PlainBillCongress, translated.Legislation. Context. Public interest.Congressional Research Service
Version 00 · Introduced in House · Mar 11, 2025
Well-Being Insurance for Seniors to be at Home Act or the WISH Act
This bill establishes a federal long-term care insurance benefit and provides specified funds for the program.
To be eligible, an individual must have reached retirement age (currently between 65 and 67, depending on the individual’s year of birth) and have had a continual serious functional disability for between one and five years, depending on the individual’s income.
Showing the opening paragraphs of the official summary.
Under the bill, an individual has a continual serious functional disability if a licensed health care practitioner has certified that the individual
has been unable to perform at least two activities of daily living (including eating, bathing, dressing, and using the bathroom) without substantial assistance for at least 90 days, or has a similar level of disability; or
requires substantial supervision to protect them from threats to health and safety due to severe cognitive impairment.
The individual must also be expected to remain disabled for at least one year.
The bill also establishes a Federal Long-Term Care Insurance Trust Fund and provides specified funds for the initial establishment of the benefit program, benefit payments during FY2026-FY2028, and public education related to the program.
Finally, the Government Accountability Office must periodically report to Congress on consumer understanding of long-term insurance offerings, the likelihood of manipulation of eligibility criteria by beneficiaries, and the likelihood of financial exploitation or mistreatment by others on whom a beneficiary is dependent.
People & committees
Rep. Suozzi, Thomas R. [D-NY-3] · D–NY
Legislative record
A procedural vote is different from passage. Passage in one chamber does not establish enactment. Explore the glossary.
Referred to the House Committee on Ways and Means.
Introduced in House
Introduced in House
Primary sources
Text links open the official source. We also preserved the text version used in the PlainBill explanation below.
No related bills are listed in this snapshot. This does not establish whether the proposal has appeared in earlier Congresses.
Source last updated: Jan 26, 2026. Consult Congress.gov for the current record.
AI Conversation Starters
Choose a perspective, copy a prompt, and paste it into your preferred AI. Each prompt includes the bill version and available official source links, and asks for counterarguments as well as supporting evidence.
Analyze H.R.2082 as objectively as possible. Explain its main provisions, who would be affected, possible benefits and harms, implementation, exceptions, and uncertainties. Present the strongest arguments for and against it, and identify evidence needed to assess its public impact.
Examine H.R.2082 through a progressive lens, focusing on fairness, access, economic inequality, and effects on vulnerable communities. Explain potential benefits, costs, and unintended consequences. Consider the strongest counterarguments and distinguish stated goals from demonstrated outcomes.
Examine H.R.2082 through a conservative lens, focusing on fiscal responsibility, institutional stability, federalism, and the scope of government. Explain potential benefits, costs, and unintended consequences. Consider the strongest counterarguments and any provisions that challenge this perspective.
Examine H.R.2082 through a civil-liberties and limited-government lens. Consider individual rights, privacy, voluntary choice, accountability, and government power. Explain tradeoffs, possible safeguards, and the strongest counterarguments without assuming the proposal is beneficial or harmful.
PlainBill explanation
Based on the full Introduced in House · 2025-03-11 text. This explanation has not received human editorial review. This overview describes the proposal’s major provisions; it does not establish what its real-world effects would be.
This proposal would create monthly federal long-term care payments for people who reach Social Security retirement age, have enough covered work, and have a serious, lasting disability. Applicants would first need to live with that disability for a waiting period tied to their earnings history. Payment amounts would depend on estimated national personal-care costs and covered work accumulated beginning in 2026. The proposal also provides startup funding, public education, and oversight; the supplied evidence does not establish that it became law.
