Colorado — Medicare for All?

A revolution is sprouting in Colorado that could make it the first state to create a single-payer health care system that covers every resident. They’re calling it “Medicare for All.”

ColoradoCareYes, a citizens’ group, wrote an amendment and collected enough signatures to get ColoradoCare on the ballot in November. If passed, it would cover everyone, with no deductibles and no co-pays for primary care.

Irene Aguilar, the only state senator who’s a practicing MD, is a driving force behind ColoradoCare

Irene Aguilar, the only state senator who’s a practicing MD, helped create ColoradoCare

Obamacare, they assert, fails to provide what it promised—affordable care. Insurance companies still control the deck, and are raising rates. The New York Times reported recently that about 20% of insured people are struggling with “crushing medical debt.” Others are paying more for health care and getting less than they were before Obamacare.

Take, for example, my neighbors, Matt, 33, and his Korean wife, Nuri, 29. He works for an educational nonprofit, and she just started her first job in America, as a stock person at a clothing store.

Before Obamacare, they had a plan that cost $500 a month for them both. They could see any doctor they chose, and their deductible was $1000.

After Obamacare, for their insurance this year, Matt spent weeks doing research, creating a spread sheet to sort out what plans were available and what they covered. The results were dismal.

None of the plans allowed Matt and Nuri to see all their present doctors, requiring them to choose from a narrow list of in-network providers. For most plans, Matt and Nuri would pay about $600 a month in premiums, but have a deductible of $2,400. Their maximum out of pocket would be $12,000. Since they’re planning to have a baby, they would surely spend $12,000 out of pocket, in addition to $7200 in premiums–a total of almost $20,000. And their projected income is $55,000.

Nuri earns about $1000 a month, so every dollar she makes would go to health care. And this was with the best–the gold plans. The bronze plans had deductibles of about $12,000 per family, so people who didn’t meet the deductible would pay for all their own health care plus $350 a month in premiums.

This is “affordable?”

ColoradoCareYes believes the state should opt out of Obamacare and replace it with universal coverage. And it’s hoped that other states will follow, like dominos.

If the proposal, Amendment 69,  passes, people would be able to see any licensed practitioner, and all bills would be sent to the state. The program would include prescription drugs, mental health care, and wellness visits.

Here’s how it would be funded. Instead of paying premiums to insurance companies, residents would have a 3.3% payroll deduction, and their employer would kick in 6.7%. Self-employed workers would pay 10% of the income they report on federal tax returns.  However, since the ColoradoCare tax would be deductible from federal tax, the actual tax that self-employed people would pay would be between 5 and 8 percent, depending on income bracket. Most important, they would pay this tax and no premiums. There’d be no hassles with insurance companies, no whopping bills that the insurance company refuses to pay.

It’s estimated that 80% of Coloradans would pay less for health care than they’re paying under Obamacare. Matt and Nuri would pay a total of about $5,000, instead of $20,000. And the state would save $4.5 billion in healthcare expenses.

The leaders of ColoradoCareYes have been working on this for eight years. They submitted their proposal twice to the legislature, which voted it down. So last year, they ran a citizens’ initiative campaign, and collected 50% more signatures than required to get it on the ballot. Bill Semple, a psychologist who’s one of the authors of the amendment, said the advantage of a citizens’ initiative is that “you create the whole system, nail down all the details, then get signatures and get it on the ballot. But if it goes through the legislature, they can amend it to hell.”

There’ll be a brutal fight to get the bill passed, because Coloradans resist new taxes, and Republicans, funded by the Koch brothers, are already demonizing it as “rationed health care,” and predicting it will bankrupt the state. An independent study commissioned by ColoradoCareYes and one by the legislative counsel concluded that the plan would be economically sustainable.

Because it’s a presidential election year, turnout is expected to be higher among progressives, millennials, minorities, and single mothers–groups who’re likely to benefit from the new program.

