A caregiver and her client
getty
Nearly two years ago, social insurance advocates were celebrating the creation of a new long-term care program in the state of Washington. Here, for instance, is what The Nation wrote in May of 2019:
“The Long Term Care Trust Act, which passed the state legislature at the end of April and will be signed into law by Governor Jay Inslee on Monday, establishes the country’s first social-insurance program to pay for long-term care. All residents will pay 58 cents on every $100 of income into the state’s trust. After state residents have paid into the fund for ten years—three if they experience a catastrophic disabling event—they’ll be able to tap $100 a day up to a lifetime cap of $36,500 when they need help with daily activities such as eating, bathing, or dressing. . . .
“The architects of the legislation were trying to find ‘a number adequate enough to meet people’s needs and at the same time not be catastrophic if everybody [made claims] at the same time,’ [AARP vice president Elaine] Ryan explained. ‘To make it actuarially sound so people could be guaranteed a benefit.’
“The policy’s universal structure and funding is also significant. All working people will pay into the fund through a payroll tax and then be able to claim a benefit when they need it. The same structure has ‘stood the test of time’ with Social Security and Medicare, Ryan noted. Politically speaking, ‘it mattered a lot that it was set up as a social-insurance program,’ Caring Across Generations’ [Sarita] Gupta said.”
It sounded great — but too good to be true.
Now officials in Washington are recognizing there are problems with the plan.
In December, Gov. Jay Inslee announced a delay in the start of the payroll tax, so that the legislature could make changes when the new session convenes on January 10th, following a multitude of complaints about the program, in particular because workers who move out of state, or who were less than 10 years away from retirement, would be paying into the system without ever being able to benefit from it. The tax is now planned to begin in April, but if House Bill 1732 passes, the tax would be delayed until July 0f 2023. In addition, House Bill 1733 would allow people working in Washington but residing elsewhere, as well as temporary workers with nonimmigrant visas, and disabled veterans and spouses of active duty military members, to opt out. Neither of these bills, however, would deal with the issues posed by the eligibility requirements themselves.
But these eligibility requirements are in place for a reason, to reduce costs with lower numbers of recipients, and to build up reserves which are spent down as current workers ultimately retire. Here’s what the 2017 feasibility study itself reported:
“We estimate the Base Plan under Option 1 will require a 0.54% payroll surtax rate over the 75-year period 2020 through 2094. We estimate an ultimate tax rate of 0.94% to cover program costs after 2094 once the population receiving benefits has stabilized.” In other words, if all Washington residents were eligible regardless of age and contribution history, the cost of the program would double, because that’s what will ultimately happen when, 75 years into the future, all retirees have paid into the program. In practice, the actuaries consulted for this report anticipated that payroll taxes would be increased well before the 75 year period ends.
In addition, the $100 per day benefit is slated to increase by no more than the inflation rate, and possibly be reduced if it is deemed necessary for solvency purposes, according to the enabling legislation. And that $100 per day benefit is anticipated to be enough for the average individual receiving 96 hours of home care per month, based on Medicaid rates, for one year, according to the legislation’s findings.
One might argue that, however imperfect this legislation might be, its flaws can be remedied in the future. But the law is a mixture of characteristics of programs of social assistance and social insurance, to its detriment. A requirement to have paid into the system is characteristic of a social insurance program, and the 10 year contribution requirement is essentially the same as the eligibility requirement for Old Age benefits in Social Security. However, true social insurance programs pay out benefits to those eligible regardless of residence — again, once you’ve paid into Social Security long enough to have earned your benefit, you can collect regardless of where you live, even if you have moved abroad. In fact, even noncitizens who worked in the United States long enough to have accumulated sufficient Social Security credits, can receive benefits after having moved back to their home countries. What’s more, many social insurance systems provide some sort of refund mechanism for workers who do not accumulate enough contribution years to be eligible.
And this hybrid system will likely prove to be unsustainable politically. Even if ordinary Washingtonians are not well-versed in social insurance concepts and theories, it will not sit right with them that those who retire with 10 years of payroll taxes have “earned” their benefits but those with 9 years have not, and, likewise, that those who have “earned” benefits would lose those “earned” benefits merely by moving out of state. How precisely this will play out over the long term remains to be seen, but the new bills are not likely to be the end of the story.
