A November ballot initiative, if passed, would create the largest change yet to health care in Colorado. Proponents say the system could be a first of its kind to model how universal health care could work nationwide. Opponents cite the significant increase in taxes, government bureaucracy and loss of jobs in the commercial insurance industry.If Amendment 69 succeeds, the state would adopt a health care system called ColoradoCare, which would be funded by a 10 percent state tax. Payroll income would be split: two thirds paid by the employer and one third as a deduction from the employee’s pay. Non-payroll income, including rent, interest, dividends, capital gains and small business income would be taxed at the full 10 percent to the taxpayer. Pensions, benefits and annuities above a $20,000 to $24,000 exemption would be taxed, depending on the age of the taxpayer.The tax revenue would fund the system described as ìMedicare for Allî by proponents. The system would cover all Colorado residents, including those currently covered by private insurance. ColoradoCare would replace the Medicaid and Affordable Care Act exchange marketplace subsidies currently administered by Connect for Health Colorado.ColoradoCare could solve some of the issues related to the implementation of the ACA, also known as ObamaCare. ìACA cut the number of people uninsured in Colorado by half, but there’s a lot of unfinished business,î said Owen Perkins, director of communications for ColoradoCare Yes. ìColoradoCare brings all those uninsured into the health care system, and makes sure every Colorado resident has full access to health care.îColoradans for Coloradans, the campaign fighting the amendment, claims to have a bi-partisan rank of politicians and high-profile figures opposing the measure, including former Democrat governor, Bill Ritter.ìThis would create a single payer, state-run health insurance plan that would replace current insurance plans by doubling the size of the state budget; and give us the highest taxes in the country, even higher than California,î said Sean Duffy, spokesman for Coloradans for Coloradans.Opponents are worried the system would force almost all private insurance companies out of the state, resulting in lost coverage for employees with specialty coverage and full benefit plans. ìI’m happy to call that fear mongering,î Perkins said. ìColoradoCare does not eliminate anything but the exchange marketplace. It’s just like if someone has their kids in private school, even though they’re paying taxes for public school.îThe public donor records for Coloradans for Coloradans suggest that private insurance companies are worried about losing significant numbers of members to the ColoradoCare system. According to Aug. 1 financial filings, Anthem, Kaiser Permanente, United Healthcare, Centura Health and HealthOne have each given at least $250,000 to the campaign against Amendment 69.ìI think a lot of people opposed to the idea will stick with private insurance out of principal, and that’s fine,î Perkins said. ìBut I would also predict, as people see how well its working, that they’ll stop paying for their private insurance; and eventually there won’t be private insurance. But there’s nothing here to outlaw it.îOpponents also point to people who have no need or opportunity to use ColoradoCare. They will be taxed for something they may never use. ìThe tax net is wide,î Duffy said. ìThe military will pay twice: once for Tricare, and then again for ColoradoCare, even if you never use it. The worst thing is small-business owners will pay 10 percent of their income. Our opponents say ‘do the math;í and, when people do, they call us and ask how can we help to defeat this.îWhether doctors and hospitals benefit from ColoradoCare is another topic of debate between the opposing campaigns.Proponents say doctors would get overall higher reimbursements. Doctors often donít get the full rate for something like Medicare, Perkins said. ìColoradoCare makes that lower rate go away, and everyone goes up to the full Medicare reimbursement rate. Doctors will no longer have concerns about taking new patients at full rate.îOpponents say the reimbursement rates are not set in the text of the ballot initiative, and would be determined once it passes. Childrenís Hospital Colorado leaders expressed concerns about being able to keep their best research doctors on staff. They might opt to leave the state because they wonít know what will be covered at what reimbursement rate, Duffy said.Single-payer universal health care is a debate that will continue in the U.S. long after Amendment 69 passes or fails. ìThe states are the laboratories of democracy, as Justice Brandeis said,î Perkins said. ìIt happened at the state level with women’s suffrage, child labor, marriage equality ó all the issues that became the law nationally. As things start to change, people will feel and vote a different way, as times move on.î
