Coloradans ponder Amendment 69’s ColoradoCare
Rising insurance rates spark concern among residents
The number of uninsured Coloradans has fallen sharply since implementation of the Affordable Care Act, but the people working to place Amendment 69 on the ballot see the lingering populations of uninsured — and underinsured — as unacceptable.
Owen Perkins sums up ColoradoCare, to be proposed in Amendment 69, this way: “It’s a universal health care plan that covers all Coloradans.”
Perkins, director of communications for the ColoradoCareYES campaign, noted that, in lieu of insurance premiums, deductibles and co-payments, the plan “pays for itself primarily through a 3.33 percent payroll tax on employees and a 6.67 percent payroll tax on employers.”
The plan also, as stated in Section 9 of the amendment, collects “10 percent of all non-payroll income from all beneficiaries.”
The amendment effort comes in the midst of concern about rising health insurance rates.
Lisa Brown, chief executive officer for Northwest Colorado Health — formerly the Northwest Colorado Visiting Nurse Association — expressed particular concern about those rates.
“The premiums are very high,” she said. “Even with very high premiums, people have high deductibles.”
Brown noted that insurance tends to be particularly costly in rural parts of the state, adding that the state’s Division of Insurance — part of the Department of Regulatory Agencies — is exploring the feasibility of creating statewide rates rather than rates that vary from section to section of the state.
ColoradoCare is described in the amendment as “a political subdivision of the state governed by a 21-member board of trustees” to administer the system. The board will preside over a budget of about $25 billion.
The text of the amendment can be found at tinyurl.com/jmabrcx. Section 6 lists the health services covered, ranging from “ambulatory patient services” to “palliative and end-of-life care.”
Perkins said the plan, even if approved by voters, “can’t go into effect, legally, unless it covers as many or more people as the Affordable Care Act at the same cost or lower, and with the same benefits or better.”
Supporters of the plan say that, even with strides made by the Affordable Care Act, strong health care remains out of reach for a significant portion of residents.
“I think that the major inadequacy in our current system is that to purchase insurance is still unaffordable for many people,” said state Sen. Irene Aguilar, D-Denver. She noted that, even when people find a plan they can afford, the deductibles and co-payments often remain out of reach.
Aguilar is the ranking member from the Democratic Party on the Senate Committee on Health and Human Services.
State Sen. Randy Baumgardner, R-Hot Sulphur Springs, voiced opposition to the amendment.
“I don’t think Amendment 69 is going to help any of the inequities out there,” he said.
Speaking of the 21-member board of trustees, Baumgardner said, “The board writes its own rules and makes its own elections. There’s no legislative oversight. There’s no way the Colorado Legislature can make any decisions on how this is run.”
Baumgardner also objected to the tax that would be levied.
“This is going to raise everybody’s taxes, whether they like this or don’t like it,” he said. “It will be like the health care that socialist countries have.
According to the Colorado Health Access Survey, from the Colorado Health Institute, 829,000 Coloradans were uninsured in 2011, or 15.8 percent of the population. The number of uninsured dropped to 353,000 people in 2015, or 6.7 percent of the population.
Perkins said the tax on employers would not reach the average level of health insurance costs they currently pay — costs that Amendment 69, he said, could eliminate.
Citing a March 2015 report from the Bureau of Labor Statistics, from the U.S. Department of Labor, Perkins said, “Businesses right now pay an average of 13.5 percent of their payroll on health insurance, and that includes the full spectrum of businesses — including those that pay zero (percent on health insurance).”
Aguilar, who is a physician, said that a plan creating universal health care throughout the country would be best, but she noted that the U.S. Congress has voted 61 times to repeal the Affordable Care Act. She said such a plan would also be unlikely to pass the Colorado Legislature.
“I think the same unreasonable toxicity around health care has trickled into Colorado politics,” she said.
Aguilar noted the difficulty of change within both parties. She cited a Republican position “against the idea of the government being in some way responsible for ensuring that people have access to health care,” adding that Democrats, too, receive “lobbying money and contributions from the health care industry.”
Aguilar also characterized as troublesome the relationship between health care and the marketplace.
“I think it’s really hard for people to understand how traditional marketplace rules don’t apply in health care, because the value (of health care) is infinite,” she said. “Most people would destitute themselves to save their lives.”
That, she said, creates an opportunity for companies to raise prices to a point higher than many can afford to pay.
Brown, with Northwest Colorado Health, said ColoradoCare would constitute a major change — one she continues to examine.
“I think it would significantly change how the business of health care operates in Colorado,” she said. “It basically would remove having health insurance companies.”
That change, she said, would lift from providers the task of helping patients figure out what their various insurance plans cover and how much they reimburse.
Brown also reflected upon Medicare, which, she said, works according to a similar philosophy.
“Medicare is available to all citizens once they’re 65,” she said. “When that age group receives their care, the differences in health outcomes start to diminish. We do have a single-payer system with Medicare that seems to work well for people.”
She also noted concern that, under ColoradoCare, “one entity would have a lot of control over the payment for the care.”
Brown said she thinks the ColoradoCare plan “has the potential to be beneficial,” adding she hopes to study more detailed analyses in the coming months.
“We’re definitely researching it and seeing what we can learn,” she said.
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