Every individual who— (1) has attained retirement age (as defined in section 216(l)(1)); (2) has filed an application for long-term care insurance benefits; (3) is insured for long-term care insurance benefits (as determined under subsection (c)) at the time such individual’s application is filed; and (4) has a continual serious functional disability (as defined in subsection (d)) and, at the time such individual’s application is filed, has had such disability for a substantial period of time (as determined under subsection (e)), shall be entitled to a long-term care insurance benefit
an estimate, to be determined by the Secretary of Health and Human Services in consultation with the Department of Labor, of the median cost of 6 hours per day of paid personal assistance in the United States, indexed to wages in the long-term care sector
the ratio (not greater than 1) of the number of quarters of coverage the individual has during the applicable base period (as defined in subsection (c)(2)) to 40.
the term applicable base period means the period that begins with the 1st quarter of 2026.
for each of fiscal years 2026, 2027, and 2028, $12,000,000 for the initial establishment of the Long-Term Care Insurance program and payment of benefits during such fiscal years
shall publish in the Federal Register a 10-year plan to educate the public
Not later than 5 years after the date of enactment of this Act and every 3 years thereafter, the Comptroller General shall submit a report to Congress
The bill names the proposal the WISH Act. Its stated goals include helping families plan for care, supporting older adults with disabilities in their communities and the care workforce, and reducing reliance on Medicaid. These are declared goals, not demonstrated results.
This Act may be cited as the Well-Being Insurance for Seniors to be at Home Act or the WISH Act.
The purpose of this Act is to enable most Americans to make plans that protect themselves and their families, to enable disabled older adults to support themselves in their communities during periods of serious disability, to support the workforce providing direct services to elders living with disabilities, and to reduce what is now necessary reliance on Medicaid.
To qualify, a person would need to reach retirement age as defined in the cited Social Security provision, apply, have the required covered-work credits when applying, and have a qualifying disability for the required waiting period when applying.
Every individual who— (1) has attained retirement age (as defined in section 216(l)(1)); (2) has filed an application for long-term care insurance benefits; (3) is insured for long-term care insurance benefits (as determined under subsection (c)) at the time such individual’s application is filed; and (4) has a continual serious functional disability (as defined in subsection (d)) and, at the time such individual’s application is filed, has had such disability for a substantial period of time (as determined under subsection (e))
The disability requirement would use an existing tax-law definition of a chronically ill individual. The condition would also have to be expected to last at least one year or until death. The referenced tax-law definition is not reproduced in the bundle.
an individual shall be considered to have a continual serious functional disability if the person is a chronically ill individual (as determined under section 7702B(c)(2) of the Internal Revenue Code of 1986) and is expected to remain a chronically ill individual (as so determined) for at least 1 year or until the individual’s death.
A person would need six quarters of coverage—covered-work credits—to meet the program's insured-status requirement. Only credits within a base period beginning in the first quarter of 2026 would count under this rule.
an individual shall be insured for long-term care insurance benefits in any month if the individual has 6 quarters of coverage during the applicable base period.
the term applicable base period means the period that begins with the 1st quarter of 2026.
The monthly payment would use a federal estimate of the national median cost of six hours of paid personal assistance per day, adjusted with care-sector wages. That amount would be multiplied by the person's covered-work credits in the base period divided by 40, capped at 100 percent. This is a payment formula, not a promise to provide six hours of care.
Such individual’s long-term care insurance benefit for each month shall be an amount equal to the product of— (1) an estimate, to be determined by the Secretary of Health and Human Services in consultation with the Department of Labor, of the median cost of 6 hours per day of paid personal assistance in the United States, indexed to wages in the long-term care sector, multiplied by (2) the ratio (not greater than 1) of the number of quarters of coverage the individual has during the applicable base period (as defined in subsection (c)(2)) to 40.
The disability waiting period would be 12 months for people whose calculated earnings history is at or below the table's 40th percentile. Above that threshold, the bill would add one month for each 1.25-percentile interval attained. A percentile describes a person's position in the comparison group's earnings distribution.
a substantial period of time means— (A) in the case of an individual who, at the time described in paragraph (3), has average indexed monthly earnings for long-term care equal to or less than the dollar amount representing the 40th percentile in the table established under subsection (f) for such calendar year, 12 months; and (B) in the case of an individual who, at such time, has average indexed monthly earnings for long-term care greater than such dollar amount, 12 months plus 1 additional month for each 1.25 percentile interval above the 40th percentile for which the individual’s average indexed monthly earnings for long-term care would attain (as specified in such table).
