Washington Cares, a state-operated program for long-term care insurance, is scheduled to begin distributing benefits on July 1, 2026. Payroll deductions for the program began in 2023.

The program has operated for a decade and survived two statewide votes attempting to overturn or weaken it. Approximately 3.7 million workers participated in Washington Cares last year, paying an additional 0.58% in payroll taxes.

Workers who contribute to Washington Cares for 10 years qualify for a lifetime benefit of $36,500, with the amount rising with inflation. For instance, a 36-year-old earning approximately $50,000 annually and contributing $291 per year for a decade could have a projected $98,000 benefit if assistance is needed at age 75. Participants who were in their 60s when deductions started in 2023 receive half the lifetime benefit.

Washington Cares benefits can be used for a range of services, including home care, transportation, adult day programs, home modifications, compensation for family caregivers, assisted living facilities, and nursing homes. Richard Frank, director of the Center on Health Policy at the Brookings Institution, stated, "Long-term care is the largest area of unprotected health risk in the United States."

An estimated 70% of Americans will need long-term care at some point in their lives. Medicare covers healthcare costs but rarely includes long-term care, whether at home or in facilities. Medicaid does cover long-term care, but it has strict limits on income and assets. "People are under the misconception that Medicare will pay for this," said Cathleen MacCaul, advocacy director for AARP Washington State. "They haven't planned for it or saved for it."

The private long-term care insurance market has seen companies like Genworth, John Hancock, and MetLife exit. In 2010, the Affordable Care Act included the CLASS Act, which aimed to create a voluntary long-term care insurance program, but the Obama administration deemed it unworkable. Private long-term care insurance sales have declined over time, with about 235,000 Americans purchasing stand-alone policies in 2010, compared to fewer than 35,000 in 2024, according to a LIMRA report. The average annual premium for new stand-alone policies in 2024 was $3,265."It's crazy expensive," said Kelly Haggett, a systems administrator in Auburn, Washington. Haggett added, "If I required care and it would protect my wife from having to spend our savings, $18,250 is not meaningless."