SB 5331 in the state legislature is called “long-term care services and supports.” The proposed program is actually a catastrophic care benefit.
This bill would create a long-term care trust. W-2 workers would pay a premium of 0.58 percent of their payroll to this trust. Small business owners could opt in. Eligible individuals would have a one-time lifetime benefit of $36,500, adjusted for inflation. This is intended to occur before Medicaid spend-down. The percentage for the premiums is fixed and therefore it is not progressive taxation, where the percentage is progressively higher with income.
We must not forget two guiding principles: universal health care, as opposed to cherry picking healthy patients, and opposition to work requirements as a condition of health care benefits.
The following persons would be excluded from enrollment: persons on disability, stay-at-home spouses and parents, current retirees, long-term unemployed, full-time students, and freelancers, musicians and artists who might not meet the hours requirements.
Section two lists those eligible to receive benefits: “age  or older, residing in the state of Washington, was not disabled before the age of , has been determined to meet the minimum level of assistance with activities of daily living necessary to receive benefits through the trust program, as established in this chapter, and who has not exhausted the lifetime limit of benefit units.”
The problematic language is “was not disabled before the age of .” What does this mean? Does this mean that a student with disabilities would have to pay the taxes while employed after graduation, but would be ineligible to receive benefits?
These exclusions from enrollment and benefits constitute cherry picking of subscribers.
By limiting enrollment to W-2 workers and business owners, with minimum hours requirements, the bill establishes a de facto work requirement for benefits. Rather than having the determination made when people apply for benefits, the work requirement is put at the beginning of the process, blocking enrollment. Imposing work requirements is not consistent with the idea of universal health care and health care as a human right.
At one of the bill hearings, Sen. Mark Mullet said that if people pay into the system for years and then retire to another state, they will lose the benefits that they paid for.
I hope that the legislature will correct these problems and give everyone equal opportunity for this benefit.