The Well-Being Insurance for Seniors to be at Home Act, or WISH Act, aims to establish a federal long-term care insurance program under the Social Security Act. Its primary purpose is to enable Americans to plan for long-term care needs, support disabled older adults in their communities, bolster the direct care workforce, and decrease the current heavy reliance on Medicaid for long-term services and supports (LTSS). Congressional findings highlight the significant costs of LTSS, the aging population, and the fact that most Americans lack adequate private coverage, leading to impoverishment before qualifying for Medicaid.

To be eligible for benefits, an individual must have attained retirement age, filed an application, be insured for long-term care benefits (having at least 6 quarters of coverage from 2026 onwards), and have a continual serious functional disability for a substantial period. The monthly benefit amount will be calculated based on an estimate of the median cost of six hours per day of paid personal assistance, indexed to long-term care sector wages, and adjusted by the individual's quarters of coverage relative to 40. Benefits cease upon death or recovery from the disability.

The bill establishes the Federal Long-Term Care Insurance Trust Fund, which will receive initial appropriations for program establishment and public education. This fund will be managed similarly to other Social Security trust funds, with provisions for investing in conservative market securities. The Trust Fund will also cover administrative costs, including start-up, outreach, and evaluation.

Beneficiaries receiving benefits who hire non-family caregivers must comply with minimum wage and payroll tax laws. They are also required to submit annual statements affirming their disability status and compliance. The bill mandates the Commissioner of Social Security to provide information to beneficiaries about obtaining long-term care services, including referrals to Aging and Disability Resource Centers. Furthermore, the Government Accountability Office (GAO) will report on potential manipulation of eligibility, financial exploitation, and market understanding of long-term care insurance, while HHS will report on unmet LTSS needs for those not eligible for this program.

A significant component of the WISH Act is a comprehensive public education plan, to be developed by the Secretary of Health and Human Services in consultation with the Commissioner of Social Security. This 10-year plan will inform the public about the likelihood and costs of long-term care, the availability of these new benefits, and the importance of planning. Additionally, the Commissioner of Social Security will provide individual notices to eligible individuals, detailing their potential average indexed monthly earnings for long-term care, their quarters of coverage, and, if applicable, the start date of their continual serious functional disability.