November 12, 2015

Colorado to vote on single payer

Politico- One of the most detailed plans to replace Obamacare this year comes not from a Republican critic, but from a group in swing-state Colorado that is proposing to scrap it for a single-payer model long sought by liberals.

Supporters, who won approval this week for a 2016 ballot measure after securing nearly 110,000 signatures deemed valid, will sell the overhaul as an Obamacare replacement plan designed in Colorado, instead of in Washington.

... The ballot initiative could attract a national audience and boost Colorado voter turnout on both sides — Democrats unhappy about the compromises made to pass Obamacare, as well as conservatives fearful that Obamacare is a stepping stone to a government-run single-payer system.

Bernie Sanders, the first major Democratic presidential candidate to advocate for single-payer since California Gov. Jerry Brown in 1992, isn’t weighing in on the Colorado measure. His campaign did not respond to a request for comment.

Colorado is an unlikely place for the battle over providing universal health care to residents, an approach far to the left of the Affordable Care Act. It was expected that a “Medicare for all” push would take hold in a state like liberal Vermont, which was the most visible trailblazer until Democratic Gov. Peter Shumlin pulled the plug on his plan last year because of cost.

Supporters say the elements that sank Vermont’s plan don’t apply in Colorado. Unlike Vermont, advocates are taking their case for "ColoradoCare" directly to voters for the 2016 ballot instead of trying to push it through a messy legislative process. Advocates also say Colorado’s plan has more details.

Most of the money to finance the model would come from a new payroll tax estimated to bring in $25 billion per year. Employers would pay two-thirds of the cost and workers would pay one-third. The state is also counting on $11.6 billion in annual federal funding it would otherwise receive through Medicaid and Obamacare.

Reid argues the new system would lead to lower administrative costs, more generous coverage without exorbitant deductibles and co-pays, and insure the people Obamacare has failed to cover — including undocumented immigrants.

A board of trustees would govern operations, be responsible for setting provider reimbursement rates and could negotiate lower prices with pharmaceutical companies. Yet similar to Vermont’s defunct plan, certain populations, including Medicare beneficiaries, are excluded from ColoradoCare. It wouldn’t abolish private insurance companies, who could still sell competing coverage.

For those reasons, the Colorado system isn’t “true” government-run single-payer, said David Himmelstein, the co-founder of Physicians for a National Health Program, a leading voice for the single-payer model.

Himmelstein, also a professor of public health at the City University of New York, said the plan is a “big advance” for the single-payer movement, but advocates have a heavy lift to get the measure passed.

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