Sept. 20--Bernie Sanders won the vote of many on the campaign trail with his promise of universal single-payer health care. People loved the idea so much that Democratic nominee Hillary Clinton adapted her health policies to more closely mirror Sanders'. At one point, even Republican candidate Donald Trump praised the single-payer system in Canada.
But a nationwide single-payer system is always a long shot. Even when states have tried to create one, they've ultimately abandoned the idea out of cost concerns.
This November, though, Colorado could move one step closer to becoming the first U.S. state to make single-payer health care a reality.
A question on the state's ballot, if passed, would create a publicly run health system in which all residents are provided care without having to pay premiums. To fund the effort, the state would add 10 percent to its income tax, with employers shouldering more of the burden than employees. That would provide approximately $25 billion a year to run the system, which would be called ColoradoCares.
Residents who like their current insurance could keep it, but they would still have to pay the additional taxes.
A poll earlier this year found that a majority of residents supported ColoradoCares, particularly millennials -- 60 percent of whom backed the measure. But as the opposition raised more than three times in funding, the initiative's chances of passage are fading. A poll this month found 65 percent of voters against it and 27 percent for it.
The idea of universal health care has the support of many liberals, but ColoradoCares faces opposition from high-profile progressive politicians and organizations like Democratic Gov. John Hickenlooper, the Colorado Hospital Association and NARAL Pro-Choice Colorado.
Their opposition is mostly about the money.
Last month, a report by the independent Colorado Health Institute concluded that the system would break nearly even in its first year but would eventually slide into financial chaos. By 2027, it would be running about $8 billion short.
"Tax revenue simply cannot keep pace with the health-care industry," said Katherine Mulready, vice president of legislative policy for the Colorado Hospital Association.
There are several other sticking points for the opposition.
For one, they say the measure offers a dangerous lack of oversight for a multibillion dollar system.
It would be run by a 21-member executive board of members elected by plan beneficiaries who wouldn't necessarily have a background in health care. The board also wouldn't be considered a state entity, so it wouldn't have to report to any state authority, such as the governor or legislature. (The state would, however, need a federal waiver to get ColoradoCares off the ground.)
For its part, NARAL Pro-Choice Colorado has chosen to oppose the measure because Colorado law prevents state money from funding abortion. "This means that presently insured women who have access to abortion services as part of their contracted benefits today (other than when the pregnancy would endanger the life of the mother) would lose access to abortion coverage benefits under Amendment 69," the organization said in a statement.
Others worry the effort may be eventually abandoned, as it was in Bernie Sanders' home state of Vermont.
The state's latest attempt to institute a single-payer system ended abruptly after more than three years of work had been put into it. The reason? Money. It was going to cost significantly more than originally expected and result in large tax increases.
The amendment passing but ultimately not being enacted is a proposition "too risky, uncertain and unaffordable," wrote the Colorado Hospital Association on their website. If that does happen, though, the funds would be returned to taxpayers and health care would return to status quo.
Despite the strong opposition, there are plenty of Coloradoans who believe that the state would be the perfect incubator for how a single-payer system could work in the United States.
State Sen. Irene Aguilar, a practicing physician, is among the most vocal supporters of the measure.
"We know that 20 percent of our population accounts for 80 percent of our total health-care costs," said Aguilar. "This would provide enhanced funding for [providers] willing to focus on that 20 percent by improving the overall health of our sickest populations."
Even if the initiative doesn't pass -- or doesn't end up working out -- critics say the conversation on how to improve Americans' access to health care is one worth having.
"We support the ACA [Affordable Care Act] and helped push for Medicaid expansion. We're deeply invested in people receiving the right care at the right time and the right place. We just don't think this amendment is the right one answer to that," said Mulready, of the Colorado Hospital Association. "It really does send a message. The industry should take that feedback for what it's worth and deliver better patient-centered care."
Mattie Quinn -- Staff Writer
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