“Consistent with the nationwide pattern, Washington state has been experiencing a steady increase in its elderly population, which has resulted in a proportional rise in the number of individuals in need care and constitute a significant portion of overall spending. In 2015, the state legislature passed a bill which mandated the Department of Social and Health Services to conduct an independent feasibility study of options to make LTSS affordable for Washingtonians.128 To fulfill this mandate, an actuarial firm was commissioned to explore possible solutions, focusing on two options: (1) a public long-term care insurance program funded by workers via payroll deductions (like WA Cares), and (2) a public-private reinsurance or risk-sharing model. After consulting with various stakeholders, the firm determined that the first option was the only viable approach since relying on the private insurance market would not reach ‘a broad and affordable solution.’129“
Source: Evelyn Wynn, Washington Cares: Other States Should Too, 75 UC Law SF L.J. 879 (2024).
“Social insurance programs are designed to be funded either entirely or partially through contributions by participants, including workers, employers, and sometimes even retirees.137 In Washington, such contributions are funded only by employers through a payroll tax that amounts to 0.58 percent of wages, or $25 a month for the typical worker in Washington.138 This contribution rate prioritizes sustainable financing as it is much lower than rates implemented in other countries,139 primarily due to substantial income inequality.140 The contribution rate is designed to be super progressive with no cap, which means that high earners will pay more in premiums than those with lower incomes. This design ensures that the burden of financing the program is equitably distributed.141 Washington state policymakers determined that their residents would be willing to pay this payroll tax contribution at a level considered affordable for most of their population.142
“The benefit was designed to be modest, with a maximum lifetime benefit of $36,500 per person. The benefit is expected to keep up with inflation,143 which makes it a valuable investment for many Washingtonians. WA Cares provides a foundation to meet LTSS costs and functions similarly to social security in that the foundation is sourced by a payroll tax.144 Because the costs of long-term care can vary widely depending on the individual’s needs, the program offers a middle ground that can help protect people from catastrophic expenses. 145 The program is not intended to address all long-term care needs, and individuals are free to purchase private insurance if they so choose.146 In fact, the introduction of WA Cares is expected to foster greater competition in the private insurance market, leading to more adaptable and better insurance policies.147
“Washington state residents who work at least five-hundred hours a year and have paid the payroll tax for either ten years without interruption of five consecutive years, or three years within the last six, are eligible for the WA Cares Fund.148 Federal employees who work in Washington do not contribute to the fund, and employees of tribal businesses only contribute if their tribe has opted in. Self-employed individuals may choose to participate, but it is not mandatory.149 The benefits become available when the worker or retiree requires assistance with three or more activities of daily living (‘ADLs’), which are defined more broadly by the state than by private long-term care insurance policies.150 The benefits are paid directly to service providers or family caregivers, as long as they receive minimal levels of training, and do not count as income for determining eligibility for Medicaid or other state safety-net programs.151“
Source: Evelyn Wynn, Washington Cares: Other States Should Too, 75 UC Law SF L.J. 879 (2024).
Washington: Demographic and Economic Data
Population estimate, July 1, 2025 (Census Bureau Data Vintage 2025): 8,001,020
Persons under 5 years, 2025 (%) (V2025): 5.3%
Persons 65 years and over, 2025 (%) (V2025): 18.3%
Persons without health uninsurance under age 65 years, 2024 (%) (2024 American Community Survey): 7.8%
Per capita income in past 12 months (in 2024 dollars), 2020-2024: $53,744
Source: US Census Bureau, “QuickFacts: Washington,” Accessed July 4, 2026.
Maryland: All-Payer Model
• The AHEAD (Achieving Healthcare Efficiency through Accountable Design) Model
Oregon: Universal Health Plan
Washington: WA Cares Fund
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Page last updated July 4, 2026 by Doug McVay, Editor.