care options, found that in 2010 there were seven potential family caregivers for every individual. That ratio is expected to decline to 4 to 1 by 2030 — when the last of the baby boom generation reaches 65 — and 3 to 1 by 2050.

As with paid family leave, the proposed solution seeks a modest payroll deduction to support a trust fund that would pay a benefit for those needing long-term care.

The Long-Term Care Trust Act would levy a 0.49 percent tax, deducted from workers’ paychecks that would fund a long-term care trust. A worker grossing $4,000 a month would pay about $20 a month into the trust fund.

Those who have worked at least three of the last six years or ten years total would be eligible to draw from the fund for long-term care services in home or at a nursing facility. A worker could qualify for up to $100 a day for a total of 365 days over her or his lifetime. And the individual and families would choose how that benefit would be used.

Beyond peace of mind for aging adults and their families, the act would also address the increasing costs to the state for Medicaid spending. In its first year, the act would save the state $19 million in Medicaid costs; by its 10th year, it would save the state an estimated $70 million every two years. By 2040, that savings is estimated to be $1.4 billion every two years.

The bills, Senate Bill 6238 and House Bill 2533, have support from bipartisan sponsors, including Rep. June Robinson, D-Everett, in the House, and Sen. Barbara Bailey, R-Oak Harbor, who told the editorial board recently that the bill is a priority for her this session.

The act also has the support of a number of organizations including AARP; the Alzheimer’s Association; Washington Health Care Association; SEIU 775, which represents home health care providers; the Senior Citizens’ Lobby and the Adult Family Home Council. A recent statewide poll found that 62 percent of likely voters supported the act.

Tacking on an additional cost to workers’ paychecks will require careful consideration by lawmakers, but as our nation ages and health care costs continue to rise, we have to begin making provisions that will help us care for older family members soon and ourselves eventually.

Hawaii is the only state in the nation that has made a similar provision for long-term care.

As it was a leader for paid family leave, Washington state can set an example for other states in assuring long-term care for all.

Correction: An earlier version of this editorial gave an incorrect name for the Alzheimer’s Association.