In November, Colorado voters will decide by ballot initiative whether to amend the state’s constitution to mandate the creation of a universal, statewide, single-payer health care system.
Initiative 20, also known as Amendment 69 and ColoradoCare, would take advantage of a waiver provision in the Affordable Care Act for states that increase health care access to citizens without adding to the federal deficit. The plan resembles a single-payer health care system proposition that fell short in Vermont in 2014.
State officials would appoint an interim Board of Trustees (BOT), classified as a “political subdivision of the state, not under the direction of the legislature, governor, or any state administrative department or agency,” to implement the plan, states an informational booklet by activist group ColoradoCareYES. Citizens would eventually elect trustees to serve up to two four-year terms without the possibility of facing recall elections.
To fund ColoradoCare, the Board of Trustees would levy a “health care premium tax,” which is exempt from the Colorado Constitution’s Taxpayer’s Bill of Rights because of BOT’s designation as a “government enterprise,” rather than an agency.
Higher Taxes, Lower Quality?
Jonathan Lockwood, executive director of Advancing Colorado, says ColoradoCare would raise taxes without increasing health care quality for lower-income individuals.
“This proposal will break the backs of lower-income families; exploit seniors, millennials, and veterans; and jeopardize economic growth,” Lockwood said. “ColoradoCare will make Colorado the highest-taxed state in the nation, and we won’t be guaranteed any health care benefits in return.”
The Colorado State Association of Health Underwriters says Amendment 69 would give the state the highest tax rates in the country.
The fiscal impact of ColoradoCare would be $25 billion in the state’s 2019–20 fiscal year, obtained through a new 10 percent premium tax on most sources of income, unless the Board of Trustees adopts a different rate, according to a fiscal impact memo from the Colorado Legislative Council Staff, the nonpartisan research arm of the state legislature.
Lack of Accountability
Linda Gorman, director of the Center for Health Care Policy at the Independence Institute, says Amendment 69 would force Coloradoans to hand over their income to unaccountable managers.
“ColoradoCare gives 10 percent of all income earned in the state and all of the taxes currently collected and spent by the state on health care to a new board that will be free to make almost any rules it wants with respect to voting districts, oversight, and what licensed health care providers in the state can charge,” Gorman said.
Gorman says the program will impose price controls and assert a “fixed claim” on an individual’s earned income, without benefitting individuals enrolled in Medicare.
“It promises to provide health care to residents, but residents have very little say in what sort of health care [the Board of Trustees] decides to give,” Gorman said.
Michael McGrady ([email protected]) writes from Colorado Springs, Colorado.
Matthew Glans, “Colorado Should Reject Single-Payer Health Care,” Research & Commentary, The Heartland Institute, March 30, 2016: https://heartland.org/policy-documents/research-commentary-colorado-should-reject-single-payer-health-care
Linda Gorman, “Amendment 69: What You Need to Know About the ‘ColoradoCare’ Single-Payer Health Care Measure,” Independence Institute, December 22, 2015: https://heartland.org/policy-documents/amendment-69-what-you-need-know-about-coloradocare-single-payer-health-care-measure