Is Amendment 69 right for Colorado?
September 22, 2016
EAGLE COUNTY — Voters during this year's general election will decide if Colorado will be the first state to have a universal health care payment system.
The ColoradoCare System Initiative, or Amendment 69, is also known as ColoradoCare. If passed, then it would create a health care payment system designed to finance universal health care for all Colorado residents.
Proponents claim that "it would cover Coloradans like Medicare covers seniors and save everyone money," said Joel Dyar, a state field director for ColoradoCareYES, the group supporting the measure.
Opponents say that "it would double the state budget; hurt small business, provides no guarantees for coverage and would hurt Colorado's economic growth," said Tony Gagliardi, state director of the National Federation of Independent Businesses, where 93 percent of member businesses are against the measure.
Here's a look at what Amendment 69 would do, the costs of the system, what it means for existing insurance, consumer choice and how the system would be administered.
What would it do?
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ColoradoCare would create a nonprofit system to pay for health care services regardless of the cause of the patient's illness or injury, according to ColoradoCareYES.
"It would replace for-profit insurance providers," Dyar said.
State residents would have comprehensive, quality, accessible, lifetime health care, according to "How it Will Work" — a manual prepared by ColoradoCareYes.
"It would create something as close to Medicare as we could get," said Sen. Irene Aguilar, M.D., D-Denver, who helped craft the proposition.
Opposition groups are concerned that Amendment 69 doesn't actually specify how coverage would work, but instead leaves that to a board to decide.
"The amendment doesn't say anything about coverage, providers or types of care. It doesn't say anything about deductibles, or specialist co-pays," Gagliardi said. "The only thing it does is to outline the duties of a board."
Aguilar, who is also a doctor, acknowledges that the amendment is written to provide guidelines that allow the board the ability to work without having to make additional amendments to the state constitution.
How much would it cost?
Funding for the system would come from a new income tax based premium and federal funding sources.
"Instead of a private insurance payment, residents would pay a 10 percent income tax," Sen. Aguilar said.
The 10 percent income tax would be shared. Two-thirds, or 6.67 percent, would be paid by employers and one-third percent, would be paid by employees. The state would generate $25 billion per year from the new income tax, according to the amendment.
"For small business owners, sole proprietors, they will have to pay the entire 10 percent of payroll tax. In addition, they will be taxed 10 percent on other income sources such as business profits, investments, pensions, Social Security and so much more than the 6.3 percent payroll tax mentioned by proponents," Gagliardi said.
Most income would be subject to the new tax including any Social Security benefits, pension payments and annuities that do not qualify for the Colorado pension/annuity subtraction. The tax would also be exempt from the Colorado Taxpayer Bill of Rights and therefore, the tax rate could be changed by the system board of control.
The Colorado Foundation for Universal Health Care estimates that under ColoradoCare, "$4.5 billion is left in Coloradans' pockets" with savings from a new system that eliminate inefficiencies and waste.
Opponents dispute the math, with Coloradans for Coloradans, a group opposing the measure, saying it would double the current state budget and give Colorado the highest state taxes in the nation.
"We can't afford it. It would bankrupt the state. It's a pipe dream," Gagliardi said.
Colorado would be eligible to apply for a waiver from the federal Affordable Care Act, allowing federal funds to go to the state to help pay for the state system, according to Aguilar.
"If we vote 'no' for Amendment 69, it's essentially voting yes for ObamaCare. This is going to replace a projected $30 billion dollars that we would pay if we don't pass Amendment 69," said, Rich Garigen, a volunteer working to pass ColoradoCare. Garigen is also part of the management team for Grand Junction based small business, CPC Solutions.
Businesses and individuals can estimate ColoradoCare costs using the calculator developed by ColoradoCareYes available at: http://www.coloradocare.org/for-you/calculate-your-savings.
What about the insurance I have now?
ColoradoCare would provide an alternative to private insurance as well as replace the plans sold through the Affordable Care Act (Obamacare) market place.
"Private insurance would cease to exist as we know it," Gagliardi said.
Federal insurance programs such as VA Benefits, Federal Health Benefit Plan, TriCare and Indian Health Services, would not be subject to Colorado law. Beneficiaries would be permitted to choose their primary care professionals. Beneficiaries would still be covered if they were temporarily living, or traveling, in another state, according to ColoradoCareYes.
Could I opt out if it were to pass?
The simple answer is no.
"Everyone would be financially encumbered to pay into the system," Aguilar said. "Everyone has access, but nothing would prevent you from buying private insurance."
Colorado residents would be able to retain the insurance provider of their choice; however, all Colorado taxpayers would be required to pay the new income tax.
What about oversight?
The system would operate using a cooperative business model. As a cooperative, the members would own it; in this case the members would be Colorado residents.
Initially, the governor and legislative leaders would appoint a 15-member interim board of trustees that would act autonomously from federal, state and local governments, according to ColoradoCareYes.
Within three years of ColoradoCare's establishment, voters would elect three trustees from each of the state's seven districts for a total of 21 trustees and the board's duties would include overseeing financial management, transparency of operations and maintenance of patient privacy, according to the amendment.
It also would ensure beneficiaries' access to quality care, among other duties. The board also would hire an executive team responsible for the system's operations.