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H.R. 2082: Well-Being Insurance for Seniors to be at Home Act

This bill, known as the Well-Being Insurance for Seniors to be at Home Act (or WISH Act), aims to amend the Social Security Act to establish long-term care insurance benefits for older individuals. The key features of the bill are summarized below:

Purpose and Findings

The purpose of the WISH Act is to support older adults who experience serious disabilities, allowing them to live independently in their communities while minimizing reliance on Medicaid. The bill acknowledges the growing need for long-term services and supports (LTSS) as the population ages, projecting that many seniors will face significant financial burdens without sufficient planning or coverage for care needs.

Long-Term Care Insurance Benefits

The bill proposes the following structure for long-term care insurance benefits:

  • Eligibility extends to individuals who are of retirement age, have applied for benefits, are insured for long-term care, and have a serious functional disability.
  • The monthly benefit amount is determined based on the median cost of paid personal assistance, multiplied by a ratio of the number of quarters of coverage the individual has compared to 40 quarters required for full coverage.
  • To be considered "insured" for benefits, individuals must have at least six quarters of coverage.
  • The definition of "serious functional disability" aligns with existing guidelines, where individuals are expected to need assistance for a significant length of time.

Federal Long-Term Care Insurance Trust Fund

A new trust fund, called the Federal Long-Term Care Insurance Trust Fund, will be established to manage the funds for this insurance program. The bill allocates initial funding for the establishment of the program and public education regarding long-term care.

Public Education and Outreach

The bill mandates the development of a public education plan to inform individuals about the risks and costs of long-term care. This includes understanding how to secure benefits and the importance of planning for potential care needs, especially during the early years of disability. Funding is designated from the trust fund for public education initiatives.

Eligibility and Compliance Requirements

Individuals receiving benefits must comply with relevant wage and tax laws if they hire non-family members to provide care. They will also be required to submit annual statements to confirm their ongoing eligibility for benefits.

Periodic Reports and Assessments

Regular reports will be submitted to Congress, evaluating the effectiveness of the long-term care benefits and addressing any issues regarding eligibility manipulation or potential financial exploitation of beneficiaries.

Expected Implementation Timeline

The bill outlines process timelines, including the establishment of the trust fund and public education efforts, while defining the base period for insurance eligibility to begin in 2026.

Relevant Companies

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Sponsors

2 bill sponsors

Actions

2 actions

Date Action
Mar. 11, 2025 Introduced in House
Mar. 11, 2025 Referred to the House Committee on Ways and Means.

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