Taxing the Wealthy to Pay for Universal Home Care

Maine is developing a well-deserved reputation for cutting-edge progressive ballot initiatives. In 2016, voters approved proposals to raise the state’s minimum wage, raise taxes on the wealthy to fund education, introduce ranked choice voting, and legalize marijuana.

The key force behind the state’s progressive ballot initiatives, the Maine People’s Alliance, has just launched a campaign to put another landmark issue on the 2018 ballot: universal home care for the elderly and disabled.

There’s no question that such services are sorely needed — particularly in Maine, the state with the country’s highest median age. Caring for this rapidly aging population is extremely costly. The median annual cost for home care is now more than $50,000. That’s about on par with Maine’s median income for an entire household.

Medicare does not cover the costs of in-home care and Medicaid reimbursement rates are so low that employers have difficulty finding workers willing to do this tough work for the meager wages they offer.

Universal home care would be a huge relief for family members facing impossible choices between paying bills for basic needs versus covering the exorbitant cost of services for their loved ones.

The big question is: how to pay for it?

The Maine People’s Alliance proposal would raise the needed $132 million through a payroll tax increase of 1.9 percent on annual salaries and wages over $127,000 and a 3.7 percent tax on investment income above that same threshold.

In part, these taxes are designed to address the unfairness of the current cap on income subject to Social Security tax. That cap is now about $127,000, and so people who earn $1 million or even $100 million a year contribute no more to the nation’s pension fund than those making $127,001.

The ballot initiative proposal would also address the fact that in Maine, as in many other states, the wealthy pay a smaller share of their income on state and local taxes than low-income residents. Because of regressive sales and property taxes, Maine’s top 1% of earners pay only 7.5 percent of their income in state and local taxes, compared to 9.4 percent for families in the bottom 20% of the income scale, according to the Institute on Taxation and Economic Policy.

Another innovative aspect of the Maine proposal is that it would be overseen by a board elected by home care services users and home care business owners and workers. It also stipulates that service providers receiving financing from the universal home care trust fund would be required to pay 77 percent of the money directly to workers. This measure is aimed at ensuring managers can’t use public funds to reward themselves with outsized paychecks.

Maine’s ballot campaign has drawn support from an array of national groups, including the Caring Across Generations campaign, which is co-led by Jobs With Justice and the National Domestic Workers Alliance (NDWA).

NDWA Executive Director Ai-Jen Poo said in an interview that the Maine model could be a “blueprint for the nation” as we grapple with the aging of the U.S. population. “Some call this demographic change a ‘silver tsunami,’” Poo said. “At Caring Across Generations, we call it an ‘elder boom’ because of the opportunity it affords to fundamentally reform our care system in a way that’s long overdue.”

Earlier this year, the Caring Across Generations campaign had a major breakthrough in Hawaii, where state lawmakers approved the nation’s first law to provide financial support to working family caregivers, no matter their income. “The Maine campaign for universal in-home care could be the next big thing in the care movement,” Poo said.

One of the key long-term goals of the Caring Across Generations campaign is universal family care. Through a state-based social insurance fund, families would receive support not only for home care for the elderly, but also child care and paid family medical leave. According to the campaign web site, “Our families deserve the care we need to live full and healthy lives, whether we’re caring for an infant or child, a loved one with a disability, or an aging parent.”

If Maine activists manage to get their universal home care proposal passed by voters in November 2018, it would be a significant step towards extending affordable caregiving across the age spectrum.