Every spring, the property tax bill arrives and I perform the same ritual: sit on the patio, stare at the number, mutter things Frank pretends not to hear. Last Wednesday evening, mid-mutter, Tom called from Denver to tell me about a payroll deduction on his friend's pay stub.
"It's a long-term care tax," Tom said. "In Washington state. 0.58 percent of everything you earn."
"Everything?"
"Everything. No cap."
"Tom," I said, "I live in Arizona. Why are you telling me this?"
"Because California's looking at one, Mom. And Minnesota. And Michigan. This is coming everywhere."
I put down the property tax bill. Somehow a new thing had arrived to worry about, which is impressive given my worry list already includes Frank's cholesterol, the weird noise the garage door makes, and whether I canceled the magazine subscription from 2019. (I didn't. It's still coming. National Geographic, if you're wondering. Gorgeous photography, but at this point I'm basically funding an expedition to my recycling bin.)
Tom sent me a link. Read it at 10:45 PM in my bathrobe, which is when I do my most alarming research. What I found was genuinely worth knowing, not just for Washington, but for every state paying attention.
What the WA Cares Fund Actually Is
Washington state did something no other state has done: it created a public long-term care insurance program, funded entirely by a payroll tax on workers, and starting July 1, 2026, it's paying out benefits.
Here's how the tax works: 0.58 percent of gross wages. No income cap. If you earn $50,000, you pay $290 a year. Earn $150,000, you pay $870. Bonuses, commissions, PTO payouts, all taxed. Premium collection started July 1, 2023, meaning Washington workers have been paying in for three years before anyone saw a dime back.
What you get back: a lifetime maximum of $36,500, adjusted for inflation going forward. Workers qualify after contributing for 10 years (though earlier access may be possible through other pathways). You have to be a Washington resident when you need care, and you need help with at least three activities of daily living: bathing, dressing, eating.
Pilot programs launched in January 2026 in four counties: Lewis, Mason, Spokane, and Thurston. Statewide rollout hits July.
One program. First in the nation. Every policy wonk from Sacramento to Albany is watching to see whether it works or collapses.
What $36,500 Buys You (and What It Doesn't)
Let me give you the number making me set my phone on the counter and stare at it for a full ten seconds.
A private room in a Washington state nursing home costs an average of $13,688 per month. Per month! A cool $164,256 a year. Against that, the WA Cares Fund lifetime benefit of $36,500 covers roughly two and a half months. Two and a half months out of what could be years of need. Assisted living in Washington averages $6,138 a month, so the benefit stretches to about six months there. Still not great.
But here's the thing. WA Cares wasn't designed to cover nursing homes. It was designed to keep people out of them.
That $36,500 can pay for in-home care aides, including qualified family members, even a spouse. Home modifications like grab bars, ramp construction, bathroom renovations. Adult day services. Respite care so your caregiver can sleep. Transportation to medical appointments. Home-delivered meals. Assistive technology and equipment to help you stay independent. Care supplies.
It's not a nursing home fund. It's an aging-in-place fund. Suddenly the math changes entirely, because a $150 grab bar and twenty hours of weekly in-home help look very different from $13,688 a month at Sunrise Senior Living.
WA Cares' own website specifically mentions beneficiaries will be able to purchase assistive technology to support aging in place: motion-activated lights, automatic medication dispensers, remote-entry door locks, and smart home devices designed for seniors. Which brings us to the robot in the room.
The Robot Connection
Washington state's Medicaid program recently approved ElliQ, the AI companion robot, for eligible recipients in long-term services and supports programs. Medicaid covers the full cost for qualifying seniors receiving in-home care. Device, subscription, everything. Not out of pocket.
Now, ElliQ isn't currently listed as a WA Cares-covered benefit. Different program, different funding stream. Still, the WA Cares Fund explicitly covers "assistive technology and equipment" helping a person function at home, and the fund's own website features an article titled "Leveraging Technology to Support Aging in Place." The door is open, even if the specific devices haven't been cataloged yet.
Why does this matter beyond Washington? Because if public long-term care programs start covering companion robots alongside grab bars and wheelchair ramps, we're looking at a genuine shift in how we define "care" for seniors living alone. Beyond physical modifications. Beyond a human aide for twelve hours a week. An AI device that checks in every morning, tracks mood, prompts medication, plays trivia after lunch, and alerts your daughter in Flagstaff when you report knee pain.
My friend Barb, who taught biology at New Trier when I taught English and now lives in Tacoma with her second husband Wayne, told me her neighbor used WA Cares pilot funds to install grab bars in her bathroom and pay her niece to come help three mornings a week. "The niece gets paid, the aunt stays home, and nobody's in a facility," Barb said. "It's not a fortune, but it's something."
From Barb, "it's something" is practically a rave review!
The 2025 Amendments Nobody's Talking About
Governor Bob Ferguson signed SB 5291 in May 2025, and the changes took effect January 1, 2026. Most people haven't heard about them, which is a shame, because the changes are significant.
Originally, the ten-year contribution requirement demanded five consecutive years within a ten-year window. Confusing. Under SB 5291, it's simpler: contribute for any ten years total. Consecutive years no longer required. If you took two years off to care for a parent or recover from surgery, your clock doesn't reset.