Social Security would establish annual earnings tables beginning in 2026. The comparison group would consist of people at least 62 whose Social Security primary insurance amount is first calculated that year. For 2036, the text also includes people whose amount was first calculated in any previous year.
The Commissioner of Social Security shall establish a table, for each calendar year beginning with calendar year 2026, setting forth— (i) the dollar amount representing the 40th percentile among the average indexed monthly earnings for long-term care (as determined under subparagraph (B)) of each individual who has attained age 62 and whose primary insurance amount is first computed during such calendar year (or, for calendar year 2036, during any previous calendar year); and (ii) the dollar amounts representing percentiles over 40 (increasing linearly from 40 in intervals of 1.25) among the average indexed monthly earnings for long-term care (as so determined) of each such individual.
The earnings-history calculation would adapt an existing Social Security formula. It would replace specified language with a reduction for benefit-computation years having neither wages nor credited self-employment income, and replace the year 1950 with 2025 in another provision. The existing formula is not supplied, so these textual changes do not establish a complete calculation on their own.
the average indexed monthly earnings for long-term care of an individual shall be determined under section 215(b) (as in effect on the date of enactment of this Act) as if such section were amended— (i) in paragraph (2)(A), by striking reduced— and all that follows through the end and inserting reduced by the number of benefit computation years for which no wages were paid in and no self-employment income credited.; and (ii) in paragraph (2)(B)(ii), by striking 1950 and inserting 2025.
For someone with 40 covered-work credits in the base period before becoming entitled to Social Security retirement benefits, the earnings calculation would use the time their primary insurance amount was first calculated for those benefits. For everyone else, it would use the time of the long-term care application.
The time described in this paragraph is— (A) in the case of an individual who has 40 quarters of coverage during the applicable base period (as defined in subsection (c)(2)) prior to becoming entitled to old-age insurance benefits, the time at which the individual’s primary insurance amount was first computed with respect to the individual’s application for such benefits; and (B) in the case of any other individual, the time at which the individual files an application for long-term care insurance benefits under this section.
Monthly entitlement would begin in the first month all eligibility criteria are met. The text sets its ending month as the earlier of the month of death or the first month the person no longer has the qualifying disability.
for each month beginning with the 1st month in which the individual meets the criteria specified in paragraphs (1) through (4), and ending with the earlier of the month in which the individual dies or the 1st month in which the individual no longer has a continual serious functional disability (as so defined).
Social Security would give new beneficiaries information about obtaining care as soon as practicable after entitlement starts. This would include contacts and service descriptions for aging and disability resource centers and area agencies on aging, including care planning, care management, and administrative help for hired care providers that may involve fees.
The Commissioner of Social Security shall provide to each individual entitled to a long-term care insurance benefit under this section, as soon as practicable following the first day of the first month of such entitlement, information describing the steps the individual may take to obtain long-term care, including an explanation of the services (including care planning, care management, and administrative services for hired care providers, by referral or in-house, for a fee) provided by, and the appropriate contact information for, the Aging and Disability Resource Centers described in section 202(b)(8) of the Older Americans Act of 1965 and the area agencies on aging (as defined in section 102(6) of such Act).
Other people could submit information concerning an application, annual statement, or other required submission. The provision expressly includes representatives and family members.
Any person may submit applicable information with respect to an individual’s application for long-term care insurance benefits, an annual statement described under subsection (i)(2), or any other information required to be submitted by the individual under this title, including, as applicable, the individual’s representative, or any family member or other appropriate person.
Payments would not count as income or assets when determining eligibility for federal assistance or state or local assistance financed at least partly with federal funds. This protection would cover eligibility determinations for the recipient, spouse, or family.
A long-term care insurance benefit payment shall not be regarded as income and shall not be regarded as a resource for any month, for purposes of determining the eligibility of the recipient (or the recipient’s spouse or family) for benefits or assistance under any Federal program or under any State or local program financed in whole or in part with Federal funds.
