By a large margin, voters in Colorado defeated a proposal to replace the Affordable Care Act with a single-payer system in the state.
By a large margin, voters in Colorado defeated a proposal to replace the Affordable Care Act (ACA) with a single-payer system in the state.
State residents voted 80% to 20% (as of 10 am on November 9) to defeat the proposal. Amendment 69 would finance universal healthcare for Colorado residents through an additional 10% payroll tax that would have provided $25 billion per year in revenue. The state could have also received a waiver from the federal government so that subsidies that would have gone to residents for use on the private market would have helped to fund ColoradoCare.
Despite the loss, ColoradoCareYES was happy with the fact that the issue was brought before voters at all and helped to highlight the frustration and dissatisfaction people have with the current healthcare system.
"Until every Coloradan has healthcare, and we pay for it fairly and responsibly, we have yet to take it all the way," Director of Operations Lyn Gullette said Tuesday night after the results were clear. "I hope each of you joins with me, and we'll take it all the way. "
The defeat is not entirely surprising. A survey from Colorado Mesa University and the Center for Opinion Research at Franklin & Marshall College had found that, as of September 18, 30% of respondents were in favor of the measure, while 56% were opposed and 14% were still undecided. A separate survey released on September 6 by Magellan Strategies reported that 65% of voters planned to reject the measure, 27% planned to approve the measure, and only 8% were undecided.
In addition, Planned Parenthood of the Rocky Mountains (PPRM) also came out against the single-payer proposal because it was concerned that under the amendment women would only be able to obtain an abortion by paying out of pocket.
“PPRM, perhaps more than most organizations, knows that the ballot process is a risky tactic for implementing sweeping policy change,” Viki Cowart, president and CEO of PPRM, said in a statement in September. “Things can unintentionally go wrong. We believe this would be the case here, and that Amendment 69 would further stigmatize and fragment abortion care in our healthcare system.”
Other opponents included more than 2 dozen state senators and representatives from both parties, and health insurers like Anthem, Cigna, and Centura.
Universal healthcare was almost on the ballot for another 2 states: Oregon and Washington. Both states had proposed initiatives for single-payer healthcare systems, but neither initiative made the ballot on November 8.
Colorado wasn’t the only blow to healthcare reform. The election of Donald J. Trump as the next president of the United States almost guarantees that the ACA will be repealed in at least some way.
Before the election, John E. McDonough, DrPH, of the Harvard School of Public Health, and David K. Jones, PhD, of the Boson University School of Public Health, weighed in on health reform in the presidential and congressional elections.
“A Republican victory that includes that party’s control of the White House, Senate, and House of Representatives would likely augur huge shifts in national health policy,” they wrote in JAMA Internal Medicine.
Sure enough, Republicans retained control of both the House and the Senate, and there will now be a Republican in the White House. While Trump’s healthcare agenda was not especially detailed, of note was the fact that he is calling for a complete repeal of the ACA.
However, as recently as October 25, McDonough sat with conservative Avik S. A. Roy, president of the Foundation for Research on Equal Opportunity, during America’s Health Insurance Plans’ National Conference on Medicare, where the assumption was that Hillary Clinton would win the presidency with a Republican-controlled Congress. To see what the healthcare discussion was at the time, read our coverage of the session.
For a deeper look at the future of healthcare in the United States and a possible repeal of ACA, read our interview with health economist Austin Frakt, PhD.