In any case, these problems will not be easy to remedy.
As always, you’re invited to comment at JaneTheActuary.com!
order generic levaquin 250mg order levofloxacin 500mg without prescription
avodart ca buy flomax 0.4mg generic order ondansetron pills
order aldactone pills purchase propecia order fluconazole 200mg pill
buy ampicillin 500mg sale bactrim 960mg us buy erythromycin 500mg generic
fildena 50mg over the counter nolvadex 10mg uk order methocarbamol 500mg online
suhagra buy online aurogra online purchase estradiol sale
buy lamotrigine 50mg order mebendazole without prescription oral tretinoin cream
tadalafil 10mg for sale avanafil 200mg for sale diclofenac brand
isotretinoin price azithromycin oral cost zithromax 250mg
indocin 50mg canada terbinafine 250mg over the counter order trimox 250mg pill
tadalafil dosage cialis 20mg price pfizer viagra
buy anastrozole 1 mg online cheap viagra professional review viagra 100mg pills for men
tadalafil 40mg generique pas cher viagra generique sildenafil 25mg pour homme
order prednisone 10mg generic sildenafil over the counter price viagra
tadalafil 5mg generika rezeptfrei kaufen viagra 200mg kaufen für männer sildenafil bestellen
accutane 40mg ca buy stromectol 3mg online stromectol coronavirus
buy doxycycline pills furosemide 40mg over the counter lasix 100mg cheap
buy altace 5mg online cheap buy astelin generic buy astelin online
catapres 0.1mg cheap buy minocin without prescription order spiriva generic
buspar 5mg without prescription dilantin cost cheap ditropan
order hytrin 1mg online buy actos 30mg pills azulfidine pills
fosamax 35mg price order fosamax without prescription famotidine drug
benicar 20mg over the counter buy diamox 250mg acetazolamide 250 mg canada
tacrolimus 5mg over the counter brand labetalol 100 mg ursodiol 300mg over the counter
bupropion 150 mg ca bupropion price purchase quetiapine sale
order molnunat pills buy cefdinir 300mg online prevacid generic
buy zoloft 100mg generic Brand viagra over the net sildenafil 100mg us
imuran 100 mcg oral guaranteed viagra overnight delivery usa sildenafil otc
tadalafil usa symmetrel 100mg pill buy symmetrel 100 mg for sale
naltrexone over the counter order albendazole online order aripiprazole 30mg online cheap
buy avlosulfon 100 mg online order avlosulfon generic aceon 4mg pill
order medroxyprogesterone 10mg without prescription order medroxyprogesterone 5mg sale cyproheptadine 4mg tablet
modafinil 100mg uk safest canadian online pharmacy ivermectin 6 mg without prescription
order luvox 100mg pills order nizoral generic glucotrol 10mg for sale
buy isotretinoin 10mg online purchase isotretinoin without prescription order prednisone 10mg generic
brand nootropil 800 mg sildenafil 100mg oral sildenafil pills 150mg
zithromax 250mg pill gabapentin pills neurontin price
us cialis sales tadalafil pill order sildenafil 100mg online
furosemide for sale online buy doxycycline 200mg online order hydroxychloroquine 400mg generic
buy cialis buy anafranil for sale clomipramine online order
brand chloroquine 250mg cenforce canada cost baricitinib
itraconazole 100mg ca sporanox 100 mg us tinidazole 500mg pills
glycomet 500mg for sale glucophage 500mg generic cialis overnight delivery
brand olanzapine purchase bystolic without prescription buy valsartan 160mg
norvasc online order tadalafil 5mg generic tadalafil 10mg us
clozapine 100mg generic clozaril over the counter order decadron 0,5 mg for sale
viagra 100mg england lisinopril 5mg brand lisinopril us
zyvox sale casino online blackjack bonus casino
prilosec 10mg usa help with writing a research paper real money spins
order lopressor 50mg buy metoprolol 50mg online buy generic levitra 20mg
help writing papers for college online casino games real money casino blackjack
order levitra 20mg online cheap lyrica 75mg oral methylprednisolone without a doctor prescription
where can i buy an essay research paper assistance viagra 50mg cheap
purchase clomid generic generic clomid online roulette real money
order tadalafil 5mg online viagra 50mg usa sildenafil 100mg sale
order aristocort 10mg pills buy claritin 10mg pill desloratadine canada
order dapoxetine 30mg online order levothyroxine generic purchase synthroid pills
buy cialis 20mg for sale viagra 100mg without prescription sildenafil on line
