Colorado voters next month will be asked to back universal health care.
The lengthy Amendment 69 constitutional question reads in part: “Shall state taxes be increased $25 billion annually in the first fiscal year, and by such amounts that are raised thereafter ... establishing a health care payment system to fund health care for all individuals whose primary residence is in Colorado ...”
The proposal – which national proponents view as a test case – would create a ColoradoCare board to administer the system.
The ambitious project would assess a 10 percent payroll tax, in which 3.33 percent would come out of an employee’s paycheck, and the remaining 6.67 percent would be paid by employers, based on the employer’s total payroll.
As an example, if a person makes $100,000 per year, the employee would have $3,330 taken in a payroll deduction and the employer would add its share, $6,670, for that specific employee. Employers would pay that percentage on each of its employees’ salaries.
Self-employed individuals would pay the full 10 percent, and would no longer have to shop for insurance through the individual marketplace. Other income that is subject to federal tax also would be taxed at 10 percent.
The unemployed would be fully covered both in terms of care and costs.
When federal contributions are included, total revenue would be $36.2 billion.
For a period of time, taxpayers would pay a smaller $4 billion tax for ColoradoCare’s implementation, while also paying for their private insurance.
The interim tax is 1 percent of payroll, instead of 10 percent. Employees would pay 0.3 percent and employers would pay 0.7 percent.
The 21-member board would be allowed to seek tax increases, if necessary. Voters would elect the board through special elections in seven health care districts.
An interim 15-member board would be appointed to make initial staff hires.
The program would operate as a zero-deductible plan. Co-pays would be assessed to supplement the system, though it’s unclear how much those co-pays would cost.
A “yes” vote for the measure would enact the $25 billion experiment.
A “no” vote would kill the proposal, leaving Coloradans with the current health care system, which is largely accessed through employers or the insurance marketplace. Some low-income and other individuals qualify for government subsidies.
Proponents say the proposal would lead to an equitable system that provides coverage for all. They point out that the current system leaves many uninsured, though the Affordable Care Act has expanded coverage.
Health care costs would be controlled, which would lead to better care, proponents say.
They also argue that health care should not be profit-driven.
Opponents, however, say the measure would burden employers and nearly double state spending. The entire current budget totals $27 billion.
Critics argue that many individuals and businesses will pay more with the new taxes than they now pay for health care.
There’s also a long list of uncertainties, including whether the system would absolutely improve care and reduce health care costs. It’s not entirely clear whether coverage would be easily accessible across state lines, and providers may not be willing to serve patients, or they might choose to leave the state.
The tax itself may not be enough, with the independent Colorado Health Institute finding that the system would struggle to cover costs.
Abortion rights groups have also raised concerns that the measure would unintentionally limit access to abortions because the state constitution prohibits state funding for those services.
There’s also fears around an elected board administering ColoradoCare, with some arguing that it would be filled with politicians over knowledgeable administrators.