T.R. Reid, a spokesman for ColoradoCareYes, who produced the PBS documentary, Sick Around the World, says the secretary of state worded the amendment so it begins: “Shall Colorado raise taxes by $25 billion…” Reid says, “If people see that and don’t understand what it’s for, we’ll lose. If we succeed in telling people that it will bring them cheaper health care and  cover everyone, with the ability to see any doctor, we’ll win.”

Reid says, "We can lead policy change from the state level."

Reid says, “We can lead policy change from the state level.”

Twenty other states—including California, Oregon, Ohio, and New York—are studying ColoradoCare to develop their own citizens’ initiatives. It’s an alternative to repealing Obamacare or fighting congressional gridlock to improve it.

As Colorado did with legalizing marijuana, the state could pave the way to providing “Medicare for All.”

Stay tuned.

I’m eager to hear your thoughts and experiences. Please leave a comment below.

 

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37 thoughts on “Colorado — Medicare for All?

  1. john helmkamp

    It’s as it should be , corporate middle man profits out ,just think , this would eliminate the nearly 20 million medical bankruptcies. in the last 10 years

    Reply
    1. Ben Levi

      Clearly the key here is the income vs. expenses aspect of the whole process. Does the bill have anything in it to limit expenses? What about the 10% tax on income… does that have any kind of upper cap on it? If you look at the whole picture, folks who are sick and not making any income will be spending more on healthcare than those who are well and making good money. Where is the personal responsibility aspect of this bill? Does it have provisions to promote healthy practices? Insurance companies only take a small piece of the health care costs pie… most of the increases are due to drug costs (going sky-high), increasing costs of unnecessary procedures and tests, and unhealthy practices such as eating unhealthy foods. I like the principle of this, but am concerned that we need a whole-system approach to health care and wonder how much this looks at that?

      Reply
      1. Sara Wright

        Hi Ben,
        You raise several good points. The tax is capped at $350 k individual and $450 k for joint filers. I can’t imagine what you mean that folks who are sick and not making money will spend more than those who are well. It’s an income tax, so if folks get too sick to work (and aren’t making income), they will still have the health care without the tax. There are several things in the bill to limit expenses. For starters, all of Colorado’s 5.4 million citizens will have group purchasing power for medical equipment as well as pharmaceuticals. Secondly, the unified system will help prevent fraud and abuse and avoid duplication of tests, records, etc. It will help physicians and patients to focus on preventative care because physicians will be paid for spending time talking with patients, not only for ordering tests/procedures and people will be able to afford to see the doctor (no deductibles!) and take preventative medication rather than cycling through the emergency rooms or winding up disabled because they couldn’t afford preventative care. One reason a single risk pool is so humane and just is that despite the best healthy practices, genetics and accidents mean we never know who will need health care when. Thank you for your interest. The bill is online in full at http://www.ColoradoCare.org

        Reply
  2. Marlene E Zimbal

    i also think that there should be dental care for all Medicare recipients. Dental care is very expensive and not all plans cover dental care. It should be provided in all states.

    Reply
  3. Judy Gorenc

    There should be something that earmarks some of the taxes received from medical marijuana for this health care system. The same people likely support both so it shouldn’t be that hard to get support. Yeah CO! Too bad the Republicans in Congress gutted all the original ideas in Obamacare and we wound up with a compromise that left the spawn of the devil still in charge. Meaning the insurance companies and pharmaceutical companies. Health care for profit (profits for all the people in the middle – not patients or health care professionals) is a bad idea. And when you are profiting from other people’s misfortune, you do not have the good of the people of this country at heart.
    Judy Gorenc

    Reply
  4. Beth Sullivan

    Go Sarah!!!
    I hope this means you’re voting for Bernie. I’ve been campaigning for him since August… I was one of a half-dozen women who started the first UCLA women’s group in 1969 and have been (as you well know) dedicated to feminist ideals in my work, but I just can’t bring myself to vote for Hillary solely because she”s a woman. I respect your intellect and talent very much and would like to hear your case if you disagree.

