(The Center Square) – The Washington state Department of Social and Health Services spending since 2015 has nearly tripled from $9 billion to $25.4 billion, a 182.22% increase heavily driven by long-term care cost increases due in part to an aging population.
Since the 2013-15 budget, long-term care spending grew from $3.8 to $12.9 billion, and now represents half of DSHS’ biennial budget.
Although Washington has its own Medicaid program called Apple Health, DSHS only handles long-term Medicaid, which falls under the department’s Medical Assistance Program. Long-term care composes 20% of total Medicaid spending in Washington state.
According to the Washington Caseload Forecast Council, the following caseloads have changed since January 2017:
Categorically Needy Aged program had an increase of 75,000 people to 100,000 by January 2025, with projections that figure will remain stable through July 2027.Medicaid eligible clients who receive care in state licensed nursing facilities decreased from 10,000 to about 7,500, with forecasts indicating it will remain stable through July 2027.The number of adults and children under the Division of Developmental Disabilities Total Medicaid Personal Care program increased from 15,000 to 17,500, with projections showing that figure will increase to 20,000 by January 2027.
According to data from state Office of Financial Management, in 2010 the median age of persons living in Washington state was 37.3 years, and by 2023 the median age had increased to 38.8 years. During that same timeframe, the percentage of Washington residents 65 or older increased from 12.3% to 17.5%.
“Washingtonians are just getting older,” DSHS Director of Central Budget Dan Winkley told The Center Square. “The population is a bigger part of the agency’s expenditures.”
He added that the elderly population is living longer and participating in those services for longer periods of time compared to the past.
Elizabeth New, director of the Center for Healthcare at the Washington Policy Center think tank, told The Center Square that a growing elderly population is driving costs, but added that “eligibility for it is very broad. Washington is super generous with what it covers.”
While long-term care has increased, other aspects of the state budget, such as public mental health, has actually gone down. The state’s 2015 supplemental budget set aside $2.3 billion for the public mental health system, a $427.4 million, or 23%, increase from the 2013-15 biennium. In the 2025-27 operating budget, $1.7 billion was allocated for public mental health.
Meanwhile, spending on Developmental Disabilities doubled since the 2015 supplemental budget from $3.2 billion to $6.1 billion in the current biennium. Included in that is the state-operated Residential Habilitation Centers that provide temporary habilitative support for individuals with developmental or intellectual disabilities.
The Center Square previously reported that Washington state’s budget more than doubled in the past 10 years and that the state was spending $150 million on illegal immigrants.
