4.13.2026 | Published | Long Term Care Map

Long-term care legislative map

Click on the name of the state to view the latest updates

Washington

The first to enact a law was Washington State, which began on July 1, 2023, with the first benefits becoming available in July 2026. The program, Long- Term Services & Supports (LTSS)is mandatory for all W-2 employees. Individuals who owned private LTC insurance prior to November 1, 2021, were eligible to “opt-out” of the payroll tax by applying for an exemption by December 31, 2021. Three bills were introduced to amend the Washington Cares Fund Long-Term Care program: House Bill 2271, House Bill 2272, and Senate Bill 6072.

Funding: 0.58% payroll tax on all wages (no income cap); employee-paid Employer impact: Employers must collect and remit tax; maintain exemption records for employees with qualifying private coverage

Not yet started

Filings started

Considering

Implemented

Long-term care legislative status

Implemented

Wyoming

Considering legislation, but nothing confirmed at this time.

Considering

Long-term care legislative status

Oregon

Idaho

The initial legislation that created the LTC task force to evaluate and complete studies to inform a state LTC program was finished in February 2024. The new Legislation is required to propose a final state LTC program. No action was taken as of the March deadline to submit legislation for the 2024 calendar session.

Filings started

Long-term care legislative status

California

Nevada

Texas

Tennessee

South Dakota

Considering legislation, but nothing confirmed at this time.

Considering

Long-term care legislative status

Utah

South Carolina

Considering

Long-term care legislative status

Rhode Island

Oklahoma

Ohio

Considering legislation, but nothing confirmed at this time.

Considering

Long-term care legislative status

North Carolina

Funding: S1179 proposes payroll tax (details pending); tax deduction bill uses tax incentives (no new revenue) Employer impact: Limited carrier market creates urgency; tax deduction supports voluntary benefits now

Filings started

Long-term care legislative status

New York

Considering

Long-term care legislative status

New Mexico

New Jersey

Nebraska

Montana

Considering legislation, but nothing confirmed at this time.

Considering

Long-term care legislative status

Missouri

While legislation did not advance beyond committee, Minnesota lawmakers continue to actively explore private insurance affordability options that include long-term care conversion.

Considering

Long-term care legislative status

Minnesota

Bipartisan care Caucus formed Department of Health and Human Services published LTSS feasibility study in January 2021

Considering

Long-term care legislative status

Michigan

What's happening: Two competing bills propose different approaches. S.2645 envisions a mandatory program with no opt-out, while H.4559 includes a voluntary opt-out provision (like Washington). Both would establish a commission to study program design, with recommendations due within 2 years. Separately, the state enacted a 20% tax credit on LTC insurance premiums (effective June 2025), incentivizing private coverage. Funding: Under study; commission will evaluate payroll tax structures Employer Impact: Tax credit makes voluntary LTC benefits more attractive now; prepare for potential mandate 2027+

Considering

Long-term care legislative status

Massachusetts

Maryland

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Considering

Long-term care legistlative status

Maine

Kentucky

Kansas

Iowa

Indiana

Funding: Payroll tax-funded (specific rate and structure pending) Employer impact: Would require payroll tax collection; exemption process details pending

Filings started

Long-term care legislative status

Illinois

Georgia

Florida

District of Columbia

Delaware

Considering

Long-term care legislative status

Considering

Long-term care legislative status

Colorado

Arkansas

Arizona

Considering legislation, but nothing confirmed at this time.

Considering

Long-term care legislative status

Alaska

Nothing pending at this time.

Not yet started

Long-term care legislative status

Alabama

Wisconsin

Learn more

No action was taken as of the March deadline to submit legislation for the 2024 calendar session.

Considering legislation, but nothing confirmed at this time.

For more information about the Massachusetts Bills, visit the links below.

Nothing pending at this time.

Not yet started

Long-term care legislative status

Nothing pending at this time.

Not yet started

Long-term care legislative status

Nothing pending at this time.

Not yet started

Long-term care legislative status

Nothing pending at this time.

Not yet started

Long-term care legislative status

Nothing pending at this time.

Not yet started

Long-term care legislative status

Considering legislation, but nothing confirmed at this time.

Considering

Long-term care legislative status

Nothing pending at this time.

Not yet started

Long-term care legislative status

Nothing pending at this time.

Not yet started

Long-term care legislative status

Nothing pending at this time.

Not yet started

Long-term care legislative status

Nothing pending at this time.

Not yet started

Long-term care legislative status

House Joint Resolution has been introduced in January 2024 to form a task force to evaluate and make recommendations for a state LTC program legislation by September 2026.

Not yet started

Long-term care legislative status

Nothing pending at this time.

Not yet started

Long-term care legislative status

Nothing pending at this time.

Not yet started

Long-term care legislative status

Nothing pending at this time.

Not yet started

Long-term care legislative status

Nothing pending at this time.

Not yet started

Long-term care legislative status

Funding: Model 1: Payroll tax; Model 2: State reinsurance pool funded by state revenues Employer impact: Varies by model; reinsurance option could strengthen private market vs. compete with it

Filings started

Long-term care legislative status

Nothing pending at this time.

Not yet started

Long-term care legislative status

Nothing pending at this time.

