Can Washington State Lead the Way on Long-Term Care Financing?

WA Cares Can Offer a Potential Blueprint for Public Long-Term Care Financing Nationwide

May 21, 2026

By:

Ezekiel J. Emanuel, MD, PhD
and Benjamin W. Veghte, PhD, MPA

Print:

An older adult with a walker being led by a caretaker on a street with fall foliage.

This op-ed originally appeared in MarketWatch on May 13, 2026.

Here’s the good news: After declining for years due to “deaths of despair” and COVID-19, life expectancy in the U.S. has risen to 79 years, its highest level ever.

But now the bad news: As they age, millions of Americans will be exposed to risks that are serious, expensive and not covered by Medicare. More than 11,000 Americans are now turning 65 every day, and seven out of 10 will end up needing long-term care, which includes help with things like eating, bathing, using the toilet and managing medications. By 2040, the number of Americans age 85 and older will double.

And then there’s the really bad news: The vast majority of older Americans — and their children — have no way of paying for the help they are likely to need.

But there is a ray of hope. Washington state has embarked on a bold experiment that bolsters families by giving all workers a way to earn access to $36,500 worth of long-term care when they need it. And this initiative is likely to be a model for the country.

If the U.S. healthcare system is dysfunctional, then the long-term-care situation is a complete and utter disaster. Many aging Americans think Medicare will provide them with long-term care. They are seriously misinformed. Medicare does not pay for long-term care. It only covers medical and limited rehabilitation costs.

Medicaid does cover long-term care, but only for people who are poor or very close to it. In most states, an older adult must have very limited savings — often less than $2,000 — and less than about $3,000 per month in income to qualify for a nursing home or in-home care funded by Medicaid.

Read the full op-ed here.