Washington is the only state in the country running a public long-term care insurance program funded by a payroll premium. If you work in Washington and your paycheck shows a “WA Cares” line, you are already in it, and as of July 1, 2026 the program is paying claims.
Almost everything about WA Cares is published by the state, which makes it unusually easy to check. Every figure below comes from the program’s own site, from the Employment Security Department’s collection rules, or from the statute itself, Chapter 50B.04 RCW, read on September 6, 2026.
What the WA Cares Fund Is
WA Cares is social insurance, not a savings account. Workers pay a small percentage of wages into the long-term services and supports trust account, and workers who have contributed long enough and who develop a care need can draw a lifetime benefit from it.
The program is administered jointly: the Employment Security Department collects the premium and decides whether you have contributed enough, the Department of Social and Health Services decides whether you have a qualifying care need and pays providers, and the Health Care Authority tracks benefit use and coordinates with other payers. That division of labor is set out in RCW 50B.04.020.
What the Washington Long-Term Care Tax Costs
The premium is 0.58% of gross wages. RCW 50B.04.080 set that as the initial rate when collections began July 1, 2023, and it caps future rates: starting January 1, 2026, the pension funding council sets the rate biennially at no greater than 0.58%, informed by a biennial actuarial audit from the Office of the State Actuary. As of September 2026, the rate employers are told to withhold on wacaresfund.wa.gov is still 0.58%.
There is no wage cap. Unlike Social Security, every dollar of wages is assessed, so the dollar cost scales straight with pay.
| Annual wages | WA Cares premium per year | Per month |
|---|---|---|
| $30,000 | $174 | $14.50 |
| $50,000 | $290 | $24.17 |
| $75,000 | $435 | $36.25 |
| $100,000 | $580 | $48.33 |
| $150,000 | $870 | $72.50 |
Employers withhold it and remit it quarterly. Federal employees working in Washington do not contribute, and neither do employees of tribal businesses unless the tribe opted in. Self-employed people contribute only if they elect coverage, and under RCW 50B.04.090 that election has to be made before July 1, 2026 or within three years of first becoming self-employed. Retired and non-working Washingtonians pay nothing, because there are no wages to assess.
What the Benefit Pays
The 2026 full benefit is $36,500 for a lifetime. The statute builds that number from the bottom up: a “benefit unit” is up to $100 paid to a registered provider for approved services on a given date, and no beneficiary may receive more than 365 benefit units over a lifetime.
The benefit unit is adjusted every year for inflation using the Seattle-area CPI-W for the 12 months before each September 1, with the new amount effective the following January 1. So the headline number rises over time. WA Cares states plainly that in 2026 the full benefit amount is $36,500.
Covered services are broad by long-term care standards and include in-home personal care, assisted living, adult family home and nursing home care, adult day services, respite for family caregivers, home-delivered meals, transportation, home safety evaluations and environmental modifications, and payments to qualified family members providing care. There is no daily cap on how fast you spend it, and DSHS pays providers directly, so there is no claim form and no waiting for reimbursement.
For scale, WA Cares says the benefit could cover about 20 hours a week of home care for roughly a year. Set that against what care actually costs and the limits are obvious: see nursing home cost, assisted living cost and home health care cost for current national ranges, or check regional numbers with the fair price tool.
How You Vest
There are three pathways, and the first two both pay the full benefit.
Ten years. Contribute for a total of ten years, with at least 500 hours worked in each of those years. This is the permanent pathway, and once you have it you keep it even if you stop working.
Three of the last six. At the time you apply, have contributed in at least three of the previous six years, again with 500 hours in each. This is a rolling qualification, so it lapses if you stop contributing.
Near-retirees born before 1968. If you were born before January 1, 1968 and contribute at least one year, you earn 10% of the full benefit for each year of contributions, currently $3,650 per year. This pathway is only evaluated after the two full-benefit pathways are ruled out.
Meeting the contribution test is only half of it. You also need a care need. For in-state beneficiaries, DSHS must find that you require assistance with at least three activities of daily living, expected to last at least 90 days. The countable activities are bathing, bed mobility, eating, medication management, mobility, transferring and toileting, and supervision or cueing counts as assistance.