A beneficiary hiring an employee who is not a family member for paid personal care would have to comply with applicable federal and state minimum-wage and employment-tax withholding laws as a program condition. This express condition is limited to nonfamily employees; it does not state that other laws are repealed for family care arrangements.
An individual entitled to a long-term care insurance benefit for a month during a calendar year shall, in any case in which such individual hires an employee who is not a family member to provide paid personal care to the individual during such month, comply with all applicable State and Federal laws relating to— (A) the payment of a minimum wage; and (B) the withholding of payroll taxes and other employment-related taxes.
Beneficiaries would have to submit a statement at least once each calendar year affirming continued qualifying disability and compliance with the specified employment laws, and reporting their country of residence. Benefits would not be payable for a month in which the applicable requirements are not met.
An individual entitled to a long-term care insurance benefit for a month during a calendar year shall submit a statement to the Commissioner of Social Security at least once during such calendar year, as directed by the Commissioner— (A) affirming that the individual— (i) continues to have a continual serious functional disability (as defined in subsection (d)); and (ii) is in compliance with the laws described in paragraph (1); and (B) specifying the country of residence of the individual.
No long-term care insurance benefit shall be payable to an individual for any month— (A) with respect to which the individual fails to satisfy any of the requirements described in the preceding paragraphs of this subsection
Payments would also stop for months beginning after five consecutive years of annual statements reporting residence outside the United States and its territories.
No long-term care insurance benefit shall be payable to an individual for any month—
(B) beginning after the fifth consecutive year with respect to which the individual has reported, in the annual statement required under paragraph (2), a country of residence other than the United States (including any territory of the United States).
The bill would add an estimate of potential long-term care payments to the benefit-estimate information required by the cited Social Security provision.
Estimates of benefits Section 1143(a)(2) of the Social Security Act (42 U.S.C. 1320b–13) is amended—
by adding at the end the following: (F) an estimate of the potential long-term care insurance benefits payable to the individual.
The bill would establish a Federal Long-Term Care Insurance Trust Fund in the Treasury. It could receive gifts, bequests, appropriations, and deposits provided for in the section.
There is hereby created on the books of the Treasury of the United States a trust fund to be known as the Federal Long-Term Care Insurance Trust Fund. The Federal Long-Term Care Insurance Trust Fund shall consist of such gifts and bequests as may be made as provided in section 201(i)(1) of the Social Security Act (42 U.S.C. 401(i)(1)) and such amounts as may be appropriated to, or deposited in, the Federal Long-Term Care Insurance Trust Fund as provided in this section.
The bill would directly appropriate $12 million to the trust fund in each of fiscal years 2026, 2027, and 2028 for startup and benefits, plus $50 million for public education. These are proposed appropriations, rather than merely permission to seek future funding.
There is appropriated to the Federal Long-Term Care Insurance Trust Fund out of moneys in the Treasury not otherwise appropriated— (1) for each of fiscal years 2026, 2027, and 2028, $12,000,000 for the initial establishment of the Long-Term Care Insurance program and payment of benefits during such fiscal years; and (2) $50,000,000 for public education relating to the Long-Term Care Insurance program as described in section 6(a).
Specified existing Social Security trust-fund rules would apply to the new fund. The managing trustee could invest a portion considered appropriate in conservative market securities. Separately, the bill would authorize necessary amounts from the fund for administration, including startup, technical assistance, outreach, education, evaluation, and reporting.
The provisions of subsections (c), (d), (e), (f), (i), and (m) of section 201 of the Social Security Act (42 U.S.C. 401) shall apply with respect to the Federal Long-Term Care Insurance Trust Fund in the same manner as such provisions apply to the Federal Old-Age and Survivors Insurance Trust Fund and the Disability Insurance Trust Fund, except that the Managing Trustee (within the meaning of subsection (d) of such section) may invest such portion of the Federal Long-Term Care Insurance Trust Fund as the Managing Trustee considers appropriate in conservative market securities.
