In an effort to better fund and increase access to long-term care, U.S. Rep. Thomas Suozzi (D-Ny.) on Thursday introduced the Well-Being Insurance for Seniors to be at Home (WISH) Act.
“We have a storm coming, with the number of disabled elders expected to double in the coming years,” Suozzi said in a statement. “Fewer family caregivers are available for these aging Americans and the market for long-term care insurance is not currently sufficient to address these demographic challenges.”
The newly introduced legislation comes at a time when the Biden administration throws its weight behind expanding home- and community-based services.
As Suozzi’s comment suggests, the WISH Act seeks to address shifting demographics in the U.S. The number of individuals 65 and older will more than double over the next 40 years, reaching 80 million by 2040, according to the Urban Institute.
Roughly 70% of people who are 65 or older will require a high level of long-term care before they die, according to Richard W. Johnson, senior fellow director at the Urban Institute. Despite that need, many seniors are unable to pay for home-based care and other services, especially middle-market individuals who do not qualify for Medicaid.
“Long-term care insurance is rarely available, and premiums have pushed plan-holders to drop out,” the legislation states. “Only 6% of seniors had any private coverage for [long-term care insurance] expenses in 2018, leaving almost all middle-class American families to exhaust their nest-eggs and become impoverished before qualifying for Medicaid.”
If passed, the WISH Act would create a new federal long-term care insurance trust fund that would help seniors purchase care services and supports in the setting they prefer.
The benefit would be funded through a payroll tax of 0.3% for workers and employers.
Additionally, the legislation would help private-insurance companies provide affordable coverage plans for seniors.
If enacted, the WISH Act would move a portion of public support for long-term care away from Medicaid and give seniors flexibility around how they spend the funds.
“The WISH Act would save the Medicaid program and millions of Americans from financial ruin, would allow people to age at home with dignity, and would create millions of good-paying, middle-class jobs in the home health care industry,” Suozzi said.
The WISH Act falls in line with the Long-Term Care Trust Act, which was signed into law in Washington in 2019. Under that state-level law, Washington residents pay into a long-term care program via an employee payroll tax.
Since its passage, the Washington law has created access to financial support for home-based care and other services that address the social determinants of health, industry leaders previously told Home Health Care News.
So far, the WISH Act has drawn support from Washington, D.C.-based LeadingAge, an association of nonprofit aging services providers.
“This legislation recognizes a simple reality: We’re all growing older,” Katie Smith Sloan, president and CEO of LeadingAge, said in a statement. “Each of us, if we’re lucky, will live well into our eighth or ninth decade of life. And the fact is many Americans from all walks of life across this country will need some kind of help beyond what our families can provide. Right now, millions of family members and friends are struggling to balance the demands of caring for loved ones — and are increasingly stressed, stretched and in unsustainable situations.”
In 2020, the monthly median cost for home health aide services in the U.S. — based on 44 hours of care per week — was $4,576, according to the most recent Genworth Cost of Care Survey. The monthly median cost for a private nursing home room was $8,821.