Long-term Care Legislation

Long-term Care Legislation

The growing challenge of long-term care (LTC) has led several states to consider legislation to address the issue. For carriers and benefit brokers, it’s important to understand what’s on the table so that we can better support employers and employees in those states. 3mpwer is closely monitoring these developments and will provide updates on any relevant long-term care legislation.

What’s driving legislative action?

Due to demographic changes, the need for long-term care and caregiving services is on the rise. At the same time, growing costs make access to care increasingly difficult. This puts many at financial risk on a personal level, and it’s a risk for states as well – when people are unable to afford care, they often rely on state-funded programs for support. State legislatures are considering action to protect their residents and to control the costs of state programs that offer support for care. 
California

Updated 3/2/23

What’s on the docket?
The Long Term Care Insurance Task Force (Task Force) was established within the California Department of Insurance in 2019 with the passage of AB 567. Its mission is to explore the feasibility of a statewide insurance program for long-term care services and support. At this time, it appears the Task Force is considering recommending several designs that would include “opt-outs” for individuals who own private coverage. Specific requirements regarding qualifying coverage for the opt out is yet to be determined.

Where do things stand?
The Task Force was mandated with providing recommendations to the Legislature by January 1, 2023, after which an actuarial study would be completed by the end of 2023 as part of the Legislature’s consideration.

On October 6, 2022, the Task Force held public meetings to discuss a draft feasibility report. The feasibility report contained five potential program designs and also noted the Task Force members’ preferred designs.

On December 15, the feasibility report was approved with minor changes from the draft feasibility report. This final feasibility report will be sent to the Governor, Insurance Commissioner and legislature. It will be used as the basis for the actuarial report which is under development with plans for completion by the end of 2023.

Given the complexity and cost to fund a state run LTC program, we would expect the legislative process to take 1-2 more years before a program is in place. The deadline to introduce new legislation for 2023 has passed.

Important dates

  • Final feasibility report due to Governor, Insurance Commissioner and legislature – 1/1/23
  • Draft actuarial report circulated for review and feedback – 9/1/23
  • Target actuarial study completion date – 1/1/24
Connecticut

Updated 3/13/23

What’s on the docket?
Connecticut introduced SB 903 earlier this session to require the Department of Insurance to study how many people are currently using LTC as a percentage of the population. The results of this study could lead to further discussion about the need for a state-run LTC program. On March 8, the bill, which would authorize the study, was referred to the Office of Legislative Research and Office of Fiscal Analysis. The study, if conducted, will be presented to the General Assembly on July 1, 2024.

Important dates

  • Study to be presented to the General Assembly – 7/1/24
Massachusetts

Updated 3/23/2023

What’s on the docket?

A democratic house representative officially introduced House Bill 652 to create a special commission that would make recommendations to establish a statewide long-term care insurance program. The bill has been referred to the Committee on Elder Affairs and, as of yet, has not been scheduled for a hearing.

Minnesotta

Updated 3/27/23

What’s on the docket?
The Minnesota Department of Human Services Aging and Disability Services Administration Division submitted a request for proposal for a contractor to study options to increase access to long term care financing, services, and support in Minnesota. As of March, 2023, this contract has been awarded to FTI Consulting who will be partnering with Altarum to conduct the study.

In addition, legislation was introduced in March, 2023, to place a constitutional amendment on the November, 2024 ballot to establish a fund for long-term care services. According to the MN Life & Financial Services Council, this bill has been introduced in previous sessions and has never advanced. 

New York

Updated 3/6/23

What’s on the docket?
A Democratic senator introduced S9082, the “Long Term Care Trust Act,” in May of 2022. As introduced, it provides the opportunity for individuals with private LTC coverage to opt-out from the proposed state plan, however, this does not include hybrid products like Trustmark’s Universal Life or Trustmark Life + Care® products. 

Where do things stand?
The bill was referred to the Senate Health Committee and the legislature did not meet again before the end of the 2021-2022 legislative session. Legislation does not carry over into the 2023-2024 legislative session and therefore, would need to be reintroduced.

In preparation for the 2023 legislative session, Trustmark is working closely with the Life Insurance Council of New York (LICONY) to educate the Senator on LTC riders included with life insurance policies. Our goal is to increase education on hybrid life products so that these products will be given consideration for the opt-out in future legislation. 

Pennsylvania

Updated 4/11/22

What’s on the docket?
House Bill 844 was introduced April 10, 2023 by a Democratic representative. The bill would establish a LTC program very similar to the WA Cares Fund. The legislation, as introduced, establishes a Long-Term Services and Supports Commission and creates a Long-Term Services and Supports Council and Trust Fund. It also imposes a payroll tax of .58% and exempts individuals who already have private LTC coverage.

Where do things stand?
The bill has been assigned to the Assembly Human Services Committee. This is the same bill that was introduced in August 2022. While it could advance out of committee, it looks as if it will be difficult to get approval of the bill in the state Senate.

Washington

Updated 3/2/23

Where do things stand?
In 2019, the “Trust Act” was passed, later establishing “The WA Cares Fund.” The program would be funded by a .58% payroll tax, but included an exemption for individuals who owned private LTC insurance prior to November 1, 2021. The LTC rider included with Trustmark’s Universal Life and LifeEvents product qualified individuals to opt-out of the WA Cares Fund and the corresponding tax.

After the WA Cares Fund was established, the legislature created the Long-Term Services and Supports Trust Commission (Trust Commission), consisting of legislators, administering agencies, and stakeholder representatives. The Trust Commission’s purpose is to develop recommendations to update and improve the WA Cares Fund, including a potential recertification requirement for individuals who received an exemption due to private coverage.

Effective October 29, 2022, spouses and domestic partners of active-duty service members may apply for a conditional exemption from the Washington Cares program. Workers with a nonimmigrant visa for temporary workers may also be eligible to apply for a conditional exemption

What’s on the docket?
The LTSS Trust Committee held a December 2022 meeting to approve the LTSS Trust Commission Recommendations Report. In regards to recertification of coverage, the report recommends:

Require all individuals with approved exemptions to provide proof that they had purchased a qualifying LTC policy prior to November 2021 and that they have maintained their policy through the present day. To maintain an exemption, recertification is required to occur at an interval of no more frequently than annually and no less frequently than every three years, beginning in December 2024. Recertification is no longer required or possible after ten years. Legislative authority would be needed in 2023 to implement by December 2024.” – View the LTSS Trust Commission webpage here for more detail.

Washington State Representative Peter Abbarno (R), introduced legislation, HB 1011, to repeal the long-term care services and supports law that goes into effect in 2023. A separate bill was also introduced that would prohibit recertification of coverage for tax exemption (SB 5639). The deadline has passed for these bills to pass in 2023.
 
The Office of the State Actuary published an actuarial study of the WA Cares Fund on October 20th, 2022. The report indicates the fund is expected to be solvent through its first 75 years. The full report can be found here.

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