Long-term care (LTC) isn’t just a policy issue—it’s a deeply personal one. It’s something many of us don’t think about until we’re forced to, and by that point, the emotional and financial weight can feel overwhelming.

I’ve seen this firsthand. My father needed care for just one month, and even in that short time, I saw how quickly costs and coordination challenges pile up. Now, my stepfather requires 12-hour care daily, and it’s a reminder every single day of how necessary—yet complex and expensive—long-term care really is.

And I’m far from alone.

The Growing Need for Long-Term Care

Here’s what the data tells us:

• About 70% of people turning 65 today will need some form of long-term care.
• This isn’t just nursing home care—it includes help with everyday tasks like bathing, eating, and mobility.
• 24/7 in-home care can cost $290,000+ per year.
• Despite the need, only about 10% of older Americans have private LTC insurance.
• Many people mistakenly believe Medicare will cover these services—it doesn’t, beyond short-term rehab or skilled nursing.

The Aging Boom—and Why It’s Different This Time

We’re not just living longer—we’re aging differently.

• By 2030, 1 in 5 Americans will be over 65.
• The 85+ age group is expected to triple by 2050.
• Long-term care needs are projected to rise from 6.3 million in 2015 to 15 million by 2050.
• The U.S. faces a looming shortage of 3.8 million unpaid caregivers and over 150,000 paid care workers by 2030.

Here’s what makes this moment unique:

Advancements in modern medicine are keeping our loved ones alive longer—but often at a cost. Chronic conditions that used to be fatal—like strokes, cancer, and heart failure—are more survivable today. That’s a good thing. But it often means people live with greater long-term care needs, including mobility assistance, memory care, and support with daily tasks for years, not months..

The Impact of Modern Medicine: Living Longer, But at What Cost?

One of the most striking aspects of the past few decades is the dramatic improvement in medical treatments and technology. Today, people can survive conditions that would have been fatal 20 years ago—things like heart disease, strokes, and even advanced cancer. Surgical advances and medical interventions have significantly increased life expectancy, and with that, the demand for long-term care has risen.

The Cost of Care Then vs. Now

In 2005, the average cost for private room care in a nursing home was about $64,000 per year. Today, that cost has ballooned to $120,000-$150,000 per year, depending on the region.

Home care services, which are often more desirable for families, cost around $19 per hour in 2005. Fast forward to today, and private home care costs upwards of $30 per hour or more in many areas.

Not only are people living longer, but they often have multiple chronic conditions, which require ongoing treatment and medical management. This increases the complexity and costs of long-term care dramatically. Additionally, medical advancements mean that conditions like Alzheimer’s disease, once considered an unavoidable part of aging, are now managed for longer periods, creating longer care timelines.

Even more startling is that the average person may now spend 3-5 years in a nursing home or with intensive at-home care—a huge jump from past decades when many only spent a year or two in such facilities. This adds to the mounting costs over time, creating a financial burden that not many families are prepared for.

Why My Story Matters—and Yours Might Too

When my father needed care—even for just one month—it was emotionally and financially taxing. And now that my stepfather is under 12-hour care every single day, I’m even more aware of how much planning, coordination, and support it takes—not just for the individual, but for the entire family.

These experiences aren’t rare anymore. They’re quickly becoming the norm. And it’s part of why so many states are starting to take long-term care more seriously at the policy level.

How States Are Responding: 13 Exploring LTC Mandates

As of early 2025, at least 13 states are actively considering or have introduced legislation related to mandatory or publicly supported long-term care (LTC) insurance programs. This movement reflects growing pressure to find sustainable solutions for aging populations and overburdened Medicaid systems.

Here’s where things stand:

• Washington – The first (and currently only) state to implement a public LTC insurance program: WA Cares Fund. Funded by a 0.58% payroll tax, it offers up to $36,500 in lifetime benefits starting in 2026. (What went wrong: A mad dash to buy private LTC insurance during the opt-out window led to insurance carriers pulling out of the market due to unmanageable demand. The state delayed rollout and had to reassess implementation strategies.)
• California – Completed a multi-year task force review; now weighing options for a public LTC insurance model funded by payroll deductions. Legislation is pending.
• Minnesota – Studying public LTC insurance, Medicare companion products, and enhanced care coordination programs. Legislative proposals are likely soon.
• Oregon – Passed legislation to study state-level LTC financing. A detailed report is expected in 2026.
• Colorado – Introduced a bill to offer tax credits for LTC insurance. It didn’t pass, but the issue remains on the table.
• Hawaii – Signed SB 2224 into law in 2024, launching a formal planning process to design a statewide LTC system. A report is due in 2025.
• New York – Proposed a Long-Term Care Trust Program funded by payroll deductions. The bill is in committee and gaining attention.
• Pennsylvania – Considered a payroll tax-based LTC fund. The proposal didn’t move forward, but growing Democratic support suggests it could resurface.
• Vermont – Launched a state study in 2025 to evaluate a public LTC trust. Recommendations are expected by mid-2026.
• Kentucky – Introduced a resolution to form a task force on LTC insurance feasibility. Under legislative review.
• Illinois – In the early stages of evaluating a state-funded LTC model. Working groups and actuarial studies are underway.
• Maine – Reviewing proposals for a potential LTC trust. Discussions and fiscal modeling are ongoing.
• Utah – Quietly considering LTC insurance reform as part of broader aging policy strategy. Legislative study expected in 2025.

Why It Matters

Each state is tackling the issue a bit differently—some pushing mandates, others launching studies—but all share a core concern: Most residents aren’t financially prepared for long-term care, and Medicaid can’t carry the load forever. By creating public options or requiring some level of private coverage, these states are trying to fill the gap before it becomes a full-blown crisis.

Final Thoughts: Plan While You Can

Long-term care is coming—for most of us. It may be for yourself, your spouse, a parent, or someone you love. The question isn’t if, it’s when, and how prepared will you be? Here’s what you can do now:

• Talk with family about care expectations and financial planning
• Look into private LTC insurance while you’re still healthy enough to qualify
• Pay attention to what your state is doing—policy changes could affect your taxes, insurance options, and care access

You don’t need to have all the answers today—but waiting until you’re in a crisis makes everything harder. I’ve lived that, and I can tell you: early planning means peace of mind.

How We Can Help

Let’s work together to ensure your business and employees thrive in 2025 and beyond. Contact us today to learn more about how we can support your organization in developing a successful and sustainable long-term care benefits strategy for you and your employees.