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ColoradoCare “Amendment 69”

Premise The ACA has not worked Current system with multiple payers is inefficient and confusing Administrative costs exceed 30% of total spending Many are still uninsured, today International models work better

Proposal Obtain an “innovation waiver” under the ACA Cover every resident in the state Offer a “Platinum” plan with no deductibles Employers pay 6.67% of payroll; Employees pay 3.33% of payroll Self-employed pay 10% of payroll

Proposal Will raise taxes by $25 billion per year Colorado elected Board of 21 will govern the plan Will replace medical component of Workers’ Compensation, will provide a Medicare Supplement for those over 65, and Medicaid will be replaced One, single payer

Proposal Interim Board to oversee implementation Obtain federal waiver grants to pay for the poor and unemployed ($11.6 billion) Elected Board will operate the system outside of the legislature/governor. Accountable to the voters only.

Concerns Cost estimate is greater than the current state budget Proposal is naïve (note Vermont’s decision) Impact on high-wage industries will be significant

Concerns Is the cost model accurate? To make it work, global budgeting/rate setting must occur: Impact on hospitals Impact on physicians Loss of jobs Employer decision making is gone Impact on small business It would be in the constitution!

It’s on the ballot!