Saturday, September 24, 2016

About ColoradoCare, Amendment 69

Before continuing I think I should share details of what ColoradoCare Amendment 69 is all about, courtesy of  Sure Amendment 69 isn't perfect.  But, consider our current profits driven health care system that too often turns into a people crushing mess that gets less responsive and ever more client hostile all the time.  ColoradoCare is a solid effort to turn that around.  

I know that today if you have issues regarding any mistakes with your health care provider or insurer rather than a constructive focused dialogue to understand and resolve the issue(s), the patient is more likely to find themselves marginalized, even made to feel villainized because it seems that all the system sees is an enemy to be ignored as much as possible.  Why have we let that happen?

All too many Colorado citizens have experienced a hostile monolithic system that sees its priorities as savings, profits, and bonuses with patient needs relegated to a distrusted bottomline threatening irritant.  

Consider the various letters and articles that Pinnacol Assurance's president and CEO Phil Kalin has peppered around Colorado these past months attacking Amendment 69 - has he ever once mentioned any of the substantive problems with Colorado's workers comp system?  Nope he gives it a white wash, like he believes it's a perfect system.  For him and his fellow executives I'm sure it is.

He'll never acknowledge that luxurious executive perks and administering compassionate effect health care for our citizens doesn't fit together.  Nope, he will use every device to encourage voters to continue their gravy train.  Will we Colorado citizens and voters give in to their PR machine?  

November 8th is the only time your opinion is taken seriously.  But only if make the effort to vote.,_Amendment_69_(2016)


ColoradoCare would contract with healthcare providers to pay for certain healthcare benefits and be responsible for administering Medicaid, children's basic health programs, and all other state and federal healthcare funds.

What would ColoradoCare do?

The system would aim to cover all state residents. Some of the comprehensive benefits would include:[2]
  • ambulatory patient services, including primary and specialty care
  • hospitalization
  • prescription drugs
  • medical equipment
  • mental health services
  • substance abuse services, including behavioral health treatment
  • emergency and urgent care
  • preventive and wellness services
  • chronic disease management
  • rehabilitative and habilitative services and devices
  • pediatric care, including oral, vision, and hearing services
  • laboratory services, maternity, and newborn care
  • palliative and end-of-life care
Amendment 69 would mandate that ColoradoCare pay for healthcare services regardless of the cause of the patient's illness or injury. The system would replace the medical care portion of workers' compensation insurance, there would be no deductibles, and designated preventive and primary care services would have no co-payments. Beneficiaries would be permitted to choose their primary care professionals and still be covered if they are temporarily living, or traveling, in another state.[2]
The initiative aims to provide healthcare to all Colorado residents regardless of financial circumstance by collecting a premium based on the resident's income.[3]
The ColoradoCare YES campaign provided a 43-page booklet about how ColoradoCare would work, found here.

How would the state pay for ColoradoCare?

The state would collect a ten percent payroll tax on workers based in the state, but this rate could be changed by the board of trustees. Workers would pay 3.33 percent of that, and the employer would pay 6.67 percent. Non-payroll income would also be taxed at ten percent.[4] The tax revenue would be exempt from the Colorado Taxpayer Bill of Rights (TABOR). The premium tax would be applied to most income sources, including:[5]
  • salaries, wages, and tips
  • rents, interest, and dividends
  • capital gains
  • business proprietors' income
  • any Social Security benefits, pension payments, and annuities that do not qualify for the Colorado pension/annuity subtraction[6]

Pensions, benefits, and annuities

In Colorado, there is an income tax deduction called the pension/annuity subtraction that allows a certain amount of retirement benefits and pension income to be exempt from income taxes. The additional 10 percent income tax proposed by Amendment 69 was designed to apply to these sources of income in accordance with this deduction, which exempts up to $20,000 or $24,000 in income from pensions and annuities, depending on the age of the taxpayer.[6]
  • To qualify for this subtraction, a taxpayer must be over 55 years old or be a beneficiary earning a pension or annuity due to the death of the pension earner.
  • The amount of pension/annuity income that can be subtracted caps at $20,000 per year for those under 65 years old.
  • The amount of pension/annuity income that can be subtracted caps at $24,000 per year for those 65 or older.

How would ColoradoCare be regulated?

The system would operate using the cooperative business model — it would be owned by the members (Colorado residents), who would elect a board of trustees.[7]
First, Amendment 69 would create a 15-member interim board of trustees appointed by the governor and legislative leaders. This board would lay the groundwork by coordinating with providers and state and federal agencies. It would then develop an election process to create a new board of trustees elected by Colorado residents, along with rules to ensure the new board's operations, records, and meetings are transparent to the public.[2]
Within three years of ColoradoCare's establishment, voters would elect three trustees from each of the state's seven districts for a total of 21 trustees. Some of the board's duties would be to "establish a purchasing authority for pharmaceuticals and medical equipment; establish separate ombudsman offices for beneficiaries and providers; establish and fund an office to prevent and investigate fraud; establish rules and procedures to ensure financial sustainability; ensure beneficiary confidentiality while allowing for research of ColoradoCare’s database; oversee financial management, transparency of operations, and maintenance of patient privacy; and ensure beneficiaries’ access to quality care." The board would then hire an executive team responsible for the system's operations.[2]

ColoradoCare is a resident-owned, non-governmental health care financing system designed to ensure comprehensive, quality, accessible, lifetime health care for every Colorado resident. The benefit package will enhance the comprehensive health care services required by Medicaid and the Affordable Care Act. 

Premiums will be collected from Coloradans based on income, securing health care regardless of financial circumstance. This efficient, universal system will operate in the interests of Coloradans. 

By eliminating layers of bureaucracy and reducing administrative and other non-medical costs, ColoradoCare will cover all residents and cost less than the current system.

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