That three-ADL standard is stricter than the two-ADL test most private policies use. It is also stricter than the test WA Cares applies to out-of-state participants, who are evaluated on the federal tax-qualified standard of two of six ADLs or severe cognitive impairment.
Moving Out of Washington
The original design lost you the benefit if you left the state. The 2024 amendment changed that, effective July 1, 2025, and it now sits in RCW 50B.04.180.
To keep coverage after you move, you need three years with at least 500 contributing hours each since July 1, 2023, and you must notify the Employment Security Department within one year of establishing a primary residence outside Washington. After that you file an annual wage report and keep paying premiums on out-of-state earnings. Reporting stops being mandatory at age 67, though you still owe premiums on any wages you do earn.
Two catches. Out-of-state coverage cannot be withdrawn once elected, and if you miss reports or payments the state cancels it permanently. And out-of-state benefits do not become payable until July 1, 2030, four years after in-state benefits started.
Exemptions and the Closed Opt-Out
The famous opt-out is gone. People who held private long-term care insurance on or before November 1, 2021 could apply for a permanent exemption between October 1, 2021 and December 31, 2022. That window closed and has not reopened. If you took it, you are permanently out of the program, though WA Cares now lets you voluntarily discontinue that exemption between January 1, 2026 and June 30, 2028 if you would rather be back in.
Four voluntary exemptions remain available, all under RCW 50B.04.055: workers whose permanent home address is outside Washington, spouses and registered domestic partners of active-duty service members, veterans with a 70% or higher service-connected disability rating, and active-duty service members with off-duty civilian employment. Approved exemptions take effect the first day of the quarter after approval, and you have to hand the approval letter to every employer yourself or the withholding continues. Separately, workers on non-immigrant visas became automatically exempt as of January 1, 2026 unless they tell their employer in writing that they want to keep contributing.
Taking an exemption means you can never be a qualified individual unless you discontinue it, so it trades a small ongoing premium for zero benefit.
WA Cares, Private Policies and Medicaid
WA Cares was never designed to replace private coverage. It is a floor.
| WA Cares | Private long-term care insurance | |
|---|---|---|
| Lifetime benefit | $36,500 in 2026, CPI-indexed | Whatever you buy, often $150,000 to $400,000+ |
| Underwriting | None | Full medical underwriting |
| Cost | 0.58% of wages, no cap | Age- and health-rated premiums, subject to increase |
| Care-need trigger | 3 of 7 ADLs, in state | Typically 2 of 6 ADLs or cognitive impairment |
| Payment | State pays providers directly | Usually reimbursement after an elimination period |
The state is building a supplemental market rather than a competing one. WA Cares says rules for supplemental private long-term care insurance, developed with the Office of the Insurance Commissioner, became effective May 1, 2026, and that policies may become available in 2027. It also notes that for people who already hold private coverage, WA Cares can cover the elimination period while the private policy’s waiting period runs out. If you are weighing a private policy alongside this, start with long-term care insurance cost and is long-term care insurance worth it, and look at hybrid long-term care insurance if you want something with a death benefit attached.
On Medicaid, the statute is explicit. RCW 50B.04.150 says benefits used under the program are not income or resources for determining eligibility for Medicaid or any other means-tested program, and WA Cares states its benefits are not subject to Medicaid estate recovery. Practically, the benefit can delay or shrink a Medicaid spend-down rather than counting against you, and it does not interact with the Medicaid look-back period the way a gift or transfer would. Medicare, for its part, still does not pay for custodial long-term care, which is the gap WA Cares was built for.
What Other States Have Done
No other state has enacted a program like this. California went furthest: AB 567 (2019) created a Long Term Care Insurance Task Force at the Department of Insurance to study a statewide program. The Task Force delivered a feasibility report on December 23, 2022 and an actuarial report to the Legislature on December 21, 2023, and the authorizing statute was repealed as of July 1, 2024 without a program being created. Other states have floated bills, but only report a state’s status if you have checked that state’s own site, because proposals move and die quickly.
Bottom Line
WA Cares is cheap, automatic, and small. At 0.58% of wages it costs a median Washington earner a few hundred dollars a year, and it delivers a $36,500 inflation-indexed benefit with no underwriting and no claim paperwork. It will not fund years in a nursing home. It is best understood as the first tranche of money you spend before touching savings, and as a reason to plan for the rest rather than a reason not to.