brand xenical 60mg buy diltiazem generic buy zovirax 800mg online cheap
tadalafil 20mg ca order cialis 10mg online cheap order plavix without prescription
buy cozaar 50mg pill order topamax online cheap oral topiramate 100mg
order ozobax for sale brand zanaflex buy toradol online cheap
sumatriptan 50mg us oral avodart purchase dutasteride sale
buy gloperba for sale order colchicine online parx casino online
play great poker online no deposit casino casino slots free
flomax 0.4mg pill buy spironolactone 25mg spironolactone online buy
order tadalafil online cheap cialis cost cipro 500mg pill
simvastatin cheap valacyclovir 500mg ca brand finasteride 1mg
flagyl 200mg price cheap augmentin 625mg buy bactrim 960mg online cheap
fluconazole 200mg tablet order generic diflucan us viagra sales
cephalexin 500mg usa cost cleocin 300mg purchase erythromycin for sale
sildenafil overnight shipping viagra 100mg price buy cialis sale
ceftin 250mg pill cefuroxime 250mg price order generic methocarbamol 500mg
online casino real money casino real money buy tadalafil 20mg generic
oral trazodone 100mg aurogra 50mg oral buy aurogra 100mg for sale
top essay writers help me with my paper buy ivermectin for humans
buy sildalis generic viagra sildenafil 150mg buy lamotrigine for sale
order deltasone 20mg online amoxil 1000mg uk amoxil 250mg ca
buy viagra for sale cialis 5mg usa order generic tadalafil 10mg
blackjack online game cialis 10mg generic buy tadalafil 40mg
azithromycin 250mg pills order prednisolone 40mg generic neurontin over the counter
poker online game buy provigil 200mg for sale cost provigil 100mg
lasix 100mg cost order plaquenil 200mg without prescription buy plaquenil 400mg online
cost fildena 50mg nolvadex medication rhinocort over the counter
cheap prednisone 40mg order mebendazole 100mg online purchase mebendazole online cheap
order tretinoin cream for sale order avanafil order avana 100mg
buy tadalafil 20mg online buy generic tadacip 20mg buy indomethacin 75mg online cheap
order lamisil pills amoxicillin 250mg brand trimox 250mg cost
buy biaxin 500mg sale clarithromycin 500mg oral meclizine us
order spiriva 9mcg pill oral minocin hytrin uk
cialis uk real casino games best real money casino
spins real money online real online casino real money slots
best online gambling poker games online online blackjack with friends
play poker online term papers writing essays writing
research paper assistance order an essay online azulfidine price
order diamox 250mg generic buy azathioprine without prescription imuran usa
buy generic digoxin 250mg buy telmisartan without prescription buy molnupiravir 200mg sale
buy coreg 25mg generic coreg 25mg cheap order amitriptyline 50mg online
amoxil uk stromectol 12mg generic ivermectin 2ml
buy alendronate online cheap furadantin 100 mg pills brand motrin
order dapoxetine 90mg sale order avana online cheap order motilium online
order nortriptyline 25mg buy pamelor 25mg for sale order paroxetine pill
purchase indomethacin pill tamsulosin 0.2mg cost cenforce canada
famotidine online buy order mirtazapine 30mg sale order remeron sale
buy doxycycline generic brand doxycycline 200mg medrol 4 mg without prescription
requip 2mg cheap buy labetalol 100mg generic buy trandate without prescription
tadacip pills generic tadalafil 10mg buy amoxicillin 250mg
tricor uk cheap sildenafil pills order generic viagra 100mg
buy nexium 40mg order clarithromycin 250mg for sale lasix 100mg brand
tadalafil pill Buy cialis usa viagra australia
order minocin without prescription buy neurontin 100mg without prescription terazosin medication
metformin ca oral glucophage nolvadex pills
buy modafinil 100mg generic order stromectol online cheap order promethazine 25mg pills
buy generic clomiphene 100mg prednisolone 40mg generic purchase prednisolone sale
prednisone oral brand deltasone 5mg order amoxicillin 500mg online cheap
order isotretinoin 10mg pills buy prednisone 10mg sale cost ampicillin 250mg
buy fildena 50mg propecia sale order finasteride 5mg online
ivermectin over the counter canada prednisone 5mg us buy prednisone 40mg pill
zofran 4mg uk generic amoxicillin 250mg trimethoprim generic
buy isotretinoin 10mg online isotretinoin 20mg without prescription purchase azithromycin pills
albuterol without prescription brand levothroid generic clavulanate
prednisolone 5mg ca furosemide online lasix 40mg usa
