Colorado rejects universal healthcare initiative, but supporters aren't giving up

By Shelby Livingston
Modern Healthcare, Nov. 9, 2016

Colorado voters on Tuesday overwhelmingly voted down a measure to create a universal healthcare system that would finance healthcare services for most state residents.

The Bernie Sanders-backed measure, Amendment 69, garnered barely more than 20% of the vote. It required a simple majority vote to pass.

Despite the outcome, which was largely expected, supporters of ColoradoCare still considered the push for universal healthcare somewhat of a success.

"Win or lose, the issue of guaranteed access to healthcare for everyone without financial barriers was finally brought before the voters,” state Sen. Irene Aguilar, who has spearheaded ColoradoCare, told a crowd of supporters Tuesday.

“Obviously, we wish we had done better,” said Lyn Gullette, director of operations for the campaign behind the ballot initiative. At the same time, “There's no way we're going to stop working,” she said.

The initiative would have established a universal healthcare system to finance healthcare services for most Colorado residents under a federal waiver available to states under the Affordable Care Act. It would be funded by payroll taxes rather than insurance premiums, and beneficiaries would have no deductibles and no copays for preventive and primary care.

Supporters have been trying for a decade to bring the plan to the statewide ballot, but past efforts, most recently led by Aguilar, never got any traction. But this time around, the plan's supporters collected more than 150,000 signatures to bring the plan before voters directly on the Nov. 8 ballot.

The measure faced an uphill battle. Opponents, mostly hospitals and insurers, raised more than $4 million, while supporters contributed just shy of $900,000 to finance their campaign. Advocacy groups representing hospitals and health insurers argued the plan would upend the coverage expansions under the Affordable Care Act, require unsustainable tax increases and undermine competition and patient choice. Employers said the payroll taxes would harm their businesses.

The Nov. 8 ballot language, though, may have been ColoradoCare's greatest obstacle. Voters came face to face with an amendment stating it would raise taxes by $25 billion to fund the system, but nowhere did it say what state residents would save in the long run, making it a very hard sell, campaign spokesman Owen Perkins said.

Still, “we did achieve universal acceptance that there's a problem with the status quo,” he said. Some initiative opponents have expressed a desire for a universal healthcare system, even if they didn't like this specific amendment, he said.

The Colorado Hospital Association said it was pleased with voters' decision to reject the measure.

“It was too risky, too uncertain and unaffordable for Colorado,” the association said in a statement.

Dr. Katie Lozano, president of the Colorado Medical Society, an organization of physicians who largely opposed ColoradoCare, said the amendment's failure doesn't validate the current health system, however.

"Our members expressed deep dissatisfaction with the current system, for their patients and their practices,” Lozano said in a statement. “It's very important to us to ensure that Coloradans have high quality, affordable health care and good access to their doctors. Currently, there are too many barriers to good care and too many hoops to jump through to get insurance to cover care for patients, resulting in high levels of physician burnout.”

ColoradoCare would have eliminated the state-run health insurance exchange and transferred those funds to the new system. Federal programs like Medicare and Veterans Health Administration coverage would remain unchanged, and residents would still have the option of buying private health insurance, though they would still pay taxes to support ColoradoCare. Benefits under the plan would include primary, mental health, specialty and dental care and be governed by an elected 21-member board of trustees who would decide benefit details and set rates for providers contracting directly with the system.

Undeterred, the campaign for ColoradoCare will begin planning its next steps come December. Volunteers are already flooding Gullette's email, asking for ways to help.

“There's no question that we're going to go forward,” she said. “People are still dying; people are suffering; people are going bankrupt.”