A recent commentary in the Wall Street Journal announced, “Obamacare’s meltdown has arrived.” Over the years I’ve heard conspiracy theories that the Affordable Care Act was designed to fail, as a means to nudge a reluctant nation one step closer to a single-payer, Medicare-for-All health care system.
Bernie Sanders famously advocated for single-payer during his campaign. In 2011, the Vermont legislature passed a bill to create a single-payer initiative. Green Mountain Care was abandoned in 2014 by Vermont’s governor — a Democrat — as being too costly. Despite an 11.5 percent payroll and a sliding-scale income tax of up to 9.5 percent, Green Mountain Care was projected to run deficits by 2020.
A similar single-payer initiative is now taking place in Colorado. Amendment 69, known as ColoradoCare, would create a taxpayer-funded health insurer. ColoradoCare would be available to nearly all Colorado residents, including Medicaid enrollees. Federal programs, such as Medicare, TRICARE and the VA would remain in place, however.
When Vermont Governor Peter Shumlin dropped his support for Green Mountain Care a year and a half ago, it looked like single-payer healthcare in the United States might have taken a fatal blow.
But no! A couple of thousand miles away, in Colorado, a new single-payer proposal is on the November ballot and might even pass.
ColoradoCare would put in place a quasi-state-administered health plan covering almost every resident of the state. Paid for by a “premium tax” on businesses and individuals, it would provide a wide range of benefits for residents not covered by any federal government program (but including those now enrolled through ACA insurance exchanges). It also would pay for Medicaid services at the same rates as other residents and provide supplemental Medicare coverage.
ColoradoCare’s proposed coverage is remarkably generous, with no deductibles and with zero copays for most primary care, but—predictably—the ballot measure to create the program faces strong opposition from insurers and most business owners.
What’s likely to happen? A June poll showed strong support, but the insurance industry is now funding a barrage of negative publicity. Support for the ballot measure may also be eroded by the announced opposition of Colorado’s Democratic governor, and by a Colorado Health Institute analysis indicating that revenues would likely be insufficient to cover costs.