Maine voters reject universal home care referendum

Maine voters Tuesday shot down a ballot initiative that would have established an unprecedented program of universal, no-cost home care for seniors and disabled people who need help with at least one activity of daily living.

Question 1 would have created a new state-run program providing free at-home services for anyone needing long-term care, regardless of income level. It would have been financed by an additional 3.8% income tax on residents earning more than $128,400 a year.

The Universal Home Care Program, the first such program in the country, would have covered an estimated 27,000 residents of Maine, which has the oldest population in the country. The initiative was aimed at boosting the pay and improving the training of home care workers, who are in short supply and have a high rate of turnover. Family caregivers would have been eligible to receive payment.

Opponents, including the Maine Hospital Association and long-term care providers, argued that the initiative would drive physicians and other well-paid professionals out of the state by significantly hiking their taxes. They also pointed to the difficulties of meshing this brand-new program with the state's existing Medicaid long-term care services.

"We like home care, and we hate being out there against home care proposals, said Jeffrey Austin, vice president of government affairs for the Maine Hospital Association. "But this is bad tax policy and bad home care and governance policy."

Despite its defeat, the ballot initiative could inspire similar measures in other states, which face similar problems with home care access and affordability as the elderly and disabled population grows.

(For more ballot measures and other election results, visit Modern Healthcare's 2018 Midterm Elections Tracker.)

The Affordable Care Act sought to address these issues through a voluntary long-term care program, but Congress ended up repealing it due to lack of financial sustainability.

The program is badly needed in Maine because half its residents either have served as caretakers or have received home care themselves, said Mike Tipping, communications director for Mainers for Home Care, which is backed by a broad coalition including the Maine State Nurses Association, labor unions and patient advocacy groups. His group now plans to seek legislation to expand access to home care services.

Taking care of disabled family members is often unpaid working falling on women, who may have to give up jobs and career opportunities. "We've heard from people across the country that see this (ballot initiative) as the leading way to address the issue," Tipping said.