Mainers could face a ballot question on universal health care in 2022

Stethoscope wrapped around hundred dollar bills

A question asking voters whether they want the legislature to direct a commission to study developing legislation that would create a publicly-funded healthcare system may appear on a future Maine election ballot.

Maine Healthcare Action, a ballot question committee first formed in 2020, is currently collecting signatures for the effort. Their citizen initiative petition was approved for circulation by the secretary of state’s office on December 3, 2020. The group has until June 3, 2022 to collect enough signatures to pose their question to Maine voters.

If their efforts are successful, the question will appear on a future Maine election ballot. Marcia Garnecky, the field director for Maine Healthcare Action, described the petition as a “citizen-led initiative” and said “it’s a great example of direct democracy.”

The proposed legislation would require a legislative commission to develop legislation that ensures all Maine residents have “comprehensive, publicly funded health care coverage” and provide “all services determined to be medically necessary” by a board established in the law. The board would consist of members representative of the state’s population. They would be appointed by the governor and would be reviewed by the legislative committee that has jurisdiction over healthcare and insurance. Members would be confirmed by the Senate.

The legislation would also be required to contain built-in mechanisms that lower healthcare costs, “provide prompt payments to health care providers at prevailing rates,” and give Maine residents freedom to choose their providers.

“Our effort currently to collect signatures and qualify for the ballot is simply a vehicle to have a very public discussion about healthcare in Maine, and to give Maine voters a real voice deciding what policy areas their elected leaders focus on,” Garnecky said. 

Past legislative commissions have also studied creating a publicly-funded healthcare system in the state. In 2017, the Maine Legislature passed a joint order creating the Task Force on Health Care Coverage for All of Maine.

The task force was directed to develop a plan that would “ensure that all residents of the State have access to and coverage for affordable, quality health care and to study the design and implementation of options for a health care plan that provides coverage for all residents of the State.”

The task force made recommendations in three areas: legislative oversight of proposals for reform, suggested legislation for the 129th Legislature to consider and continued study of issues discussed by study groups created by the task force.

In the first area, the task force recommended the Joint Standing Committee on Insurance and Financial Services be renamed and its jurisdiction be expanded to cover healthcare reform efforts. It also recommended the task force be reestablished by the 129th Legislature in order to give it more time to study health care reform.

The task force also recommended the 129th Legislature introduce concept draft legislation to address pharmacy benefit managers and the Maine Health Data Organization.

Further, the task force recommended monitoring activity in other states in order to “implement a state-sponsored wholesale importation program for certain high cost prescription drugs from Canada.” It also recommended continued study of model legislation to establish a state commission with authority to set rates for high-cost prescription drugs and monitoring federal activities related to healthcare, as well as other states that had implemented an individual mandate.

Some of these recommendations were incorporated into LD 2110, which was considered by the 129th Legislature. An early version of the bill, which was eventually replaced by an amendment, would have created the Maine Commission on Affordable Health Care. The commission would have been an “independent executive agency” responsible for overseeing the “health care delivery and payment system” in Maine.

The commission was removed when the bill was replaced by an amendment. The amendment created the Office of Affordable Healthcare, an office located within the legislature charged with “analyzing data from the Maine Health Data Organization and the Maine Quality Forum and making recommendations to the joint standing committee of the Legislature having jurisdiction over health coverage matters on methods to improve the cost-efficient provision of high-quality health,” to Maine residents.

Though LD 2110 died when the 129th Legislature adjourned, the office was established through LD 120, a bill considered by the 130th Legislature and which became law in July 2021 without the governor’s signature.

The office is required to develop proposals for legislative consideration on “potential methods to improve the cost-efficient provision of high-quality healthcare” and “conduct a systematic review of the health care system and develop proposals to improve coordination, efficiency and quality of the health care system.” It must also deliver an annual report to the governor, the legislative oversight committee and the advisory council of its findings, due no later than January 1 every year.


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