Question 1, also known as the Universal Home Care initiative, would be devastating to Maine’s economy and jeopardize services for Maine’s truly needy.
The initiative establishes three new tax revenue sources to be dedicated to the Universal Home Care Trust Fund, including a 1.9 percent payroll tax on employers for wages paid out over $128,400, a 1.9 percent wage income tax on employees for wages earned over $128,400, and a 3.8 percent income tax on Maine adjusted gross incomes over $128,400.
Enactment of Question 1 would raise Maine’s top marginal income tax rate to 10.95 percent, a 53 percent increase. Maine would have the third-highest top marginal income tax rate in the country behind only California and Hawaii, and would surpass Vermont to implement the highest income tax rate in New England. Question 1’s passage would also introduce the highest income tax rate in the country at the $128,400 income level.
According to Maine Revenue Services and Maine’s Department of Administrative and Financial Affairs, Question 1 imposes a marriage penalty on joint filers who earn above the $128,400 income level. As a result, 108,000 Mainers representing 58,355 resident tax returns, or nine percent of all filings, will be affected by Question 1.
Profile of Mainers Experiencing Tax Increases Under Question 1
Number of affected Maine married and filing joint returns
Affected joint returns as a share of total affected Maine returns
Number of affected Maine returns
Number of affected Mainers
Using data collected from the U.S. Census Bureau, we estimate that approximately 22,900 Mainers will be eligible for services under the Universal Home Care program. The estimated cost of delivering services to these individuals varies between $268 million and $375 million, depending on the care model under which services are delivered. As Maine’s population continues to age, the price tag of the Universal Home Care program will grow.
UHC Program Eligibility and Cost Estimates
Estimated eligible population
Total program costs (agency-based model)
Annual cost per enrollee (individual provider model)
Annual cost per enrollee (agency model)
Total program costs (individual provider model)
Within the initiative is a program to provide stipend to family caregivers in Maine that, by design, appears ripe for abuse. Family caregivers in Maine currently offer approximately $2 billion in unpaid care each year. It is clear, given the estimated costs of the Universal Home Care program and the unpaid care that currently exists in Maine, that the $310 million in anticipated revenues will not be enough to cover all eligible persons or provide stipend to all eligible family caregivers. Therefore, the program is not truly “universal,” and it is likely that rationing of services or further tax increases will be necessary to serve the full eligible population.
Question 1 includes a mandate that requires providers participating in covered programs to devote 77 percent of reimbursements received from the Universal Home Care Trust Fund on “direct service worker costs.” However, this term is left undefined in the initiative, leaving uncertainty over how providers must expend 77 percent of the funds they receive from the program.
Data show that current wages for home care workers in Maine reflect between 63 and 67 percent of the reimbursement to provider agencies. The 77 percent mandate within Question 1 could cause a measurable disparity between the wages of home care workers serving clients under the Universal Home Care program versus clients in existing Medicaid and state-funded programs. In addition, the 77 percent mandate could leave provider agencies without adequate compensation to make up for the costs associated with employment.
The undemocratic design of the Universal Home Care Trust Fund Board abandons our traditions of representative government. The Board’s autonomy over the program and use of the Universal Home Care Trust Fund leaves many remaining questions for which we cannot answer.
However, implementing the Universal Home Care program in coordination with existing programs will prove chaotic for any Board tasked with doing so. Enacting a program that is to supplement, not supplant, existing programs is difficult when the program being enacted has less stringent eligibility requirements and is not obligated to abide by federal rules imposed through Medicaid.