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The Colorado Creation of ColoradoCare System Initiative, also known as Amendment 69, is on the November 8, 2016, ballot in Colorado as an initiated constitutional amendment.[1]
A "yes" vote supports creating ColoradoCare, a healthcare payment system designed to finance universal healthcare for Colorado residents partly through an additional 10 percent payroll tax—two thirds paid by employers and one third by employees—providing approximately $25 billion per year in revenue.
A "no" vote opposes this proposal, leaving the Colorado healthcare system unchanged.
Overview
ColoradoCare
Amendment 69 is a citizen-initiated constitutional amendment that would establish a political subdivision of the state called “ColoradoCare.” The measure was designed to establish a statewide program to provide universal healthcare coverage and finance healthcare services for Colorado residents. Amendment 69 would not prevent people from purchasing private health insurance. A 21-member board of trustees would govern ColoradoCare. As ColoradoCare would operate as a cooperative, members would vote for candidates to serve on the co-op's board and decide whether taxes should be increased to provide additional funding to the program. To fund ColoradoCare, a 10 percent payroll tax would be implemented, with employers paying 6.67 percent and employees paying 3.33 percent. Other non-payroll income would also be taxed at 10 percent.[1][2]
ACA and state healthcare systems
A section of the Affordable Care Act (ACA) allows states to create their own healthcare systems. If given a waiver, Colorado would be eligible to receive subsidies that would otherwise go to state residents to use on the private market. This means that Colorado could receive federal funding towards ColoradoCare.
State of the ballot measure campaigns
Opponents, organized as Coloradans for Coloradans, had outraised supporters five-to-one, as of October 18, 2016. ColoradoCare Yes had received about $836,813, while opponents raised $4,048,293. The top donor to the “Yes” campaign was Lyn Gullette, who contributed $168 thousand. The top donor to the “No” campaign was health insurance firm Anthem, Inc., which provided $1 million. Polls indicate low support for Amendment 69, with 28.5 percent of voters supporting and 60.5 percent opposing the measure.
Initiative design
ColoradoCare is intended to provide universal healthcare coverage for most Coloradans. Beneficiaries of Medicaid and military programs, such as Tricare, would continue to receive healthcare coverage through the federal government.
What would ColoradoCare do?
The system would aim to cover all state residents. Amendment 69 would require the following 11 categories to be included as comprehensive benefits:[1]
ambulatory patient services, including primary and specialty care
hospitalization
prescription drugs and medical equipment
mental health services and substance abuse services, including behavioral health treatment
emergency and urgent care
preventive and wellness services
chronic disease management
rehabilitative and habilitative services and devices
pediatric care, including oral, vision, and hearing services
laboratory services, maternity, and newborn care
palliative and end-of-life care
Amendment 69 would mandate that ColoradoCare pay for healthcare services regardless of the cause of the patient's illness or injury. ColoradoCare would replace the medical care portion of workers' compensation insurance. Beneficiaries that would be eligible for Medicaid or the Children’s Basic Health Plan would receive benefits required by federal law in addition to ColoradoCare's standard benefits.
ColoradoCare would not charge beneficiaries any deductibles, nor would designated preventive and primary care services have copayments. Other copayments would be waived in cases of financial hardship.
Beneficiaries would be permitted to choose their primary care professionals and still be covered if they are temporarily living, or traveling, in another state.
How would ColoradoCare be funded?
The Colorado Department of Revenue would collect the following taxes to fund ColoradoCare:[1]
A 10 percent payroll tax, with employers paying 6.67 percent and employees paying 3.33 percent.
A 10 percent tax of all non-payroll income.
Non-payroll incomes would include income from self-employment, interest and dividends, capital gains, business proprietors' income, and any Social Security benefits, pension payments, and annuities that do not qualify for the pension/annuity subtraction. The Colorado pension/annuity subtraction allows a certain amount of retirement benefits and pension income to be exempt from income taxes. The additional 10 percent income tax proposed by Amendment 69 was designed to apply to these sources of income in accordance with this deduction, which exempts up to $20,000 or $24,000 in income from pensions and annuities, depending on the age of the taxpayer.[3]
To qualify for this subtraction, a taxpayer must be over 55 years old or be a beneficiary earning a pension or annuity due to the death of the pension earner.
The amount of pension/annuity income that can be subtracted caps at $20,000 per year for those under 65 years old.
The amount of pension/annuity income that can be subtracted caps at $24,000 per year for those 65 or older.
