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Colorado -- First With 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.
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A revolution is sprouting in Colorado that could make it the first state to create a single-payer health care system, ColoradoCare, 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.

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, physical therapy, 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 their gross income. 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."

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.

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