Our system of paying for long-term care services is badly broken. Medicare does not pay for long-term care in assisted living or in a nursing home, which many people don't realize till it’s too late. Private long-term care insurance is purchased by fewer than one in ten people. Medicaid that pays for most long-term care costs in the US can require big financial decisions for asset protection planning, for those lucky and smart enough to get the right kind of advice. For those who don't get the right advice, Medicaid eligibility requires that they almost completely impoverish themselves before qualifying under strict asset and income rules.

Nonetheless, Medicaid costs and all long-term care expense continue to grow[SW1] – and the crisis will only get worse as the baby boomer population bulge ages.

Care and support services outside of a nursing home for seniors and disabled citizens is effectively not part of the broad social safety net in the United States, that provides doctor and hospital care through Medicare and retirement income through Social Security.

A difficult task falls on those elderly and disabled who need help with daily living activities, to provide for their own care and meet their own needs – particularly on “orphan elders,” with no friends or family nearby to help – and especially on caregivers themselves.

Caregiving can be a brutally exhausting job, both physically and emotionally. Often it can even be financially draining too, when caregivers need to miss or quit their jobs. A high proportion of caregivers spend their own money for help and assistance for a loved one.

Now, Washington is the first state to establish a taxpayer-funded, universally available, long-term care benefit. It will be available to help both needy seniors and disabled and their dedicated, hardworking caregivers. It’s similar to Medicare and Social Security, which feature universal requirements and benefits.

The benefit is $100 per day, for a lifetime maximum of $36,500, though the benefit cap amount is indexed to grow with inflation. Those eligible are people with disabilities who need help with daily living activities and have paid into the system for 10 years (or just three years, in the case of catastrophic illness).

The coverage can be used for a wide range of needs, as determined by the recipient, for his or her own benefit.

It's funded by a universal, mandatory tax on all working people of only 58 cents per $100 of income – that’s just over half of one percent. [SW2] This tax is expected to cost the average Washington wage-earner about $18 per month or a little more than $200 per year.

While $36,500 won't provide for someone for life, it can help needy individuals pay for whatever is required, such as for outside caregiver help, to compensate family for their help, accessible home retrofits such as a ramp, transportation to and from medical appointments, and other disability related purposes.

It can help someone stay out of a nursing home or care facility longer, so it's expected to save Washington State Medicaid dollars, that otherwise would pay for expensive nursing home care when someone can't to stay at home any longer.

Advocates say that it's important for everyone to begin to see care needs of the elderly and disabled as a shared, communal responsibility, instead of just an individual need. This legislation was a result of a long, consensus-building process of education, advocacy, and compromise.

Critics call it a government overreach and one more objectionable tax. Supporters say it doesn't go far enough.

Remember that if you need long-term care, an elder law attorney may be able to help you get the care and services you need, while saving more of your own money for you to keep – especially if you are headed toward expensive nursing home care.

The long-term care crisis is happening now, and it’s going to get worse. 70% of Americans will need some kind of long-term care after turning 65. This program for universal family care may be a model for changing in coming years.

[SW1]What do you mean? Are the budgets getting bigger or smaller?

[SW2]This is a bit confusing