By Linda Gorman
If passed in November, Amendment 69 creates a bureaucracy called ColoradoCare. It will have a larger budget than the entire State of Colorado. Amendment 69 increases the income and payroll tax rates by 10 percent to fund ColoradoCare. The state income tax rate will be 14.63 percent, the nation’s highest.
Amendment 69 exempts ColoradoCare from Colorado’s fair election laws. Taxes can be raised again each year if a majority of those “who cast votes on the proposed increase” say yes. ColoradoCare will design its own campaign laws, voter registration requirements, donor reporting, and election certification rules. The bureaucracy will be free to manipulate election outcomes, and increase its tax take, by holding snap elections at inconvenient times in obscure places.
Voters for ColoradoCare tax increases must be 18 or older and a Colorado resident for at least a year. Residents are people who say they are residents. In an age of easily forged documents it will be virtually impossible to prove that someone has not been a Colorado resident for a year.
Neither voter registration nor US citizenship is required to vote in ColoradoCare elections.
As icing on the “let’s go back to holding corrupt elections” cake, Amendment 69 lets ColoradoCare accept gifts, grants, and donations from any source.
But what about Amendment 69’s supposed guarantee of superb cradle to grave health care? Would it make massively higher taxes for a wildly expensive and unaccountable health bureaucracy worthwhile?
Amendment 69 does not contain health care guarantees. Section 1 directs ColoradoCare to control “the per capita cost of health care.” In practice, this means that if someone gets more health care, someone else must get less. It also directs ColoradoCare to “optimize quality, value and healthy outcomes.” If you and your care are insufficiently valuable, ColoradoCare doesn’t have to pay.
Section 9 of Amendment 69 stipulates that paying ColoradoCare taxes does not “constitute the purchase of a health insurance policy.” Without a policy contract, ColoradoCare is not required to provide you with any particular treatment or service. According to legal opinion provided to the Colorado Health Foundation, the Colorado Governmental Immunity Act will protect ColoradoCare from lawsuits brought by people harmed by its refusal to provide care.
Boilerplate language lifted from the federal Obamacare statute requires that ColoradoCare cover broad categories of health care. The requirements are so general they are effectively useless. The Obamacare experience has shown that commanding insurers to cover “prescription drugs” does not distinguish between formularies including only drugs that have been around since the 1950s and formularies covering effective new drugs like the humanized monoclonal antibodies that successfully target macular degeneration and refractory forms of cancer.
Amendment 69 includes another effectively useless directive guaranteeing that people be allowed to choose their primary care provider. This sounds good until one realizes that it does not guarantee that who you see will necessarily be a physician. Covered primary care providers may be limited to nurse practitioners or physician’s assistants. It also fails to guarantee that patients have the right to choose their treatments, specialists, or hospitals.
ColoradoCare does not cover people in Medicaid, Medicare, and other federal programs. It does not cover people with private insurance. These people must still pay the 10 percent tax increase. Amendment 69 does not guarantee that out-of-state treatment is covered. It merely directs ColoradoCare to “establish policies and procedures to pay benefits for health care services rendered to a beneficiary who is temporarily living or traveling in another state.”
Under ColoradoCare, people may end up needing coverage for health care provided out of Colorado.
Amendment 69 uses price controls to ration access to ColoradoCare’s “free” care. It gives ColoradoCare the power to set prices for anything provided by any state licensed provider of health products or services. Providers cannot accept more than the allowed amount even if patients or insurers want to pay more to ensure decent care.
Amendment 69 makes Colorado a health care Mecca. Be a resident for 15 minutes and you’re covered, legal or illegal, taxpayer or not. But who will supply health care as physicians, investors, suppliers, and taxpayers flee the state?
Amendment 69 is a deadly combination of the highest taxes in the nation and an unaccountable bureaucracy that dictates the care you may receive and the price you may pay for it.
It guarantees death and taxes, not health care.
Linda Gorman directs the health care policy center at the Independence Institute.