× Expand Robert F. Bukaty/AP Photo Steven Michaud, the Maine Hospital Association president, speaks at a news conference with doctors opposed to Question 1, the religious and philosophical exemptions referendum on vaccinations, in Augusta, Maine, February 2020.

Last year, the Maine legislature tossed out the state’s time-consuming, undemocratic caucus system for the 2020 presidential candidate selection contest, and switched to statewide primaries for both parties. It’s instructive for reasons that have gotten little attention in the wake of the Iowa vote-counting meltdown.

Mainers learned their collective lesson in 2016 when the caucuses were plagued not by technology issues, but by lines in Portland and other more populated places in the southern part of the state. Rural areas did not have enough people available to manage caucuses, which meant that some volunteers conducted caucuses in several towns at different hours.

Caucuses won’t go away entirely in Maine; instead they will morph into county and municipal affairs, where the party faithful can focus on selecting local leaders and handling internal party matters like choosing delegates rather than trying to corral voters into a multi-hour process that few wanted to participate in and many simply couldn’t, because of the rigid, onerous time commitment.

Maine voters approved ranked-choice voting in 2016 for statewide elections, but it won’t be used in the 2020 presidential primary. A separate bill had to be passed for ranked-choice voting in the presidential race; Democratic Governor Janet Mills allowed that bill to become law in 2019 without her signature after the legislature passed it. Because bills that become law in this manner don’t take effect until 90 days after the current legislative session ends, that means it won’t be used in the March 3 primary.

Further complicating the process is a Republican-backed signature-gathering effort that would eliminate RCV by ballot measure before the general election in November. “I would not at all be surprised if they succeed in collecting signatures to get this on the ballot again,” says Robert Glover, a University of Maine political science professor. “But I would not expect the outcome of a statewide referendum to be any different.”

Back on the campaign trail, regional “favorite son” Bernie Sanders, who is dominating fundraising efforts here, will probably register a win. Sanders trounced Hillary Clinton in the caucuses in 2016, 65 percent to 35 percent. While primaries will likely expand participation, Sanders remains favored.

A February 18 Colby College poll of a small sampling of Mainers who planned to vote in the Democratic primary supported Sanders by 25 percent. The big question is which candidates do well enough to meet the 15 percent threshold for Maine’s 24 delegates.

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The primary will also be a test for Elizabeth Warren, who is in trouble in her home state of Massachusetts, to see if she can gin up more support elsewhere in New England. Glover cautions that unlike Bernie, she has not excited rural Democrats and labor voters. The Bloomberg brand is not taking off either: His anti-gun salvos against Sanders and Representative Jared Golden, who represents northern Maine, don’t stand to resonate in a low-crime state where 55 percent of adults own guns.

The big question may be whether Joe Biden, who came in fourth in the Colby survey, gains any ground. Amy Klobuchar has made stops in Maine, but there have been few overall candidate visits to the state. Pete Buttigieg suspended his campaign Sunday night.

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The COVID-19 crisis and the Trump administration’s inept response may influence the outcome of a referendum on the ballot on Tuesday, which would allow for religious and philosophical exemptions from vaccination requirements for students and health care employees. The Maine legislature passed a law prohibiting these exemptions in the spring of 2019, only to have anti-vaccine activists gather enough signatures for a “people’s veto” to repeal the law.

As the federal government scrambles to articulate something approaching a coherent strategy to confront the disease, states like Maine are pretty much on their own. There won’t be a COVID-19 vaccine for many months, but when it arrives, only widespread participation can make it effective. With Maine health officials warning that COVID-19 inevitably will hit the state, Governor Mills has joined doctors, nurses, and health care organizations in urging Mainers to vote no on Question 1.

Support for vaccination opt-outs crosses party lines. Republicans in rural regions have supported opt-outs, as have Democrats on the left. Glover notes that a considerable amount of misinformation has been spread about the bill by signature collectors who’ve claimed, for example, that the medical exemption would be removed. (That’s false; the medical exemption would be retained.) In a bid to attract Democrats, anti-vaccine activists are claiming that “Big Pharma” is behind Question 1.

The referendum marks the first time voters in any state have voted on the vaccination-exemption issue. Only four states—California, Mississippi, New York, and West Virginia—prohibit both religious and philosophical exemptions; most other states allow for religious exemptions. “The fact that Maine is voting about this as we stare down a global public health crisis hopefully is not lost on Maine voters,” says Glover.