A right to health care in Colorado?

Ballot drive would establish constitutional right in Colorado

By Peter Marcus
The Colorado Statesman, May 31, 2013

Proponents of a universal health care system in Colorado are expected to kick off a ballot drive Saturday that would establish a state constitutional right to health care.

The question would appear on the 2014 ballot, asking Colorado voters to approve, “As a matter of human right and public good for all residing in Colorado, access to an appropriate single standard of high quality health care without financial barrier.”

The single health insurance program would essentially put out of business the for-profit, private health insurance industry in Colorado, which includes about a dozen providers.

More insurance carriers could come to the state as part of the Connect for Health Colorado exchange, an online marketplace for health insurance made possible by the federal Patient Protection and Affordable Care Act and by subsequent state legislation. The exchange is scheduled to launch on Oct. 1.

But proponents say it is time for the private health insurance industry to find other ways to make its money. “Quality health care as a part of our individual and collective quality of life shall not be treated as a private, for-profit commodity in Colorado,” states the final text of the proposed “Right to Health Care” initiative.

Proponents are modeling their drive similar to how marijuana activists designed Amendment 64 last year. The question would simply ask voters to make health care a constitutional right. It would then be up to the legislature to implement a framework for operating a universal system.

Premiums would be collected by the Department of Revenue and controlled by the state. Proponents expect that a 9 percent income tax would cover costs. The initiative would cap premium costs at 9 percent of an individual’s income, but the legislature could ratchet that down, if possible. Lawmakers would need to send to voters a separate tax question under the Taxpayer’s Bill of Rights.

The state would still be eligible for federal assistance, including Medicaid and Medicare, but it would need to apply for a waiver, which it can do in 2017 under the Affordable Care Act.

Proponents must collect 86,105 valid signatures to place the question on the ballot. They will kick off that effort Saturday at First Plymouth Congregational Church in Englewood.

“I do think that voters will see that there will be some improvements under the Affordable Care Act… but a lot of people are going to see that their costs are going to keep rising, and what they’re able to get is going to be backing off, and folks are not going to be happy about that,” explained Donna Smith, author of the proposed ballot question and executive director of Health Care for All Colorado. “They’re going to be wanting something different.

“Coloradans are basically fair people,” she continued. “We don’t like to see people suffer when it’s not their fault.”

Smith knows something about suffering. She is a two-time cancer survivor, most recently battling carcinoid syndrome.

She and her husband have been married 37 years. They have six kids and 15 grandchildren. The couple always had health insurance, which helped her husband with heart complications and her through cancer treatment. But even with the insurance, it wasn’t enough. The couple became flooded by copayments and deductibles.

“We hung on as long as we could, but then we went under,” described Smith.

Her heart-wrenching story caught the attention of documentarian Michael Moore, who featured the saga in “Sicko,” his 2007 brutal expose on the health insurance industry. Smith and her husband were forced to sell their house in order to pay for bills and everyday living expenses. Still, they went bankrupt.

“That’s not something folks aspire to do in life, to be featured in a Michael Moore film, because that usually means something pretty horrible has happened in your life,” declared Smith. “He didn’t shoot us because we were unique… he chose us because we represent so many Americans who are struggling — even with insurance — and not able to have the care they need, and not have the financial coverage they need.”

Nathan Wilkes, co-author of the proposed ballot initiative, has a similar heartbreaking story to tell. His drama began in 2003 when his son, Thomas, was born with severe hemophilia. The illness quickly exceeded $1 million in treatments.

“The struggle that we dealt with in maintaining coverage and keeping him healthy was mind boggling,” explained Wilkes, who was also appointed to the Colorado Health Benefits Exchange Board.

His story caught President Barack Obama’s attention in 2009 while the administration pushed the Affordable Care Act. Wilkes introduced the president at a town-hall meeting in Grand Junction in August of that year and he was flown the next month to Washington by the White House to be a guest at Obama’s address to a joint session of Congress on health care reform. Wilkes sat in the presidential box, directly two rows behind First Lady Michelle Obama.

He said parts of the Affordable Care Act helped, including a ban on lifetime benefit caps. But Wilkes believes there are still significant gaps that need to be addressed, which is why he is pushing for the ballot question. Much of that has to do with cost as insurance premiums continue to rise.

“Nothing has addresses the medical costs… nothing has addressed the exorbitant administrative bureaucracy,” he explained. “Still, our biggest fight day in, day out is dealing with medical bills and denials and insurance problems…”

Wilkes said universal health care in Colorado is necessary from an economic standpoint. Proponents point out that health care expenditures in the United States are about 18 percent of gross domestic product. Also, of 1.2 million personal bankruptcy filings in 2012, about 62 percent were linked to a medical crisis. Of those, about 75 percent had insurance.

“The fiscally responsible position is to fix this health care crisis,” said Smith. “It’s not fiscally responsible to continue to throw money at a system that’s broken. That’s not good.”

Insurance industry expresses concern

The health insurance industry says that it doesn’t disagree that the system is in need of repair. It just doesn’t believe a universal system is the answer.

“The reforms aren’t perfect, but we’ve been on record now for years saying the system was broken and has to be fixed,” explained Ben Price, executive director of the Colorado Association of Health Plans. “The changes being implemented now are a great start.”

The industry is concerned that a proposal for universal health care is premature given the fact that the Affordable Care Act is still being implemented, including an exchange. Recent filings show that providers in Colorado have gone all-in with the new Connect for Health Colorado exchange.

“On Oct. 1, Coloradans will be able to begin comparing plans, and on Jan. 1, many Coloradans who couldn’t get insurance before will be able to get covered,” said Price.

“The work isn’t done — health care costs are skyrocketing and health insurance premiums are simply a reflection of those costs — we have to work together to tackle cost if the health care system is going to be sustainable,” he continued. “Clearly, our work is cut out for us.”

Rather than eliminate for-profit health insurance, Price believes the answer is free market economics. He said that is evident in Colorado.

“In many states, only one or two insurance carriers are operating, but in Colorado, consumers have a dozen major carriers, each offering multiple different types of plans, all competing for Coloradans’ business,” described Price. “In fact, we’re the fourth most competitive state in the nation in terms of health insurance.”

He said proponents would be better off waiting to see how the exchange is implemented.

“We’re ahead of the curve here in Colorado, one of the few states that will be launching a state and not federal-run exchange in 2014, putting the real numbers and real information in front of consumers and employers, offering them a clearer picture of what they are choosing,” said Price. “In our opinion, choice and competition is a positive, with this alternative proposal being ‘same care’ for all.”