The WISH Act: Transforming Long-Term Care Insurance and Aging-in-Place Solutions in the U.S.
The WISH Act proposes a federal long-term care insurance trust fund to provide monthly funds for long-term care expenses after a waiting period, aiming to support aging in place and reduce reliance on Medicaid. (Source: Fotor AI)
As the United States faces a rapidly aging population and rising long-term care costs, the Well-Being Insurance for Seniors to be at Home (WISH) Act has emerged as a landmark policy proposal to address the nation’s long-term care crisis. Introduced in Congress in March 2025, the WISH Act aims to create a federal long-term care insurance trust fund, offering monthly benefits to help Americans age in place while reducing the strain on Medicaid and transforming the long-term care insurance market.
“Why the WISH Act?”
Key Features of the WISH Act
Federal Long-Term Care Insurance Trust Fund: The WISH Act proposes a universal insurance program funded by a payroll tax (split equally between employers and employees), creating a dedicated trust fund similar to Social Security and Disability Insurance.
Monthly Benefit for Long-Term Care: After a waiting period (one to five years, based on income), eligible seniors would receive a monthly cash benefit (about $3,600, inflation-adjusted) to pay for home-based or community-based care, supporting the strong preference among older adults to age at home.
Income-Based Waiting Period: Lower-income individuals would access benefits sooner, while higher-income individuals would have a longer waiting period, ensuring equitable access and program sustainability.
Public-Private Partnership: The WISH Act is designed to complement, not replace, private insurance. During the waiting period, individuals could use private insurance, personal savings, or family support, with the federal benefit kicking in for catastrophic, long-term needs. This structure incentivises private insurers to offer affordable, short-term coverage and revitalizes the private LTC insurance market.
Medicaid Relief: By providing a federal benefit before seniors exhaust their assets, the WISH Act is projected to reduce Medicaid expenditures and prevent seniors from having to spend down their savings to qualify for care.
Market Impact and Industry Opportunities
Expanding Home-Based Care: By providing a reliable funding source for in-home care, the Act is expected to drive demand for home health services, assistive technologies, and aging-in-place solutions—key growth sectors in the care economy.
Stimulating Private Insurance Innovation: With the government covering catastrophic risk, private insurers can offer more affordable, flexible policies for the initial years of disability, broadening market reach and reducing consumer costs.
Supporting Workforce Development: The influx of federal LTC funding is likely to create new jobs in home care, care management, and related services, supporting economic growth and professionalization in the care sector.
Promoting Equity: The universal, income-adjusted design ensures middle-income Americans have access to care without impoverishing themselves, addressing a major gap in the current system.
Driving Industry Partnerships: The WISH Act encourages collaboration between public and private sectors, technology providers, and care organizations to deliver integrated, high-quality services.
Current Trends and Outlook
The long-term care insurance market is already evolving, with the global market size projected to reach $49.44 billion by 2030, driven by demographic trends, regulatory reform, and technological innovation. The WISH Act aligns with these trends by fostering a more sustainable, consumer-centric insurance ecosystem and supporting the broader shift toward home-based, tech-enabled care.
Recent industry support for the WISH Act—from organizations such as the National Council on Aging, American Geriatric Society, and major insurers—reflects growing consensus on the need for systemic reform. Public education and outreach are also integral to the bill, with requirements for nationwide campaigns to boost LTC literacy and planning.
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