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How Washingtonians access health care is on the ballot — and could be again in the future

Initiative 2124 would make state's long-term care insurance program optional

By Annie Todd Criminal Justice/Enterprise Reporter

This election reporting is provided free to all readers as a public service by your locally owned Cascadia Daily News. Thanks for supporting truly local news by donating to CDN or subscribing here.

With four months to go until Election Day, a coalition of health care advocates has launched its campaign against a ballot initiative that they fear would “kill” Washington’s long-term care insurance program.

Initiative 2124 would make it optional for workers to pay into WA Cares, a statewide insurance program that allows Washingtonians to earn a long-term care benefit that could be used on expenses related to caretaking, medical equipment or meals. The program was approved by state lawmakers and signed into law in 2019.

I-2124 is one of three statewide initiatives Washingtonians will find on their November ballot, and is the only one focused on health care. 

But how residents access health care could end up on a future ballot by next year as another group, not connected to WA Cares, travels the state building momentum for universal health care access.

The potential impact of I-2124

Health care advocates pleaded for Washingtonians to vote against the measure in a Monday, July 15 press conference announcing the launch of “No On I-2124.”

Since last July, a 0.58% tax has been applied on Washington workers’ paychecks to fund the program. In July 2026, workers who qualify for the program will be able to access up to $36,500 in a lifetime benefit that will be adjusted over time for inflation. The benefit could grow up to $50,000 in the next 20 years.

Those who do not pay into the program include federal employees, tribal business employees, unless the tribe has chosen to opt in, and self-employed workers who opted out. 

Additional exemptions added in 2023 include workers who live outside of Washington, spouses of active-duty U.S. military members, those who have a non-immigrant work visa, or are a veteran with a 70% service-connected disability rating or higher, according to WA Cares.


Ai Jen Poo, executive director of Caring Across Generations, told the group assembled at No On I-2124’s press conference, held at Harborview Park in Seattle, that the ballot initiative would cut a lifeline to the 4 million Washingtonians who are eligible for WA Cares.

“The choice between working to survive and caregiving to survive is not a real choice,” Poo said. “The whole country is watching Washington. Defeating Initiative 2124 is critical not just to the future of working Washingtonians, but truly to the future of care across America.”

I-2124 is one of three ballot initiatives backed by Let’s Go Washington, founded by hedge fund manager Brian Heywood. Organizers have said previously that not all those paying into the program will be able to access the benefits and thus should be able to opt out.

“If it’s such a great program, people shouldn’t be forced to pay into it,” said Hallie Balch, the director of communications for Let’s Go Washington. “We want to advocate for systems and programs that work for the people of Washington state, and not just blanket programs that everybody has to be a part of just because the state says that they have to be a part of it.”

Don’t confuse I-2124 with Washington Health Trust

While Let’s Go Washington and No On I-2124 are on the road arguing over long-term care insurance, another group is hosting a series of town halls educating Washingtonians about another option that aims to take insurance providers out of the health care equation.

Since 2016, Whole Washington has tried and failed to get an initiative on the ballot to create a state universal health care program, known as the Washington Health Trust (WHT). 

The group hasn’t had much luck in the Legislature either: Three bills creating the program, introduced in 2019, 2021, 2023 and reintroduced in 2024, didn’t even make it out of committee. 

This time around, the grassroots organization is hoping to gin up support for the trust by traveling the state in the next month, including going to Eastern Washington to listen to health care concerns from residents.

At a town hall on Saturday, July 13 at the Bellingham Public Library, Carey Wallace explained Whole Washington’s vision for the Washington Health Trust that would be paid for by taxpayers. Revenue would be collected from employer and employee wages, earnings from sole proprietors and from capital gains taxes. 

Certain taxable items, like retirement accounts, home sales and family farms, would be exempt.

“We pay taxes right now for all kinds of things, including Medicare and Medicaid,” Wallace said. “This would be an employment tax structured very similar to how we pay for insurance.”

Washington residents, including college students and people who live out of state for a portion of the year, would be eligible for the trust if it were to become law. 

But for now, the Washington Health Trust remains a policy idea. By holding town halls in communities across the state and starting the conversation about what universal health care could look like, Whole Washington hopes it’ll have laid the groundwork to get people to sign the initiative petition in 2025. 

“It’s really a third of the battle,” Wallace said of the petition process, adding that the group will need about 405,000 signatures to get on the ballot. “We know from other states’ experiences but once we get the signatures, we’re probably going to get hit with a legal battle of some kind … there’s that second battle, and then comes the get out the vote.

“It’s at least a three year plan and hopefully this is year one.”

Annie Todd is CDN’s criminal justice/enterprise reporter; reach her at annietodd@cascadiadaily.com; 360-922-3090 ext. 130.

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