H.R. 2082 — WISH Act

This section states congressional findings on long-term services and supports (LTSS) needs among older Americans—including that more than half entering old age will need LTSS averaging $298,000 per person for about two years, the population aged 85 or older will double by 2035 and nearly triple by 2050, more than 1 in 5 middle-income seniors will become Medicaid-eligible for LTSS, 1 in 5 will need LTSS for over five years (accounting for nearly half of all LTSS expenses and 60% of Medicaid LTSS spending), and only 11% have private LTSS coverage—and declares the Act's purpose to enable personal planning for LTSS risks, support community living for disabled older adults, bolster the LTSS workforce, and reduce Medicaid reliance.

This section establishes long-term care insurance benefits as a new entitlement under Title II of the Social Security Act (added as new section 235). To qualify, an individual must have attained retirement age (as defined in section 216(l)(1)), filed an application, acquired insured status (6 quarters of coverage since the first quarter of 2026), and had a continual serious functional disability—defined as being chronically ill under IRC section 7702B(c)(2) (i.e., unable to perform at least two activities of daily living or requiring substantial supervision due to cognitive impairment) with an expectation of remaining so for at least one year or until death—for a substantial period (generally 12 months, or longer for those with higher average indexed monthly earnings for long-term care per a percentile-based table established annually beginning in 2026). The monthly benefit equals the estimated median U.S. cost of 6 hours per day of paid personal assistance (indexed to long-term care sector wages), prorated by the individual's quarters of coverage during the base period to 40 (not to exceed full amount). The Commissioner of Social Security must provide new beneficiaries with information on obtaining long-term care services, including contacts for Aging and Disability Resource Centers and area agencies on aging. Any person may submit beneficiary information (text cuts off).

This section establishes the Federal Long-Term Care Insurance Trust Fund in the Treasury to support a new Long-Term Care Insurance program. (As background, the fund parallels Social Security trust funds such as the Federal Old-Age and Survivors Insurance Trust Fund, which finances Old-Age, Survivors, and Disability Insurance benefits from dedicated payroll taxes, gifts, and appropriations.) The fund consists of gifts and bequests authorized under section 201(i)(1) of the Social Security Act (42 U.S.C. 401(i)(1))—with that provision amended to explicitly include the new fund—and appropriations from general Treasury revenues, including (1) $12 million for each of FY2026 through FY2028 for program establishment and benefit payments; and (2) $50 million for public education activities. The section applies specified Social Security Act management provisions (subsections (c), (d), (e), (f), (i), and (m)) to the new fund; authorizes expenditures from the fund for administration of the program (including start-up costs, technical assistance, outreach, education, evaluation, and reporting); and requires the Board of Trustees of the Social Security trust funds to report to Congress every five years, beginning five years after enactment, on the impact of long-term care benefits and potential geographical adjustments.

This section directs the Secretary of Health and Human Services, in consultation with the Commissioner of Social Security, to publish in the Federal Register a 10-year plan to educate the public on long-term care needs, experiences, costs, insurance benefits, and planning options not later than 90 days after enactment—with modifications as needed based on effectiveness research—and appropriates $50 million from the Federal Long-Term Care Insurance Trust Fund for this purpose. The section further requires the Commissioner of Social Security, beginning one year after enactment, to provide notices to eligible individuals (i.e., those with a Social Security number and wages, net earnings from self-employment, or a wage pattern indicating likely noncovered employment) specifying (1) their average indexed monthly earnings for long-term care (and percentile ranking among peers) as of the prior month, (2) quarters of coverage for insured status under the Social Security Act, and (3) disability onset date if applicable; notices are mailed not later than 540 days after enactment and upon attaining ages 45, 55, 65, or retirement age, and made available annually online for individuals age 35 and older.

This section directs the Comptroller General to submit to Congress, not later than five years after enactment of this Act and every three years thereafter, a report on the performance of the WISH Program that includes (1) a description of the likelihood of manipulation of eligibility criteria by beneficiaries or beneficiary advisors and recommendations on possible remedies; (2) a description of the likelihood of financial exploitation or elder mistreatment by others on whom a beneficiary is dependent or otherwise connected and recommendations on possible remedies, including the merits of a financial management service or fiscal intermediary as used in Medicaid's Cash and Counseling program (i.e., a consumer-directed personal assistance services demonstration); and (3) a description of the marketplace and consumer understanding of long-term insurance offerings and recommendations on possible remedies, including the merits of standardizing such offerings.

This section directs the Secretary of Health and Human Services, acting through the Administrator of the Administration on Community Living (ACL) and in consultation with the Commissioner of Social Security, to submit a plan to Congress not later than three years after enactment and every three years thereafter that includes (1) estimates of long-term services and supports needed by individuals not eligible for benefits under section 235 of the Social Security Act—including individuals disabled in childhood, individuals living with disabilities before retirement age, and individuals not insured for such benefits—and (2) proposed strategies and costs to mitigate unmet needs for such individuals.