buy modafinil 200mg for sale order provigil 200mg online cheap metoprolol 50mg tablet
college essay help long island write my admission essay best essay writing services
dutasteride without prescription cephalexin cheap buy orlistat pill
order doxycycline for sale acyclovir over the counter buy zovirax sale
help with writing essays for college applications essay paper writing help help essay 123
synthesis essay thesis definition thesis statement thesis proposals
buy azathioprine without prescription brand azathioprine naproxen 250mg canada
uiuc thesis master thesis examples dedication thesis
ditropan 2.5mg us buy prograf 1mg generic oxcarbazepine canada
does the thesis have to be in the first paragraph parts of thesis 3.5 arcane thesis
thesis writing help uk working thesis statement plural thesis
buy omnicef 300mg without prescription order lansoprazole 15mg sale order protonix 20mg generic
buy simvastatin online cheap generic promethazine purchase sildalis for sale
avlosulfon usa order asacol online buy tenormin tablets
uroxatral uk generic diltiazem diltiazem usa
order sildenafil 50mg generic cialis online ordering order generic tadalafil 10mg
order promethazine tadalafil on sale tadalafil 10mg sale
ezetimibe 10mg oral buy tetracycline 500mg for sale methotrexate buy online
levaquin 500mg cheap levofloxacin 500mg without prescription oral bupropion 150 mg
order coumadin 2mg without prescription zyloprim 100mg pills zyloprim 100mg us
purchase cetirizine for sale atomoxetine generic order zoloft 50mg sale
cenforce usa order glycomet online order generic glucophage 500mg
is 20 mg sildenafil enough sildenafil online pharmacy sildenafil white pill
lexapro price order naltrexone 50 mg pill order naltrexone 50 mg online cheap
lipitor pills female viagra sildenafil buy viagra
coupon for tadalafil sildenafil & tadalafil tadalafil online purchase
purchase letrozole online purchase sildenafil for sale free shipping viagra
memorial pharmacy maryland board of pharmacy midkiff pharmacy
tadalafil generic cialis 20 mg https://justtadafilix.com/ cheap tadalafil tablets
tadalafil show up on drug test https://tadafilax.com/ tadalafil used for
goodrx tadalafil 10mg is tadalafil like viagra is tadalafil same as viagra
tadalafil 20mg usa cialis 20mg without prescription best non prescription ed pills
purchase cialis buy tadalafil generic best ed pills online
walmart cialis price https://crocilismen.com/ cialis sale online
shelf life of cialis https://hdcillis.com/ tadalafil 30mg per ml x 30 ml
viagra 2018 https://foxviagrixed.com/ viagra 100 mg tablet price in india
viagra 100mg cost https://ac3vigra.com/ buy generic viagra online no prescription
order amoxil 1000mg pill order amoxicillin 500mg pills buy prednisolone 10mg sale
viagra sildenafil 100mg https://leepvigras.com/ sildenafil citrate online
100mg viagra price https://ethvigrix.com/ brand name viagra
order accutane 10mg without prescription amoxil 250mg sale azithromycin without prescription
buy gabapentin 100mg pills doxycycline 100mg us oral doxycycline 200mg
buying cialis with dapoxetine https://uhdcilise.com/ 5 mg cialis
order prednisolone 5mg online cheap prednisolone 20mg buy furosemide without prescription diuretic
tadalafil 5mg online https://hoscillia.com/ cialis online overnight delivery
viagra online sale in india https://vivigrix.com/ buy sildenafil 20 mg
buy clomid cheap buy serophene generic purchase plaquenil for sale
cialis manufacturer coupon 2018 https://wwcillisa.com/ can you take viagra and cialis together
buy doxycycline online augmentin 375mg usa cheap augmentin 625mg
oral atenolol 100mg buy medrol for sale buy letrozole without a prescription
cheap levoxyl generic order vardenafil pill levitra 10mg price
buy generic albendazole purchase aripiprazole generic provera canada
cheap glycomet buy norvasc 5mg oral amlodipine 5mg
praziquantel brand periactin over the counter cyproheptadine 4 mg us
lisinopril 2.5mg for sale omeprazole tablet buy metoprolol 100mg without prescription
buy pregabalin 75mg online cheap purchase pregabalin sale priligy canada
buy methotrexate 10mg for sale generic warfarin buy metoclopramide 10mg online
order xenical without prescription buy acyclovir for sale purchase zyloprim online cheap
Embrace your natural curls with these gorgeous and stylish hairstyles.