There are authorized to be made available for expenditure, out of the Federal Long-Term Care Insurance Trust Fund, such sums as may be necessary to pay the costs of the administration of section 3, including start-up costs, technical assistance, outreach, education, evaluation, and reporting.
The trustees would report to Congress within five years after enactment and every five years afterward. They would evaluate the benefits' impact and recommend whether payment amounts should vary geographically; the reporting requirement itself would not change payment amounts.
Not later than 5 years after the date of enactment of this Act and every 5 years thereafter, the Board of Trustees (as defined for purposes of title II of the Social Security Act) shall submit a report to Congress evaluating the impact of long-term care insurance benefits under section 235 of such Act and making recommendations relating to potential geographical adjustments of the amount of such benefits.
Within 90 days after enactment, Health and Human Services, consulting Social Security, would publish a ten-year public education plan. It would address care needs, experiences, costs, program benefits, and planning with private insurance, family support, and savings, especially for the early years of disability. The plan would be revised as needed based on research and experience, with $50 million appropriated from the trust fund to carry it out.
Not later than 90 days after the date of enactment of this Act, the Secretary of Health and Human Services, in consultation with the Commissioner of Social Security, shall publish in the Federal Register a 10-year plan to educate the public about the likelihood of needing long-term care, the nature of the experience of long-term care in various situations, the costs of long-term care, the availability of long-term care insurance benefits, and the importance of planning and considering private insurance coverage alongside family support and savings (especially during the first years of a serious disability). Such plan shall be modified as necessary based on research on the effectiveness of various strategies and modifications with experience.
There are appropriated, out of the Federal Long-Term Care Insurance Trust Fund, to the Secretary of Health and Human Services $50,000,000 to carry out paragraph (1).
Individual notices would cover people with a Social Security number who have wages or self-employment earnings, or whose earnings patterns indicate likely work outside Social Security coverage. Eligibility for these notices would be separate from eligibility for care payments.
In this subsection, the term eligible individual means an individual— (A) who has a social security account number; and (B) (i) who has wages or net earnings from self-employment; or (ii) with respect to whom the Commissioner has information that the pattern of wages or self-employment income indicate a likelihood of noncovered employment.
The notices would show an earnings-history calculation based on the preceding month, the person's percentile among people whose corresponding earnings measure is calculated that month, accumulated covered-work credits, and, when applicable, the start date of a qualifying disability.
a notice that specifies— (A) (i) the average indexed monthly earnings for long-term care that would be calculated for the individual under paragraph (2)(B) of section 235(e) of the Social Security Act if such average indexed monthly earnings for long-term care were calculated in the month before the month such notice is provided; and (ii) for purposes of applying such section to the individual, the percentile in which such average indexed monthly earnings for long-term care of the individual would fall among the average indexed monthly earnings for long-term care (as determined under such paragraph (2)(B)) of each individual whose average indexed monthly earnings for long-term care are calculated in such month; (B) the number of quarters of coverage the individual has in the month before the month such notice is provided for purposes of attaining insured status for long-term care insurance benefits under such Act; and (C) in any case in which the individual has a continual serious functional disability (as defined in section 235(d) of such Act), the date on which such disability began.
The notice requirement would begin one year after enactment. Initial mailed notices would be due within 540 days, with additional mailings at ages 45, 55, 65, and the referenced retirement age. Eligible people age 35 or older would also have notices available through their Social Security website accounts, updated annually.
Beginning 1 year after the date of enactment of this Act and in accordance with paragraph (2), the Commissioner of Social Security shall provide to each eligible individual a notice
A notice described in paragraph (1) shall be provided— (A) by mail— (i) to each eligible individual not later than 540 days of the date of enactment of this Act; and (ii) to each eligible individual in the month the individual attains age 45, age 55, age 65, and retirement age (as defined in section 216(l) of such Act); and (B) for each eligible individual who has attained age 35, by making such notice available on the individual’s account on the website of the Social Security Administration, to be updated annually.
