This summer, Washington state’s pioneering long-term care insurance program is facing a crucial test. In July, eligible residents began receiving benefits for the first time, marking a new stage in the state’s yearslong effort to help people afford care as they age.

Lawmakers around the country should be watching closely. The coming years will tell us whether Washington’s model — the first such state-run program in the nation — is one that other states, or even the federal government, can emulate. The critical question: Will it help close a social safety-net gap that leaves millions of Americans with healthcare costs they can’t bear?

Long-term care — or help with daily personal care or health tasks that people are unable to perform on their own — is easy to ignore until you or someone you love needs it. It’s no surprise, then, that many Americans don’t know who pays for it: 45% of retirement-age adults wrongly believe Medicare covers those costs.

In reality, Medicaid covers long-term care for those poor enough to qualify, while the wealthy typically pay for it out of pocket. That leaves a vast middle facing substantial costs that many are unprepared for.

The need is coming for most of us. Some 70% of Americans aged 65 or older will at some point require long-term care, according to the Department of Health and Human Services. That could range from something as simple and relatively affordable as help with getting dressed while recovering from surgery to as complex and costly as memory care.

Washington’s solution, called WA Cares, is funded by a 0.58% payroll tax, which the state started collecting in 2023. Someone fully vested is eligible to receive $36,500 to spend on long-term care services. The size of the benefit — which, by the way, is portable if you move out of state — will grow with inflation.

The sum’s modest size has generated much debate. Can it possibly be enough to make a difference? “It’s not going to meet 100% of the needs of 100% of the people,” concedes Bea Rector, the acting secretary for Washington state’s Department of Social and Health Services.

But that doesn’t mean it won’t be meaningful. Rector offered a few examples of how far $36,500 might stretch: A family caregiver could be paid for 10 hours of work a week for two years; doorways could be widened and wheelchair ramps built to allow someone to continue to live at home; or an elderly person could get 10 meals delivered each week for three years.

It’s also important to put that money in the right context. People’s instinct is to compare the WA Cares benefit to the cost of living in a nursing home — and it’s true, in those terms, that the money won’t go far. The most extreme example is memory care, which averages $8,400 per month, according to the AARP.

But that’s not the right parallel to draw, says Norma Coe, a health economist at the University of Pennsylvania. She points out that the average Social Security check currently comes out to just over $2,000, or about $50,000 per year for a retired couple. WA Cares’ benefit could carry real heft in a household relying only on that income.

As Washington’s experiment unfolds, it offers an incredible learning opportunity for the rest of the nation. A dozen other states are contemplating what long-term care programs might look like, though progress has been glacial. Lawmakers everywhere should be keeping an eye on early signs of WA Cares’ effectiveness, as well as areas where it might need improvement.

An important test will be how quickly people can get benefits when an urgent need arises — for example, if an elderly parent is suddenly released from a rehab facility and needs help at home.

Washington officials have tried to make the process seamless. Families don’t pay for care themselves and then seek reimbursement; rather, the state has registered a range of qualified providers it directly pays. And officials established a network of providers before the benefits launched this summer — even going so far as to launch a home care aide course for high school students.

Whether that’s enough to counter the longstanding shortage of home health workers — a situation made worse by this administration’s immigration policy — remains to be seen.

Another early measure of the program’s impact will be the physical, mental and financial well-being of the family and friends who do so much of the heavy lifting in the absence of outside help. Such unpaid caregivers are the invisible backbone of the current system, and the toll on them is immense. For them, a modest reserve of money could be a lifeline, Coe says. They might be able to keep their jobs, or simply take a weekend off when they need one — say, to attend a child’s graduation.

Health policy experts also want to know if this money will help people live at home longer, which is vastly cheaper than being in a nursing home. Moreover, if people don’t have to become so impoverished that they qualify for Medicaid to access long-term care, it could ease state budgets. Long-term care accounts for roughly 20% of state Medicaid spending, according to health-policy research group KFF.

Coe also believes Washington’s program could benefit the broader system. For example, it might prompt insurance companies to create new products to supplement the benefits states offer. Maybe, then, a realistic way forward for federal long-term care coverage is to offer modest yet meaningful basic care for everyone through Medicare, and let the private market fill in the blanks for those who want more coverage.

Getting to a sustainable approach to supporting our most vulnerable really ought to be a federal, not state project. It’s an issue lawmakers keep pushing off for tomorrow. And yet the longer we wait, the harder the problem is to solve — and inevitably, most of us will get caught up in the struggle.

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This column reflects the personal views of the author and does not necessarily reflect the opinion of the editorial board or Bloomberg LP and its owners.

Lisa Jarvis is a Bloomberg Opinion columnist covering biotech, health care and the pharmaceutical industry. Previously, she was executive editor of Chemical & Engineering News.

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