    Sara, I really miss you. You’ve been such a good friend to me through the years. I’m forever grateful… I hope all’s well in your life and send you much love,
    Beth

    Reply
  5. Oliver A. McBryan

    The proposed tax for Coloradocare would apparently apply to those on Medicare while they would gain no benefits. What is needed is to extend Medicare downwards in age. So ColoradoCare should apply to those under 65 and they should pay the tax. Those over 65 already paid tax for 45 years for their benefits. This bill will only pass if supported by seniors so structuring it to not hurt seniors will be key.

    Reply
    1. Sara Wright

      Oliver, 85 percent of Medicare beneficiaries will pay less than they do by using ColoradoCare as their supplemental plan. In addition, many seniors are parents and grandparents who have family members they help with medical expenses. The passing of ColoradoCare would ensure all Coloradans, including family members, friends, and neighbors, are covered with quality health care. Also much retirement income is exempt. Learn more: http://www.ColoradoCare.org.

      Reply
  6. David Stein

    Someone is finally making sense. Now for the rest of the country. It should be the Congress doing this, but if not, then state by state until we shame them into accepting their responsibility.

    Reply
  7. Judy Cleborne

    My Anthem coverage went up over 100 percent in price in 2016. When I called to inquire about it, I was told that the insurance companies have the option to raise premiums and in my case, they sure did. I returned to Covered CA to obtain a different plan and am now paying $25 a month with Molina Healthcare. They are a less well-known name, but I hope to make it to July with them when I qualify for Medicare.

    I wanted there to be national health care for decades and am glad it exists. The increase in premium that I experienced was not what the designers had in mind, I doubt. It indicates that the best solution is still out there and maybe a program like ColoradoCares is the answer, but it sounds it too good to be true.

    Reply
  8. kathy goodman

    This sounds “right on” to me. But I have not explored it. Can you let me know what the agreement against this might be and can you think of any unintended consequences ( good or bad) of moving into ColoradoCareYes?

    Reply
  9. Terry

    Your blogs are always so informative and provocative.
    What would happen to people already on Medicare who only pay a very small amount? Does it address people on medicare? Would it cover licensed chiropractic, massage & acupuncture?

    Reply
  10. Joseph Drew

    Like other advanced industrialized countries we should have medical care access for all. I favor adoption of the British or German or French or Canadian model.

    Reply
  11. Joey Bortnick

    Hi Sara
    Thanks for sharing this. I hope CA goes for it! Sounds wonderful! Hope you’ve been well. I have a story to share with you so I’ll connect soon. Have a magical Valentines Day! Have you moved into a condo yet??? Looking forward to reading your blogs! Respect and Blessings, Joey Bortnick

    Reply
  12. Rosemary Williams

    Sara, A very effective way to bring more attention to this issue would be to start a petition on either change.org or care2.com. Both are highly respected ways to engage the public in a cause.

    Best,
    Rosemary Williams

    Reply
  13. Alicia Bay Laurel

    I am thrilled to hear this news. I see a welcome change of political climate regarding health care since Michael Moore’s movie “Sicko” and the Tea Party backlash to ObamaCare. I am excited by the national response to Bernie Sanders candidacy, which includes national single payer health care as part of his platform. Good to know that the people of Colorado will be voting on state single payer health care this election. Thank you for the great article, Sara!

    Reply
  14. James E Morlan

    A suggestion. Write your next blog with the following title, Women who fail to vote for Hillary deserve a very special place in Hell! 😊

    Reply
  15. healer

    In Calgary Alberta, the wait for an ’emergency MRI is one month, for an ‘elective’ MRI is 9 months .
    Universal medicare is pushing every province to bankruptcy. Medicare is the ticket to stand in line, not for care, which is “mediocre care”. “Universal health care will be a playground for bureaucrats.

    Patient abuse of the system is endemic as there is no competition to governmental sloth.

