Not every question lends itself to a “yes” or “no” answer.
Should Maine recognize that it’s facing a long-term care crisis? Yes.
Is helping people stay in their homes as they age better for them and their families? Yes.
Is improving pay and working conditions for caregivers the only way to make sure there are enough people willing to do the job as the elderly population explodes? Yes.
Do we support Question 1, the universal home care initiative? Sadly, no, or at least not yet.
The authors of this ballot question picked the right issue, but there is too much wrong with the program’s design for us to be able to sign off on the package. If the only choices are “yes” and “no,” we have to say “no.”
This is a hard choice because it rewards the “Stop the Scam: No on 1” campaign, which has decided to rely on scare tactics instead of engaging with this issue more honestly. Providing home care for the elderly and people with disabilities is not a “scam” – it is a serious unmet need.
If it were to pass, Question 1 would establish a universal home care benefit paid for with a tax on high earners. It would be extended to Mainers older than 64 and all people with disabilities who need assistance with at least one activity of daily living such as shopping, cooking, cleaning or bathing.
Revenue collected from a payroll tax on wage and non-wage income in excess of $128,400 would go straight to a trust fund, which could be used only for this program. Spending would be governed by an independent board made up of members who are elected by three specific interest groups – home care agencies, home care workers and consumers.
SIMPLISTIC VIEW OF HEALTH CARE
Carving out one program with its own financing and eligibility standards doesn’t address the interlocking problems Mainers face as they age. Home care, assisted living and skilled care nursing homes are not competitors. Over the course of a lifetime, someone will likely need more than one kind of care, and could benefit from integrated programs that would facilitate easy movement between different levels of care.
We also question the wisdom of concentrating control of the program in so few hands. The governor and Legislature are elected by all of the people, and that’s who should be making the ultimate decision on allocating resources. Creating an independent board with independent financing would make government even less accountable to people who are not in one of the three constituency groups.
ISSUE REQUIRES COOPERATION
This is the kind of complex initiative that should have started as a bill and have been put through the legislative process. A referendum would have made sense if, as with Medicaid expansion or the minimum wage, a popular idea were blocked by a minority of lawmakers. But with this issue, the process begins with an all-or-nothing vote instead of ending with one.
The “Vote No” campaign has tried to turn this into primarily a tax issue, heavily suggesting that ordinary middle-class people would have to pay higher rates.
They have been able to enlist tax experts to say that the 3.8 percent income surtax would affect families who earn $128,400 a year and not individuals. But that it is clearly not the intent of the referendum’s authors, and the Legislature would have more than adequate time to fix any ambiguity.
As intended, the first $128,400 of an individual’s income would be exempt from the tax, meaning that the vast majority of Mainers would never have to pay it.
Maine deserves better. Whether or not Question 1 passes, the next Legislature and governor will have to engage on this issue, and this kind of politics won’t help them find common ground.
An issue this complicated demands compromise, but there is no compromise choice on this year’s ballot.
We see this as the wrong way to attack the right problem, and we support a “no” vote on Question 1.
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