Single-payer healthcare proposals at the state level aren’t much of a priority for busy benefit brokers, agents and advisers whose attention is on legislation that has a much better chance of passage. But leading industry groups are closely watching a grassroots campaign take shape in Colorado, where voters already have legalized marijuana.

What’s significant is that activists decided to pursue a statewide ballot initiative that would bypass the legislative process. Proposition 69, also known as Amendment 69, would not only decimate the private group healthcare market, warns the Council of Insurance Agents & Brokers (CIAB), they claim it would also would eliminate workers’ compensation policies, limit consumer health care choices, undermine quality of care and cost taxpayers $25 billion.

Colorado state capitol building in Denver

After years of lobbying for single-payer legislation at the federal level, a more localized movement is now afoot, observes Joel Kopperud, VP of government affairs at CIAB. “It’s almost coming from the bottom-up rather than the top-down now, and they’re going state by state,” he says.

It’s important for Prop 69 opponents to defeat the measure by a wide margin, he explains. Otherwise, his fear is that it will resurface not only in Colorado, but other states.

Colorado’s tax proposal under Prop 69 to create ColoradoCare is “upside-down,” says Kopperud, who also points out that the state-run insurance exchange is bankrupt. Most of the funding would come from a 10% tax on all earned income generated in the state. Employers would pay a 6.67% tax and employees would pay a 3.33% tax, nearly doubling Colorado’s income tax rate to 7.96%.
Given these circumstances, Kopperud believes “it’s ridiculous” to suggest the state “can somehow create some massive state-run insurance program and run that cleanly.”

With the disappearance of risk-mitigation components from Colorado’s health insurance market, Kopperud says “there’s no incentive for private companies to encourage their workforce to be healthier or have better safety standards.”

Many state initiatives afoot
Chris Hartmann, VP of congressional affairs at the National Association of Health Underwriters, describes Prop 69 as “probably the most active of the current proposals that are out there within states to implement the single payer.” He also references an attempt to gather signatures in Oregon and single-payer legislation in New York that has passed the lower house.

“Any of these single-payer initiatives would have a negative effect, not only on benefits advisers, agents and brokers, but also on consumers."

At least 15 states have introduced single-payer bills, according to Healthcare-NOW, a proponent of national single-payer healthcare. They include Colorado, Illinois, Maine, Maryland, Massachusetts, Minnesota, New Mexico, New York, Ohio, Oregon, Pennsylvania, Rhode Island, South Carolina, Vermont and Washington. An additional 11 states have floated similar proposals at one time or another.

Sen. Bernie Sanders’s home state of Vermont, where the Democratic presidential candidate has long advocated “Medicare for all,” came close to establishing the nation’s first single-payer system, although the effort failed last year. Legislation passed Hawaii in 2009, but was vetoed by then-Republican Gov. Linda Lingle, who then refused to implement it after lawmakers overrode her action.
“Any of these single-payer initiatives would have a negative effect, not only on benefits advisers, agents and brokers, but also on consumers,” Hartmann says. But he also argues it would be difficult to implement, citing Vermont’s attempt as a prime example.

Hartmann worries that single-payer proposals will damage innovation, competition and creativity in the private healthcare market. Advisers biggest concern, he maintains, is ensuring that healthcare is affordable for their clients.

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