    Reply
      1. healer

        Just as in Canada. Whoever controls the purse, controls the physicians. The last government in Alberta acknowledged a redundancy of 1600 health care poo-bahs earning more than $100K each and was going to give them pink slips. The new government supported by unions rescinded that dismissal and is going after M.D.s to lower their fees to fund the $$ shortfall.

        Reply
        1. healer

          Tens of thousands of Canadians travel to the USA yearly to receive timely care with well over a billion dollars spent out of pocket. If Colorado emulates the Canadian model, there will be a whole new state industry of “Waiting time committees” just as in Canada….as your care will deteriorate as timeliness disappears.

          Reply
  16. Amy

    This is one of my dreams. This is the only way this is going to happen. State by state. If we leave it to the federal government it will take 50 years! Thanks for keeping us in the loop!

    Reply
  17. John

    Amazing!! Colodrado leads and Sander’s revolution empowering people’s voice is the new prairie fire!!

    Keep up the good work fanning the fire and send in your contribution to Bernie!!

    Reply
  18. Yael

    I signed this petition. Now I’d like to see the details. Where do we get a full copy? (I’m a bit worried about the photograph of the senator as she also promotes the movement towards mandatory medical care or) vaccines, for all without true informed consent) thanks.

    Reply
  19. Silvia

    I live in California and my husband and I have Medicare and Tricare for life, based on his military service. Three years ago I had a life saving surgery which cost $500K–we din’t have to pay a nickel of it because Tricare pay for 20% and Medicare Pays 80% of the medical expenses.
    I absolutely support any measures that can reduce the astronomical cost of medical care in the U.S. I hope Coloradans are able to pass this measure and that it will become law. I’m sure California will follow suit if it succeeds in Colorado.
    Thank you for letting me know about this. I’m a fan and I read your blog overtime I hear from you. Best, Silvia

    Reply
  20. Charley Cropley, N.D.

    Great article, Sara.

    I am in agreement with “Medicare for all”… as a means of funding medical care.
    A funding model does not address the causes of the abysmal state of our collective Health. Nor does it provide effective Therapeutic solutions. I realize this is not the intent of this bill. However if we do not discover both the causes of our collective illnesses and effective therapeutics, our costs will continue to escalate and shortly bankrupt us.

    In Boulder we are creating a Naturopathic model of community Healthcare that will offer effective, affordable and sustainable solutions. The center of this will be a 100 bed spa-hospital entitled Boulder Center for Integral Naturopathic Medicine. Check it out.
    http://charleycropley.com/boulder-center-for-integral-naturopathic-medicine/

    The funding, organization and governance of this facility will be brought about by collaboration between our local grassroots movement and the national Naturopathic profession. Naturopathic Medicine is a traditional model of medicine that provides many, not all answers to our current crisis.
    http://charleycropley.com/meet-dr-cropley/about-naturopathic-medicine/

    The Integral Model offers a comprehensive way of understanding Health and medicine.
    https://www.integrallife.com/about

    Reply
  21. Linda Newton

    Hi Sara,

    TR Reid is an expert on the various health care systems extant. Is the Colorado plan based on any of them in particular?

    Reply
  22. Marta

    Go Colorado! And may the rest of the country follow. It’s about time America caught up with most of the developed countries around the world when it comes to healthcare.

    Reply
  23. Ilmar

    Sounds like a GREAT idea! Good luck on making it a reality. I wonder though what Trump has in mind with his single payer system?

    The Colorado proposal doesn’t go far enough. To really “fix” the system you would need to also negotiate super-group rates on drugs which would piss off big-pharma, then have tort limitations which would have the lawyer up in arms and finally broaden who can act as a medical practitioner. By that I mean that for many things nurses could replace doctors in many instances for example. Couldn’t a trained nurse write prescriptions for most common medications and is a doctor really needed to tell you that you have a cold? This of course would put doctors in total revolt and threaten to practice elsewhere. Only way it could be done right is at the federal level.

    Oh so many special interests!

    Reply