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CHA UPDATEBy Ryan Westrom

AMENDMENT 69

The upcoming November election will decide not just who will win the White House, but for Colorado, it will also determine one U.S Senate seat and seven seats for the U.S House of Representatives. Of equal interest are the Colorado State Senate and House of Representative races – 83 contests that will determine control of both chambers for the upcoming legislative session that begins in January. While health care issues are often bipartisan, control of the House and Senate will likely dictate which legislative proposals have a chance of ultimately passing and becoming law, such as a Hospitals Provider Fee (HPF) enterprise.

This year’s ballot will also be crowded by nine ballot measures. While some have no direct impact on health care, others could significantly impact health care as we know it in Colorado. The ballot measure that would impact the landscape of Colorado health care the most is Amendment 69 – also known as ColoradoCare. ColoradoCare seeks to establish a “universal single payer health care system” in Colorado, and according to the proponents, ColoradoCare would increase coverage, increase benefits and increase access to care while reducing health care costs.

As voters determine their vote on this important issue leading up to Election Day on Nov. 8, here are a few of the important facts to consider about Amendment 69:

■ ColoradoCare would be funded through a mandatory payroll tax – 3.33 percent tax on employees’ gross pay and 6.67 percent tax on total payroll tax from all em-ployers. In addition, a 10 percent tax would be added to all non-payroll income (e.g., capital gains, investment impact interest on savings accounts and business in-come).

■ If passed, ColoradoCare would have an estimated bud-get of $38 billion, which according to the Colorado Legislative Council staff, would include $25 billion in new taxes.

■ ColoradoCare is specifically designed to operate inde-pendently from state government and will be run by a 21-member board elected by its plan members. The board will decide coverage details for beneficiaries and negotiate reimbursement rates to health care providers. The board will be independent and will not report to the governor, legislature or any other public entity.

■ While the ColoradoCare board will finalize the services that will be covered, the amendment specifies 11 catego-ries of health services that must be covered: ambulatory patient services, hospitalization, prescription drugs and durable medical equipment, mental heal and substance use disorder services, emergency and urgent care, pre-ventive and wellness services and chronic disease man-

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agement, rehabilitative services and devices, pediatric services, laboratory services, Maternity and newborn care and palliative and end-of-life care.

■ While ColoradoCare is marketed as a “single payer sys-tem,” not all other payers will go away. Medicare, VA, TRICARE and ERISA plans will still exist. Additionally, it is anticipated that commercial coverage could still be available if Amendment 69 is passed.

■ All Colorado residents will be required to pay the tax for the program whether they actively use ColoradoCare coverage or not. Medicare and other government recipi-ents could end up paying for health care twice, as they will be required to pay the new state tax.

■ It is unclear how long it will take to launch and imple-ment this new system, since it will require federal ap-proval. However, ColoradoCare would begin collecting a partial amount of taxes in July 2017, and proponents anticipate ColoradoCare would be fully functional by 2019.

■ The Colorado Health Institute, an independent health policy research institute, issued an in-depth financial analysis of the ColoradoCare proposal and found that the program may break even in its first year but then would slide into ever-increasing deficits in future years. At that point, the program would have essentially three options for covering the deficit: cut benefits, raise taxes or reduce provider rates.

These are just a few of the factors to consider when voting for Amendment 69 this November. Many organizations have done independent analysis and released opinions on ColoradoCare, if you are interested in learning more about Amendment 69 and what it means for your community.

“We agree that appropriate mental health facilities are not always readily available to treat persons having a mental health crisis. While well-intentioned, we are concerned that SB 16-169 does not provide adequate due process for individuals.”

Additionally, Governor’s Hickenlooper’s veto letter called upon CDHS to create a new task force to review and create solutions around the issues SB 16-169 attempted to address.

It is anticipated that these issues, along with other health care topics discussed during the 2016 session, including pricing transparency and disclosures of free standing emergency departments (FSEDs), will be introduced again in the 2017 legislative session. The unknown for next year’s session is whether the November elections will change the outcomes of these important issues or if it will be another session of missed opportunities.

CHA UPDATE (CONT)CHA (continued)

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