OLYMPIA, Wash. — With Washingtonians aging rapidly, how will the state provide long-term care? Many groups believe the bipartisan legislation known as the Long-Term Care Trust Act is one solution.

The novel program would provide long-term care insurance through a payroll deduction of about 0.5 percent. Those funds would then be able to fully cover the average cost for in-home care for one year.

Sarita Gupta, co-director of the group Caring Across Generations, said this legislation would be especially helpful for Washington's 830,000 family caregivers taking care of their Baby Boomer parents.

"They're living much longer than ever before - about 20 years longer than when our safety net was put into place,” Gupta said. “So, we need more supports around elder care, and a lot of the financial burden is actually falling on families."

Gupta said it's important to note that Medicare does not cover long-term care.

On Wednesday, the House Committee on Health Care and Wellness held a public hearing on House Bill 2533. Today, the Senate Committee on Health and Long Term Care is holding a public hearing on its companion bill.

University of Hawaii political science professor Lawrence Nitz is in Olympia supporting the bills. Last year, Hawaii passed similar legislation to provide funds for working caregivers.

Nitz said this type of legislation is crucial, not only to keep down health care costs for state budgets, but also because it allows family caregivers to keep working.

"Every time we have someone leave the labor force unnecessarily, when a little bit of money could have kept them there, this is a loss to the economy,” Nitz said. “We lose their whole wage, and that adds up very quickly."

Nitz said long-term care insurance from the private sector typically benefits the wealthy because they are the only ones able to afford it over a long period of time.

Gupta said if the country doesn't seize the opportunity to get ahead of this issue and build a long-term care infrastructure, many families could be heading toward a financial cliff.

"We'll have millions of families who will be struggling and juggling to meet their care needs, and many who will fall through the cracks,” Gupta said. “And so, the urgency is now, the opportunity is now before it reaches that level of crisis."

The legislation is receiving support from a broad range of groups, including the state chapter of the Alzheimer's Association, Casa Latina and the caregivers' union SEIU 775.


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After more than 50 years of use, some Michigan lawmakers say naloxone may not be the best choice in an overdose situation.

Naloxone is sometimes called the "Lazarus drug" because of its powerful ability to seemingly resurrect people after a drug overdose.

Sen. Kevin Hertel, D-St. Clair Shores, and some of his colleagues have introduced a bill which would open the door for what they say are more costly, but more powerful, antidotes.

"Given the prevalence of fentanyl in our communities, and how much stronger some of these drugs that we're now seeing are, we believe -- and in talking with others -- that there should be other tools to respond to an overdose," Hertel explained. "To make sure we're doing everything we can to save somebody's life."

Not everyone is on board with the proposed legislation, Senate Bill 542. Opponents argued the more expensive naloxone alternatives are not necessary, and using them would only increase profits for the pharmaceutical industry.

Jonathan Stoltman, director of the Opioid Policy Institute in Grand Rapids, said while the naloxone alternatives do help in overdose situations, they can also cause nasty side effects.

"The newer approaches, they put people into more severe withdrawal," Stoltman pointed out. "That's a pretty profound negative side effect. The one approach is very inexpensive and works great; the other approach is far more expensive and has this strong negative side effect."

Sponsors of the bill say they're hoping to give Michigan residents a chance to chime in on the issue in a public hearing sometime in June. Michigan saw more than 3,000 opioid overdose deaths in 2021.


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New Mexico saw record enrollment numbers for the Affordable Care Act this year and is now setting its sights on lowering out-of-pocket costs - those not reimbursed by insurance. More than 56,000 New Mexicans are enrolled in a medical health insurance plan on the state exchange - an increase of 12,000 people overall.

Colin Baillio, deputy superintendent with the state's Office of Insurance, said the state has boosted its outreach and made efforts to improve the overall consumer experience.

"We saw a 40% year-over-year increase, and New Mexico saw the biggest percentage increase during the open-enrollment period among all of the state-based marketplaces," he explained

Part of the enrollment increase is due to what's called the "unwinding" - a federal directive that required all states to redetermine Medicaid eligibility following a three-year pause on checks during the COVID pandemic. He said by using expanded tools made available by the federal and state government, 8% of New Mexico's population is now uninsured - down from 23% in 2010.

Following approval by lawmakers in the 2024 legislative session, the New Mexico governor signed seven health care-related bills into law - one of which requires annual reporting of prescription drug pricing. Baililo said the Affordable Care Act built the foundation that has allowed the state to pursue additional affordability initiatives.

"I'm really glad to see that there's so much interest in the next step of health reform, really leaning into these out-of-pocket cost issues and making it easier for people to afford to stay covered and see their doctors," he continued.

Two years ago, the state also passed a one-of-a-kind law that did away with behavioral health co-pays for people in certain insurance plans.

New York's medical aid-in-dying bill is gaining further support. The Medical Society of the State of New York is supporting the bill. New York's bill allows terminally ill people with only six months to live to use this option, with safeguards requiring two physicians' approval.

The bill's Assembly sponsor Amy Paulin, D-Westchester, said despite the growing support, other hurdles lie ahead.

"Now we have what I believe, if it came to the floor, a majority. There's still a hesitation on the part of leadership. You know, we need members to assure leadership that they no longer have reservations," she said.

Other newly resolved concerns center on making sure insurance companies and doctors who don't support this aren't held liable. She's optimistic the bill will pass after nine years in the Legislature. New York would be the 11th state along with Washington, D.C. to have medical aid in dying legislation.

Corinne Carey, senior New York campaign director with Compassion and Choices finds the pandemic drew a vivid picture of a person's end-of-life experience. There were images of people dying on ventilators, apart from loved ones, and unable to communicate. She said people began thinking about a "good death."

"And, what is a good death is being surrounded by loved ones, having some measure of control, experiencing the touch of your loved ones, and being the one in the driver's seat," she explained.

Now people have different options for end-of-life care, each of which presents various challenges. Polls show medical aid in dying has garnered considerable support since being introduced in 2015. A 2022 Compassion and Choices poll finds 57% of nurses support medical aid in dying professionally, although fewer support it personally.