Amendment 69 will be an economic disaster, force doctors to flee Colorado in droves, allow taxes to be raised without voter approval and represents a “utopian fantasy world,” according to Colorado State Treasurer Wayne Stapleton.
On the other hand, according to ColoradoCare supporters, the statewide health care program, or Amendment 69, would offer more medical coverage to more people for less than what they’re paying now, keep health care dollars in state instead of sending them to out-of-state private insurance companies and would need voter approval of any future tax increases, according to T.R. Reid, best-selling author, filmmaker and former Washington Post reporter.
The two men debated the merits of Amendment 69 before about 80 members and guests of the Denver Mile High Rotary Club Wednesday morning, with spirited and lively answers to questions from moderator Todd Breyfogle, director of seminars for the Aspen Institute, and the audience.
Under ColoradoCare, residents would not pay health insurance premiums or deductibles; all health care would be paid for by Colorado taxpayers to the tune of $25 billion in income and payroll taxes.
Saving money, changing status quo
Reid said around 500 people die in Colorado every year because they couldn’t afford to see a doctor and were uninsured. Those without health insurance go to hospital emergency rooms when they need care, “so we all pay that bill,” he said.
“It just makes more sense to have everyone pay so everyone can be covered,” Reid added during the debate. “And we’d have a system that is based and controlled right here in Colorado, instead of by private insurance companies from out-of-state.”
Reid acknowledged ColoradoCare is not free, but quickly noted the $25 billion cost in its first year is around $5 billion lower than current medical insurance premiums paid in Colorado. He also noted private insurance companies recently announced plans to boost their premiums by 20 percent next year.
“I’d like to ask Mr. Stapleton why isn’t he fighting for lower premiums and joining us instead of supporting the status quo?” Reid asked.
Stapleton said he understood the frustrations with the current health care system and added he is “the last person to be here defending the current system.” Stapleton said the national Affordable Care Act, or Obamacare, had helped cut health insurance costs in Colorado and reduced the numbers of those without health care insurance by more than half.
“But this proposal is contingent on a $25 billion tax increase and when you try to determine what type of coverage you get for that, there is no specificity,” Stapleton said.
He also predicted ColoradoCare would eventually have to exclude covered medical conditions due to high costs.
“So you’ll see specialty doctors that would not be covered take their practices elsewhere,” Stapleton said. “Rural communities are very worried they will lose their doctors” if the amendment is approved.
Reid said ColoradoCare would not cover long-term medical needs, and someone who goes to their doctor and says they are a Colorado resident will have to provide proof of residency, “just like they have to show when they get a hunting license or anything else.”
Stapleton said Reid was suggesting “everyone will get coverage with a hub cap, but you can’t drive with a hub cap.”
Reid said ColoradoCare’s coverage is required by federal law to meet at least the “silver” coverage level of the Affordable Care Act, and is also required to cover any and all doctors residents may choose for their care.
A strong disagreement surfaced over what ColoradoCare’s exemption from the Taxpayer’s Bill of Rights would allow. Stapleton said it would allow the program’s board to raise taxes without voter approval. Reid said that was not true, that the exemption only allows ColoradoCare to keep and spend all the revenue it receives — “presumably for expanded coverage” — instead of issuing refunds.
Board requirements, election procedure criticized
The make up of a 21-member board of directors to oversee ColoradoCare also concerned Stapleton, who said the measure does not require members to have any medical background, and they would be chosen through an independent election, not overseen by the Colorado Secretary of State.
“You’re darn right I don’t trust the board the way it will be set up, because you can be a convicted felon and get chosen to be on this board because the election isn’t run by the secretary of state,” he claimed. “And I can guarantee that they will hire lawyers who will tell them they can raise taxes without a vote of the people.”
Reid said the ColoradoCare board members would be chosen from seven districts across the state, compared to private insurance company board members “who are all hedge fund managers from outside Colorado.”
Reid also claimed opponents, Coloradans for Coloradans, had reported raising $4.4 million to oppose Amendment 69, with $4 million of that coming from large, out-of-state private insurance companies.
“The private insurance companies are terrified of ColoradoCare and they’re trying to kill us,” he said.”This is a text-book case of how out-of-state interests are trying to buy your vote.”
Stapleton, who co-chairs Coloradans for Coloradans with former Gov. Bill Ritter and Denver Metro Chamber of Commerce CEO Kelly Brough, said ColoradoCare would be a “nebulous institution, with a myriad of unanswered questions.”
“If they find a statewide health care program can’t be set up in 12 months as the measure requires, they can disband and then leave the state’s health care in complete anarchy,” he said. “This has just gone too far afield and I think everyone should be highly skeptical of the claims they’re making.”
“Tried and true method” to change
Reid said the health care system cannot be fixed at the national level, so the state level is a “tried and true method” to affect needed change.
“I truly believe that Coloradans are able to run a health care plan on their own and show the rest of the nation where we could have been a long time ago,” he added.
Stapleton said Colorado does not have a triple-A bond rating because, in part, “it’s too easy to amend the state constitution.”
“That’s why we have this on the ballot,” he added. “Colorado is a test tube for this kind of program and it’s been tried and failed in Vermont.”
Stapleton referred to a December 2014 decision by Vermont Gov. Peter Shumlin to end a 4-year initiative to develop a single-payer health care system in his state. The effort would have established a government-financed system, called Green Mountain Care, to provide universal coverage, replacing most private health insurance in Vermont.
Instead of ColoradoCare, Stapleton said a “badly needed” state audit of the medical exchange established under Obamacare should be conducted, then Gov. John Hickenlooper and state lawmakers need to figure out the best way the state should proceed.
“This would be an economic disaster for Colorado, with a 10 percent employment tax, and senior citizens would not be exempt,” Stapleton added. “If someone is already covered by Medicare, they would still have to pay for ColoradoCare.”
When asked about who covers the costs of Stapleton’s travels around Colorado to oppose Amendment 69, he said 99 percent of those costs he paid out of pocket.
“None of it was paid by my office, but I feel I have a moral obligation to warn all of Colorado about the economic doom our state faces from this amendment, so I feel it’s absolutely in line with my duties as treasurer,” Stapleton said.
In summary comments, Stapleton called ColoradoCare “an unmitigated economic disaster,” that Colorado would become the highest taxed state in the nation and that “unprecedented powers” would be given to a board of directors and the state health care system would end up “in a black hole.”
Reid said if voters cast ballots against the amendment, they are supporting the health care system status quo.
“You’re voting to pay out-of-state companies $35 billion a year, giving approval to yearly 20 percent increases in premiums and letting them get away with it year after year,” he added. “I will gladly pay the ColoradoCare tax because I want live in a state where everyone gets the care they need. A decent, ethical society should provide health care for everyone who needs it.”
The arguments may have swayed undecided Rotary Club members and guests. According to informal voting results before and after the debate, 23 percent favored the amendment before, 33 percent after it ended. Before the debate, 44 percent opposed the amendment, 54 percent said they opposed it afterward. Undecideds dropped from 33 percent before the debate to just 10 percent after.