According to the measure's fiscal impact statement, the taxes for ColoradoCare would generate $25 billion in revenue for the program in budget year 2019-2020.[4]
Tax revenue collected for ColoradoCare would be exempt from the Colorado Taxpayer Bill of Rights (TABOR).
The ColoradoCare Board of Trustees would conduct an annual assessment of the program's revenues and costs. Should more revenue be needed to maintain ColoradoCare's fiscal stability, the board would refer to members a ballot question asking them whether taxes should be increased. A majority vote would be needed to increase taxes.
How would ColoradoCare be administered?
ColoradoCare was designed as a cooperative. Beneficiaries of ColoradoCare would be considered members, and members would elect a Board of Trustees to govern ColoradoCare. The measure would create a 21-member Board of Trustees and seven electoral districts. From each of these seven electoral districts, members would elect three Trustees. Districts would need to be compact and contiguous and have roughly the same number of residents. Trustees would serve four-year terms and receive "reasonable compensation and expense reimbursement."[1]
The board's duties would include:[1]
hiring an executive team to administer the operations of ColoradoCare;
establishing separate ombudsman, also known as a public advocate, offices for beneficiaries and providers
establishing a Central Purchasing Authority for negotiating favorable prices for prescription drugs, medical equipment, and services;
approving and making publicly available an annual budget;
establishing procedures for managing surplus funding, maintaining operating reserves, increasing benefits, and issuing refunds to members;
establishing an efficient and accessible system of medical records and billing records;
establishing and funding an office to prevent and investigate fraud;
establishing rules and procedures to ensure financial sustainability;
establishing rules for independent annual performance and financial audits;
establishing rules to ensure transparency in operations and decision-making;
ensuring beneficiary confidentiality while allowing for research of ColoradoCare’s database; and
establishing an appeals procedure that allows beneficiaries and providers to challenge coverage and payment decisions
Single-payer healthcare — everyone covered, no exceptions, no insurance company bureaucracy — has been a dream of many people, especially liberals, for decades. Amendment 69 proposes to do just that at the state level, creating a new system of ColoradoCare paid for with a 10 percent payroll tax.
Yet the opposition comes not only from conservatives and business groups but from many liberal advocacy groups who would like to see single-payer at the national level. One of the benefits of a single-payer system is supposed to be its simplicity, but Amendment 69 is proving to be anything but, as its impacts would touch on everything from abortion to TABOR.
Here’s the language you’ll see on your ballot:
“Shall state taxes be increased $25 billion annually in the first full fiscal year, and by such amounts that are raised thereafter, by an amendment to the Colorado Constitution establishing a healthcare payment system to fund healthcare for all individuals whose primary residence is in Colorado, and, in connection therewith, creating a governmental entity called ColoradoCare to administer the healthcare payment system; providing for the governance of ColoradoCare by an interim board of trustees until an elected board of trustees takes responsibility; exempting ColoradoCare from the Taxpayer’s Bill of Rights; assessing an initial tax on the total payroll from employers, payroll income from employees, and nonpayroll income at varying rates; increasing these tax rates when ColoradoCare begins making healthcare payments for beneficiaries; capping the total amount of income subject to taxation; authorizing the board to increase the taxes in specified circumstances upon approval of the members of ColoradoCare; requiring ColoradoCare to contract with healthcare providers to pay for specific healthcare benefits; transferring administration of the Medicaid and children’s basic health programs and all other state and federal healthcare funds for Colorado to ColoradoCare; transferring responsibility to ColoradoCare for medical care that would otherwise be paid for by workers’ compensation insurance; requiring ColoradoCare to apply for a waiver from the Affordable Care Act to establish a Colorado healthcare payment system; and suspending the operations of the Colorado health benefit exchange and transferring its resources to ColoradoCare?”
Who in their right mind would support this? Only a leech could justify voting for this. Again, if you don't pay taxes you shouldn't be allowed to vote!!
That would be a reason to move from that state if you are a producer and a reason to move there if you are a uh non producer. Good luck Colorado if that obomanation passes.
it sounds good on the surface, but what are they not telling the people? for instance, is it portable? if someone covered under the system goes on vacation to disneyland are they covered if they have to stay in a california hospital? or suppoe they go out of the country, are they covered if they have to stay in a london hospital?
I hope it passes because 10% is complete bs... way too low... more like 25% to make it sustainable.... I hate when liberals put this up knowing that it will never pass...
It's very unlikely to pass, so I'm not sure why it's even worth discussion in a general forum. Signed...A Coloradan
Why would it not be a topic of discussion?
It is a politically controversial topic and following the outcome of such things is a decent and informative way to keep abreast of which way the political "wind" is blowing in our country.
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