Colorado: Let's dispense with the notion that Single Payer is doable in the current political environment.
2018 MIDTERM ELECTION
Time: D H M S
Don't worry, I'm not gonna rehash the whole thing, but some of you may recall that way back in January (a lifetime ago, this morning), I caused a bit of a brouhaha (or a "bro-ha-ha") when I noted that Bernie Sanders' Single Payer Healthcare Plan (aka "Medicare for All"), while sounding awesome in theory, was not only absurdly lacking in detail even for a general campaign outline, but that there were simply too many logistical problems for it to go into effect within such a short timeframe (which I assumed would be perhaps the same 5-year timeline as the ACA, since Sen. Sanders didn't specify any sort of timeline himself).
The response from Bernie's supporters was, to put it mildly, negative.
While I knew that a national single payer system was a non-starter, I thought that perhaps it might be feasible to get one through at the state level (assuming the funding mechanism could be adequately resolved, which was the Achilles' heel of Vermont's failed attempt a few years earlier).
Enter ColoradoCare, which, if passed, would have been partly funded by their existing ACA Medicaid/APTC/CSR funds (I think) being redirected towards a single payer system which would have covered everyone in the state except for those already on Medicare, in the VA and the Indian Health Service). The remaining funds would have come from a special state payroll tax and so forth.
Of course, ColoradoCare ran into some snags along the way, in part due to not adequately addressing concerns over taxpayer funding of abortion:
The ballot campaign to create universal health care in Colorado drew an unlikely and prominent opponent this week: NARAL ProChoice Colorado, one of the state’s leading abortion rights groups.
The organization — more accustomed to fighting to expand health care services — is opposing Amendment 69 because it worries that the measure could limit access to abortion care.
Under NARAL’s legal interpretation, a constitutional ban on using “public funds” for abortion approved by voters in 1984 would prohibit Colorado Care from covering the procedure because it would be a political subdivision of the state.
...This is almost identical to one of the many concerns I (and many others) have expressed about Bernie's national SP proposal: The Hyde Amendment prohibits any federal funds from being used to perform abortions, but a national single payer plan would mean that all healthcare services would be paid for using federal funds...meaning that any woman who needed an abortion would have to pay the full price out of her own pocket unless some private charity/donations helped her out.
Until today, I assumed that ColoradoCare would resolve this issue by simply making sure that abortions are paid for using the state-based portion of the tax revenue instead of the federal portion...but it appears that CO has their own state-level law on the books similar to Hyde at the federal level.
In spite of these issues, the ColoradoCare initiative at least seemed to be a lot more detailed and thought-out than Bernie's outline of his national plan, so while I couldn't give it a formal endorsement, I did at least give it some serious attention and strongly urged Single Payer advocates to jump all over it as their only realistic chance of implementing a Single Payer system in the U.S. on a wide scale for the forseeable future. SP fans keep insisting that there's huge public demand for it, so this seemed to be a perfect test case.
The argument in favor of ColoradoCare seemed even stronger in light of this fall's unpleasant individual market rate hikes and carrier withdrawls, so you would think the ballot initiative would have had a fighting chance yesterday, right?
WASHINGTON ― Colorado voters rejected a ballot measure that would have created a first-in-the-nation single-payer health insurance system, a significant setback for progressive proponents of universal health care.
Tuesday’s defeat of Amendment 69 was decisive, as predicted. Polling ahead of Election Day showed that two-thirds of residents opposed the measure, which would have established a program called ColoradoCare to cover most people in the state.
The ColoradoCare initiative faced significant political headwinds. In addition to opposition from state Republicans, business groups, the health insurance industry and the Colorado Medical Society, powerful state Democrats also lined up against it, including Gov. John Hickenlooper, Sen. Michael Bennet, several U.S. representatives, Colorado House Majority Leader Crisanta Duran and a number of other state legislators.
Progressive groups and labor unions were divided on the measure. Supporters included National Nurses United, Public Citizen, filmmaker Michael Moore and scholar-activist Noam Chomsky. But ProgressNow Colorado, NARAL ProChoice Colorado and others opposed Amendment 69, arguing that a single-payer system is only appropriate on a national level.
Even the public backing of Sen. Bernie Sanders (I-Vt.), a single-payer proponent who had bested Hillary Clinton in Colorado’s Democratic presidential caucus, wasn’t enough to win over voters.
In fact, it looks like it's even worse than that...according to this AP update, ColoradoCare actually was crushed 80% to 20% in the end.
I should note that this one can only be partly blamed on Donald Trump, since Hillary Clinton won the state. And yes, perhaps it would've done better if Hickenlooper, Bennet and so forth had supported it (or at least not openly opposed it). But still...80 to 20???
ONCE AGAIN: I support a single-payer system (or at least a SP-plus-supplemental system) eventually, but it would have to be done in phases. It's pretty clear to me that this was just too big a shock to the system all at once for people to swallow, even if the numbers added up (and plenty of intelligent people in the state disagreed as to whether they did).
Not that it matters. With the GOP now having a complete chokehold on the entire federal government, one route seems to be just as out of reach as the other anyway.