The Comptroller General would report within five years after enactment and every three years afterward on risks of eligibility manipulation, financial exploitation, and elder mistreatment, as well as the insurance market and consumer understanding. The reports would assess possible remedies, including financial-management intermediaries and standardized insurance offerings; the bill would not impose those remedies through this section.
Not later than 5 years after the date of enactment of this Act and every 3 years thereafter, the Comptroller General shall submit a report to Congress including— (1) a description of the likelihood of manipulation of eligibility criteria by beneficiaries or beneficiary advisors and recommendations as to the merits of 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 as to the merits of possible remedies, including the merits of imposing a financial management service or fiscal intermediary as has often been implemented by states in Medicaid’s Cash and Counseling program; and (3) a description of the marketplace and consumer understanding of long-term insurance offerings and recommendations as to the merits of possible remedies, including the merits of standardizing insurance offerings to improve consumer understanding.
Within three years after enactment and every three years afterward, Health and Human Services would submit a plan addressing people excluded from these benefits. It would estimate unmet care needs, including those of people disabled in childhood, people with disabilities before retirement age, and people lacking insured status, and propose strategies and costs. This planning requirement would not itself give those groups benefits.
Not later than 3 years after the date of enactment of this Act and every 3 years thereafter, the Secretary of Health and Human Services, acting through the Administrator of the Administration on Community Living and in consultation with the Commissioner of Social Security, shall submit a plan to Congress that includes— (1) estimates of the long-term services and supports needed by individuals who are 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 who are not insured for benefits under such section; and (2) proposed strategies and costs of mitigating unmet needs for such individuals.
The supplied official-actions snapshot, updated January 26, 2026, records introduction in the House and referral to the House Committee on Ways and Means on March 11, 2025. It does not establish subsequent legislative action or enactment.
Source snapshot updated 2026-01-26T21:44:38Z. 2025-03-11: Referred to the House Committee on Ways and Means. 2025-03-11: Introduced in House 2025-03-11: Introduced in House
A closer look
Reviewed version: Introduced in House · 2025-03-11. These findings describe provisions and who may benefit; they are not judgments of waste, corruption, or motive.
This review covers the supplied bill text. “None identified” does not rule out provisions in later versions or accompanying reports and disclosures.
Provisions outside the bill’s main subject, or policy changes attached to appropriations.
None identified in the reviewed text
No unrelated provision or separate policy rider was identified in the complete supplied introduced text. Its provisions concern the proposed care-insurance program, funding, education, and oversight. This conclusion is limited to that version and does not establish absence in other versions or accompanying materials.
Spending directed to particular recipients or places outside ordinary competitive or formula-based allocation.
None identified in the reviewed text
No congressionally directed spending for a particular recipient or place was identified in the complete supplied introduced text. The program appropriations do not by themselves establish an earmark. This conclusion is limited to that version and does not establish absence in other versions or accompanying materials.
Narrow exceptions, exemptions, or preferential treatment that warrant a closer look.
Findings to examine
The supplied introduced text contains a narrow family-care exception within a benefit-specific compliance condition. This classification does not establish improper purpose or an exemption from other applicable laws.
Beneficiaries who hire family members for personal care would fall outside the bill's express condition requiring compliance with minimum-wage and employment-tax withholding laws when hiring a care employee. That condition expressly applies only to employees who are not family members, and failure to satisfy it can prevent payment. This is a narrow exception within the main care policy; the text does not establish a general exemption from labor or tax law.
An individual entitled to a long-term care insurance benefit for a month during a calendar year shall, in any case in which such individual hires an employee who is not a family member to provide paid personal care to the individual during such month, comply with all applicable State and Federal laws relating to— (A) the payment of a minimum wage; and (B) the withholding of payroll taxes and other employment-related taxes.
No long-term care insurance benefit shall be payable to an individual for any month— (A) with respect to which the individual fails to satisfy any of the requirements described in the preceding paragraphs of this subsection
Full text preserved for this analysis. Legislative record snapshot: Jan 26, 2026. How PlainBill uses AI