Washington became the first state to start deducting workers’ paychecks to fund long-term care benefits. (This story premiered on All Things Thoughted on July 25, 2023.)
Aisha Lascaux, Host:
When older people in the United States require long-term care from nursing homes and home care assistants, most have to pay out-of-pocket. The costs can be huge. Washington this month became the first state to try to address the problem with a public long-term care benefit funded by payroll taxes. From member station KUOW in Seattle, Eilis O’Neill provides more information.
Iris O’Neill, Byline: Veronica Tausiri uses a lift to get her mom out of bed every morning.
Veronica Tausili: So this is the Heuer elevator here. He’s my best friend (laughs).
O’Neill: Tausiri’s mother has been bedridden for over three years due to complications from diabetes, a broken femur and cancer.
Tausiri: I’m going to come in every morning and undress her and then clean her up. I have to lift her up on her Hoyer lift to change her sheets.
O’Neil: Tausiri and her mother live at her sister’s house about an hour south of Seattle. In 2020, Tausiri quit her job as an escrow officer to take care of her mother full-time. She cashed in her severance pay to pay for her living expenses. Since then she has had little time off.
Tausiri: When I go out, I always have a time limit. Because I have to go back home to change my mother.
O’Neill: Tausiri’s mother will no longer be able to benefit from the state’s new long-term care program. You have to pay for at least 3 years to withdraw anything. If the program already existed, it would not cover Tausiri’s mother’s full-time care. But Tausiri could have been used for respite care, and she could have hired a home caregiver after she injured her shoulder in a car accident and was unable to lift her mother. she says.
David Grabowski: Here in the United States, we rely heavily on family caregivers because we don’t have a public system in place.
O’Neill: David Grabowski is a professor at Harvard University who studies health policy. He said paying for long-term care is a challenge for families across the country. That’s because Medicare doesn’t cover long-term care. Private long-term care insurance is expensive and usually has a cap on benefits. If you have a pre-existing condition, many people do not even qualify for it. So people have two options. You can either dump all your savings and get Medicaid, or rely on your family.
Grabowski: Unpaid care is not free. We primarily provide this care to women and low-income individuals. To do this care, I often have to take time off from work.
O’Neill: About 7 out of 10 people will need long-term care at some point. Washington’s new payroll tax will automatically take the state from most people’s monthly paychecks. After that, if you need help with basic tasks of daily living, you can apply for lifetime benefits of up to $36,500, which will increase with inflation.
Cathy McCall: The future is a little scary, but at least I know I’m in for it.
O’Neill: Kathy McCall is advocacy director for AARP Washington and an advocate for the new program. McCall said people could use the money to pay for home care or respite care. again…
McColl: For many people, building ramps in their homes is enough to keep them living in their homes. Or maybe it’s just meal delivery.
Mr. O’Neill: Among those opposing the new program are state Republican legislators who argue that the private insurance market would have been a better option.
(Soundbite from archived recording)
John Brown: This is a woefully inadequate program.
O’Neill: State Senator John Brown held a press conference shortly after the payroll tax went into effect. He said the new program would not provide enough money to pay the full cost of long-term care. And another tax is bad for Washington residents.
(Soundbite from archived recording)
Brown: This is going to be another step in the inability to pay the cost of living in Washington state for workers as a whole.
O’Neill: Proponents of the tax agree that it’s not enough to pay for years of care. They see this as a bailout during short-term crises or a way to help people stay home longer. Meanwhile, other states are moving in the same direction. California is considering a tax similar to Washington, and several other states are considering options. I’m Aerith O’Neill from the Seattle area, NPR News.
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