Opinion: State’s long-term-care law ‘is broken beyond repair’

Elizabeth Hovde of the Washington Policy Center states the case why lawmakers need to repeal the state's long-term-care law

Elizabeth Hovde of the Washington Policy Center states the case why lawmakers need to repeal the state’s long-term-care law

Elizabeth Hovde
Washington Policy Center

Washington state is hosting webinars to discuss issues related to caregiving and long-term care — and to try and rally support for WA Cares, the government-run program created by a 2019 law and that is supposed to be funded by a new payroll tax on workers. 

Elizabeth Hovde
Elizabeth Hovde

The law has been hard to support. Even the governor and a Democratic-led Legislature that brought WA Cares into existence worked to delay the law’s payroll-tax collection until July 2023. That’s when W2 workers will start seeing a 58-cent-per-$100 payroll tax eating up more of their income. And they might never see the money again, despite the state’s assurances that it is going toward a benefit workers can use for long-term care needs. (Long-term care is considered to help with activities of daily life, such as bathing, meal preparation, taking medications and so on.)

The delay was sought to give the Legislature a chance to try and clean up the financial and fairness trainwreck that is WA Cares. Lawmakers and a state commission are trying to get the program closer to solvency, which may require a higher tax or a lower program benefit. They are also trying to make the law less of an easy target for hate, since it seems like WA Cares was set up in a way that ensures most people in the state never qualify for the program, given vestment criteria and other eligibility requirements. 

If most people don’t qualify, however, lawmakers can hardly brag that they have solved the long-term-care (LTC) crisis coming at us as the population grays. They will have only cost-shifted some of the state’s long-term-care spending onto workers. I have written a paper outlining many of the law’s shortcomings and harms. See it here.

In addition to financial and fairness problems, this long-term-care law is riddled with misguided compassion. That brings me to the lastest WA Cares webinar. It was called, “The Gender Gap in Caregiving.” During it, the host and guests painted a picture of women as victims to try to get more support for the off-target law. How are women victims? Women are more often family caregivers than men, and family caregivers often aren’t paid for helping loved ones as they age. 

On the other side of long-term care, women live longer. And instead of viewing men as the victims in that fact, the state has been insistent about suggesting that women are mistreated by the private long-term-care insurance industry, as plans can cost them more. Rarely is it explained that the higher cost is because women live longer and are more likely to need long-term care. Acknowledging this would take the fire out of the “women are mistreated” claim often made by WA Cares’ representatives.

The gender-gap webinar extolled the value of WA Cares, making it clear that one of the primary groups of people this law was created for and would help was long-term caregivers: The WA Cares Fund will collect taxpayer money that can provide caregivers, including family caregivers, a wage. There is a catch. The law outlines that caregivers who are paid by a recipient of fund dollars must have state-required, state-chosen training. It is also worth noting that Service Employees International Union 775, which is among the largest campaign donors in the state, lobbied for the law’s passage and continues to seek support for it today. 

It is possible that officials at the Employment Security Department will grant a monopoly to Service Employees International Union 775 to provide the required training — and that family caregivers will pay dues to this union. Stay tuned.  Details are yet to come.

The training requirement could naturally increase the cost of caregiving for the elderly. It could also bring a substantial financial windfall to SEIU 775.

Given the union’s strong interest in WA Cares, it was no surprise to me that the political and advocacy coordinator for SEIU 775 was one of the webinar’s panel guests. At one point, Jessica Gomez-Barrios of SEIU said, “Washington state is a national leader in long-term care, in part because our Medicaid program includes paid family caregiving, bringing thousands of unpaid women caregivers into the workforce, and WA Cares will bring in even more.” SEIU 775 represents thousands of long-term-care workers.

The gender-gap webinar did not touch on a few important ways in which the law will actually work against some women. For starters, to receive a benefit from WA Cares, you need to have paid the payroll tax for 10 years, without a break of five or more years. This contribution detail imposes a particular hardship on people who choose to take time away from formal work to raise a family or care for elderly relatives.

Another problem for some women (and men)? The regressive payroll tax means some low-income workers will be forced to hand over a portion of their income to benefit not their later selves, but others with higher incomes and who may not need help. This program creates a safety net that is far too wide. 

Lawmakers need to repeal the state’s long-term-care law. It is broken beyond repair. 

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


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