Not yet started

Long-term care legislative status

Nothing pending at this time.

Not yet started

Long-term care legislative status

Nothing pending at this time.

Not yet started

Long-term care legislative status

Nothing pending at this time.

Not yet started

Long-term care legislative status

Nothing pending at this time.

Not yet started

Long-term care legislative status

Nothing pending at this time.

Not yet started

Long-term care legislative status

Nothing pending at this time.

Not yet started

Long-term care legislative status

Nothing pending at this time.

Read the disclaimer

This document is not intended to be taken as advice regarding any individual situation and should not be relied upon as such. Marsh & McLennan Agency LLC shall have no obligation to update this publication and shall have no liability to you or any other party arising out of this publication or any matter contained herein. Any statements concerning actuarial, tax, accounting or legal matters are based solely on our experience as consultants and are not to be relied upon as actuarial, accounting, tax or legal advice, for which you should consult your own professional advisors. Any modeling analytics or projections are subject to inherent uncertainty and the analysis could be materially affected if any underlying assumptions, conditions, information or factors are inaccurate or incomplete or should change. d/b/a in California as Marsh & McLennan Insurance Agency LLC; CA Insurance Lic: 0H18131 Copyright © 2026 Marsh & McLennan Agency LLC. All rights reserved. MarshMMA.com

Considering legislation, but nothing confirmed at this time.

Considering

Long-term care legislative status

North Dakota

Considering legislation, but nothing confirmed at this time.

Considering

Long-term care legislative status

Louisiana

Considering legislation, but nothing confirmed at this time.

Considering

Long-term care legislative status

Mississippi

Considering legislation, but nothing confirmed at this time.

Considering

Long-term care legistlative status

Virginia

Considering legislation, but nothing confirmed at this time.

Considering

Long-term care legislative status

Vermont

Employer impact: Would require payroll tax collection; program details pending

Filings started

Long-term care legislative status

West Virginia

Considering legislation, but nothing confirmed at this time.

Considering

Long-term care legislative status

New Hampshire

Considering legislation, but nothing confirmed at this time.

Considering

Long-term care legislative status

Maine

Funding: Study phase only; no funding mechanism proposed yet Employer impact: Monitor for potential legislation in 2027+; timeline suggests 2028+ implementation at the earliest

What's happening: House Bill 4918 proposes creating the Long-Term Care Trust Act. The bill references similar program structures to those in Washington and Hawaii but has not yet provided specific details on tax rates, benefit levels, or vesting requirements.

What's happening: Assembly Bill 1663 takes a unique approach by proposing a study of TWO distinct models: (1) a traditional public payroll tax program providing limited benefits (like WA/HI), or (2) a public-private reinsurance model where the state reimburses private insurers for catastrophic claims to encourage market expansion.

What's happening: Two separate legislative tracks are active. One bill (introduced in January 2025) proposes a personal income tax deduction for LTC riders attached to life insurance policies. Separately, Senate Bill S1179 proposes creating a "New York Long-Term Care Trust" funded by payroll taxes. Session adjourned June 2025; discussions expected to resume in 2026.

What's happening: House Bill 5664 proposes creating the West Virginia CARES Fund, a payroll tax-funded program following the Washington/Hawaii model. Funding: Payroll tax (rate and structure details pending; expected to mirror HI/WA models)

Employer impact: If passed, employers would collect/remit payroll tax starting in 2027

Filings started

Long-term care legislative status

Hawaii

What's happening: Senate Bill 2931 would establish the Hawaii CARES Fund, providing benefits in $100 units up to 365 units ($36,500 lifetime maximum). Eligibility requires the inability to perform 3 of 6 ADLs or severe cognitive impairment, plus vesting requirements. Funding: Payroll tax (rate TBD); premium collections would begin January 1, 2027

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H.3025

S.2645

H.4559

H.3025

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Connecticut

For more information about Pennsylvania House Bill 2779, visit the link below.

Max $36,500 lifetime benefit ($100 per day) .58% payroll tax for every $100 earned – no cap. Employee paid tax Work 500 hours for 10 years or 3 years if individual experienced a catastrophic disabling event Loss of three activities of daily living to activate LTC benefits 3 ADL’s required Hybrid life plans expected to be approved for opt-out.

Program design

Workers near retirement (born before 1968) will be able to qualify for partial benefits on a pro-rated basis. (1/10th of the lifetime benefit for each year) Opt-out available if an individual has a private LTC plan or is self-employed. Opt-out period will be limited.

Bill proposal

Pennsylvania introduced House Bill 2779 on August 22, 2022. The Aging and Older Adult Services Committee was developed to enact a bill that provides statewide long-term care. The proposed bill appears to mirror the Washington State Cares Fund Act (WA Cares Fund). The bill will not receive consideration in 2022. New legislation was introduced in April 2023 to create a state LTC program was referred to the state’s Senate Health and Human Services Committee, where it remains without action.

Filings started

Long-term care legislative status

Pennsylvania

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What's happening: Bill 122 directs the Commissioner of Social Services to conduct a comprehensive study of the state's long-term care needs and infrastructure gaps. This is the earliest stage of legislative development—data gathering before program design. A report is due by January 1, 2027.

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