cozaar 50mg tablet buy topamax 200mg generic topiramate 200mg tablet
order crestor 20mg order crestor 20mg for sale purchase domperidone online
buy generic imitrex for sale how to buy sumatriptan dutasteride canada
tetracycline pills flexeril 15mg sale baclofen medication
ketorolac without prescription how to buy colchicine cheap inderal
buy zantac 300mg online cheap purchase meloxicam online order celebrex 200mg pill
order generic tamsulosin 0.4mg tamsulosin 0.4mg usa order spironolactone sale
cymbalta 20mg without prescription order duloxetine 20mg sale order nootropil
how to get betnovate without a prescription buy betnovate creams order itraconazole 100mg generic
buy combivent no prescription linezolid oral buy linezolid 600mg pill
prometrium order online tindamax 300mg cheap zyprexa 10mg generic
order nateglinide 120mg online buy generic starlix 120 mg cheap candesartan 16mg
order bystolic 20mg online cheap clozapine 100mg tablet buy clozapine generic
buy simvastatin no prescription order valtrex generic sildenafil 100mg us
order carbamazepine 400mg online where can i buy ciplox lincomycin pills
canadian cialis cialis daily buy viagra
purchase duricef online generic cefadroxil purchase proscar generic
buy fluconazole 100mg generic purchase ampicillin generic cipro 1000mg cheap
order estrace 2mg for sale order estradiol 1mg generic minipress 1mg us
generic flagyl 200mg buy keflex 250mg for sale buy generic keflex over the counter
mebendazole for sale retin cost tadalafil canada
tamoxifen 10mg sale buy ceftin pills for sale order ceftin generic
buy indomethacin 50mg capsule purchase cefixime online cheap order cefixime 200mg pills
buy amoxicillin 500mg sale trimox generic buy biaxin pills
clonidine 0.1mg over the counter order meclizine 25 mg for sale tiotropium bromide 9 mcg cheap
order suhagra generic where can i buy sildalis order sildalis
minocycline 100mg pill buy terazosin medication pioglitazone over the counter
purchase arava online cheap generic arava 10mg azulfidine over the counter
azithromycin ca azithromycin online order neurontin 800mg canada
female cialis pill buy sildenafil 50mg online tadalafil drug
The art of Turkish ceramics is as old as civilization itself. Discover more about it on our website.
buy furosemide for sale doxycycline 200mg without prescription order albuterol 4mg sale
vardenafil 10mg price buy vardenafil 10mg pills generic hydroxychloroquine 200mg
order ramipril without prescription altace usa buy arcoxia no prescription
buy vardenafil 20mg generic plaquenil us buy plaquenil
oral asacol buy avapro 300mg pill purchase avapro for sale
benicar 10mg cheap purchase divalproex online cheap divalproex 250mg pill
buy carvedilol without prescription buy cenforce pills how to buy chloroquine
diamox 250mg oral buy generic azathioprine 50mg buy azathioprine 50mg online
Amazing issues here. I’m very glad to peer your article.
Thanks a lot and I’m having a look forward to touch you. my website : mp3 juice
lanoxin 250mg oral order telmisartan sale buy molnunat no prescription