Portability — sort of. Workers who leave Washington can now continue coverage if they've paid in for at least three years. They have to opt in within one year of moving and maintain their own records and payments. Senator John Braun, the Republican leader, called this "unworkable" and worried about misreporting. He might be right. Still better than the original setup, which was: move to Arizona and lose everything you paid. Period.
Opt-outs got a second chance. If you bought private long-term care insurance before November 1, 2021, you could permanently opt out of the tax. Now those people can rejoin before July 1, 2028, if they want back in. Veterans with 70 percent or higher service-connected disability get a permanent exemption. Temporary visa holders are automatically exempt starting January 2026 unless they choose to opt in. Active-duty military in civilian jobs can apply for exemption too.
And the big one: a new framework for supplemental private insurance. Private insurers can now offer policies that complement WA Cares benefits, providing at least 12 months of coverage after the $36,500 runs out. Think of it as gap insurance for a public program everyone knows isn't enough on its own.
Actually, it's more like a public foundation with a private second story. Neither one is the whole house, but together they start to look like something a person could actually live in.
Why Arizona Should Be Paying Attention (and So Should You)
I don't live in Washington. Neither does Frank. Neither, probably, do most of you reading this. So why does this matter?
Because Washington is the test case. At least a dozen other states are actively considering similar programs. California has legislation stalled in the state Legislature, but the concept isn't dead. Minnesota is reviewing Washington's structure closely and could move in the next year or two. New York introduced a bill with exemptions for veterans and non-residents. Michigan, where I grew up, where my brother still lives, where the winters alone are a long-term care event, is on the list too.
An American turning 65 today has almost a 70 percent chance of needing some form of long-term care. Medicare doesn't cover it. Most people don't have private LTC insurance, because those premiums doubled and tripled over the past decade and half the companies left the market. Medicaid covers long-term care but only after you've spent down nearly everything you own.
So what fills the gap? Either your family does it: your daughter quits her job, your son moves back home, your spouse burns out at 74 trying to lift you into the shower. Or a public program does. Washington chose a public program. It's imperfect. Modest benefit. Clunky portability. Yet it exists, which is more than 49 other states can say.
Every time I read about what it actually costs to age at home, I think about the gap between what people need and what's available to them. WA Cares doesn't close that gap. It acknowledges it, though. Change starts there.
The Critics Have a Point (But So Does the Fund)
Let's not pretend this is perfect. Critics are loud and some of them are correct.
$36,500 is not enough. Everyone agrees on this, including the people who designed the program. A year of in-home care in Washington averages over $70,000. Six months is all the lifetime benefit covers. For someone with dementia who needs care for five to eight years, $36,500 is a rounding error.
No portability for people who never paid in. If you moved to Washington in 2024 and plan to retire in 2030, you won't have ten years of contributions. You're paying a tax with no benefit at the other end. That stings.
Every penny comes from workers, not employers. One hundred percent employee-funded. Your employer doesn't match it. Your employer doesn't even see it on their side of the ledger. Meanwhile, the worker earning $35,000 feels that 0.58 percent a lot more than the one earning $200,000, even though the dollar amount is higher for the latter.
Administrative complexity is real, too. Self-employed workers have to opt in. Part-time workers in multiple states face overlapping rules. Cross-border workers in Portland who commute to Vancouver, Washington, have their own headaches.
But — and this is the part critics tend to skip past — the fund is indexed to inflation. That $36,500 will grow. Supplemental insurance, a brand-new framework, creates a private market where none existed before. Programs can be amended, expanded, improved. It took Social Security decades to become what it is now. WA Cares is version 1.0. Messy, incomplete, underfunded. Also: first!
What I Told Tom
Tom called back on Sunday. He does this — calls with information, then calls again to see if I've processed it. Insurance adjuster energy. Very Tom.
"So what do you think?" he asked.
I'd spent four days reading about Washington's long-term care fund, about what Medicaid covers and doesn't, about what other states are considering, about a robot in Tacoma that asks a woman how she slept. Sobering numbers. Barb confirmed what I suspected. I'd even mentioned it to Frank, who sat with it for a minute the way Frank does, turning it over before he speaks, and then said, "Sounds like they're trying."
Frank's right. They're trying.
$36,500 won't pay for a nursing home. But it'll pay for the grab bars so you don't end up in one. It'll pay your niece to come three mornings a week. It might, someday, pay for the little robot that notices you're in pain before your daughter does.
Is it enough? No. Not yet. Is it more than any other state has managed? Yes.
I told Tom I thought every state was going to have this conversation eventually, whether they wanted to or not, because the math doesn't work any other way. He said, "You should write about it." I said, "Tom, I'm already writing about it. I started Tuesday."
He paused. "You wrote it before you called me back?"
Forty-five years I've been his mother, and the man is still surprised I have my own process. That's Tom. Bless his heart.
My property tax bill is still on the counter. National Geographic is still coming. And somewhere in Tacoma, Barb's neighbor is getting help three mornings a week from a niece who's getting paid for it, in a home that now has grab bars in the bathroom, funded by a program that didn't exist two years ago.
Not perfect. But there. Which, for the people who need it, is enough to start.
