WA Cares program set up to help our expanding aging population

Editor's note: The following was written in response to a column by Kris Johnson, "WA Cares set to collect, despite flaws," published May 26.

If you’re a worker in Washington, even if you are near retirement, you’re soon going to be building a safety net to help you pay for long term care in the likely event you need help due to a serious injury, illness, disease or the normal setbacks that can come with aging.

Most people simply don’t have enough money saved to pay for someone to help us when we can’t use the toilet, bath, or make meals by ourselves. And the data tells us chances are high that you, or a family member, will have to take time off of work to help care for someone in your life. WA Cares is a new public benefit for working Washingtonians that will help cover expenses related to long term care such as home modifications, medical equipment, a home care aide, or even to get paid for your time caring for a loved one.

Unfortunately, some are spreading misinformation about WA Cares for their own political motives. The number of Washingtonians over 75 is expected to double in the next 15 years. A lot of folks don’t realize that Medicare and health insurance do not cover home care or the costs of living in a long term care facility.

Research shows that 70% of us will need some type of long-term care, yet 90% of Americans do not have long-term care insurance, either because they can’t afford it or are denied a policy because of a pre-existing condition. Many will be forced to drain their family savings to afford care and spend down to poverty level to qualify for Medicaid assistance.

Private long term care insurance is expensive. Annual premiums are several thousand dollars a year, higher for women than men, companies regularly jack up premiums, and you must continue paying premiums even after you stop working. Even if you can afford them, not everyone can get a private long term care insurance policy. In fact, one in five people will likely be denied long-term care insurance coverage due to pre-existing conditions like diabetes, cancer, or high blood pressure.

Long term care insurance companies are also notoriously unreliable, going belly up, canceling coverage, even charging women more than men. Most private insurance policies require a 90-day waiting period before reimbursing benefit claims; three months can seem like an eternity when you need help dressing, bathing, preparing meals or managing medication.

According to data collected by the U.S. Health and Human Service Department, most spells of intense need for long term care are relatively short; only 24% of older adults receive more than two years of paid long term care; and, only 15% spend more than two years in a nursing home.

WA Cares was not created to pay for 24/7 skilled nursing care for years. It was designed to be a critical lifeline of support for the majority of people who don’t yet need full time nursing care, but do need support with daily living tasks to be able to live independently at home as long as possible.

WA Cares provides $36,500, which will increase with inflation. That $36,500 goes a long way when you are paying for a home care aide to spend a few hours a week helping with meal preparation, medication management, transportation, or to cover the cost of home modifications and medical equipment.

Another erroneous claim being made about WA Cares is that the program isn’t fiscally solvent. In fact, actuarial projections for WA Cares solvency included scenarios where up to 1.5 million workers (50% of Washington workers) opted out of the program, still leaving the program solidly solvent through 2075.

The insolvency crisis is actually happening in the private long term care insurance market. Growing numbers of private long term care insurance companies are filing for bankruptcy. When these companies go out of business, they leave policyholders who have paid tens of thousands of dollars in premiums without the benefits they paid for when they need them.

Not all workers will tap into worker’s compensation or disability insurance that they pay into, or will ultimately depend on Medicare or Medicaid, but these programs provide a critical safety net that benefits our community as a whole. WA Cares strengthens that safety net by providing reliable, flexible funds to help pay for the care most of us will need at some point in our lives.

Washingtonians are fortunate to live in a state that is leading the way with innovative solutions like WA Cares that will help us stay in our homes when we are faced with disabling illness, unexpected injury, or the normal limitations that come with aging.

Laura Cepoi is executive director of the Olympia Area Agency on Aging, and Walt Bowen is president of Washington State Senior Citizens’ Lobby.

This article originally appeared on Kitsap Sun: WA Cares strengthens a safety net our state desperately needs