While the needs of younger Washingtonians will be the Legislature’s primary focus next year in the form of school funding, lawmakers also will have to attend to the state’s older residents.
The population is aging, fueled by the baby boomer generation and by extended life spans, and that fact promises to place a heavy burden upon the health care system. Of course, it is no surprise that populations throughout the United States are growing older, but two statistics in particular drive the point home — today, 11 percent of Washington residents are 65 years or older; by 2030, an estimated 20 percent will be 65-plus.
With that in mind, it is incumbent upon next year’s Legislature to begin some long-range planning for how the state will deal with the attendant health concerns and costs. While the changing demographics long have been anticipated, little has been done to quantify what impact that will have upon state services. Gov. Jay Inslee’s last budget request included $500,000 for a study that might have answered those questions, but the earmark was scratched from the final budget. Whether the information comes from a state-financed study or from reliable estimates by private organizations, it would seem prudent for lawmakers to lend their attention to the issue during the 2015 session. The stakes are simply too high to ignore. The current budget, for the 2013-15 biennium, includes $1.8 billion for the state Medicaid program’s long-term services and support. That represents about 6 percent of the budget, a number that is likely to grow over the next 15 years.
Undoubtedly, this can be a difficult conversation, on both the private and the public policy levels. Individuals, succumbing to human nature, typically are reluctant to envision a future that includes a loss of independence, one that requires assistance for such daily activities as preparing meals and getting dressed. Relatively few of us are financially prepared for a stage of life that is inevitable for many, and long-range planning is necessary at both the individual and the state levels.
In Washington, Medicaid payments account for about 62 percent of long-term services and supports, with families picking up most of the remainder. The implementation of Medicaid assistance, however, requires that a recipient liquidate all their savings and property, increasing the burdens on families.
According to AARP, formerly the American Association of Retired Persons, in 2009 about 42 million unpaid family caregivers provided assistance to adults in the United States that would be worth about $450 billion. That was an increase from about $375 billion just two years prior, and the numbers are likely to continue growing — even though projections suggest the number of unpaid family caregivers is likely to decline.
All of this presents an untenable future for long-term aging care, but Washington can approach the issue from a position of strength. A survey sponsored this year by AARP, measuring categories such as family support or access and affordability, ranked the state second only to Minnesota in terms of long-term services and supports. Washington has a long tradition of strong social services, but the landscape for aging care is changing, and leaders cannot adequately prepare without adequate information.
Families will continue to provide care, and Medicaid will continue to pay some of the bills, but some long-range thought will be required to ensure that services are available for the elderly.