Amendment 69: Benefits vs. Costs

Colorado has led the nation on a number of issues over the years. We were among the first to legalize marijuana, and now Amendment 69 aims to provide Coloradans with state-provided health insurance. This amendment, known as ColoradoCare, leaves a lot of questions unanswered, and it will be up to us to vote either for or against it on November 8. Here is what we know about Amendment 69 so far.

Amendment 69 Changes the Colorado Constitution:

This new amendment to the Colorado constitution sets up a statewide system to pay for health care. In order to pay for these health care services for Colorado residents, new taxes need to be imposed. These taxes will be added to almost all sources of income. This tax increase STARTS at 10% and includes taxes on all income including retirement and taxable social security incomes. Furthermore, the amendment to the constitution would establish a board of trustees to be appointed who would oversee the operations of ColoradoCare.

This new state-funded health plan would provide health coverage for people who currently do not have any. It could potentially replace the current healthcare coverage for many people. However, it is important to note that some people may still have to purchase private health insurance. Even if they carry their own health insurance, they will still be required to pay the additional taxes to fund ColoradoCare.  What’s more, ColoradoCare does not specify what happens if we travel outside of Colorado and require medical care.

ColoradoCare’s Coverage

Amendment 69 outlines the types of services which must be covered by the proposed plan. However, many services and coverage still remains unclear. Covered services include primary and specialty care, hospitalization, prescription drugs, medical equipment, and emergency care. Other types of coverage will be up to the board of trustees to determine.

Board of Trustees

Initially, the trustees for ColoradoCare will be appointed. Fifteen interim board members will be appointed by state legislators and the Governor. These board members will determine procedures for electing the permanent 21-member board of trustees in the future, and will not give Coloradans the chance to have a say about who is in charge of their healthcare. It is also reported that board members will be able to set their own salaries with impunity.


Impact on Taxpayers

The proposed amendment to our constitution requires the biggest tax increase we have ever seen. New taxes on wages paid by employers as well as income received by individuals would be required to raise the amount of money needed to implement ColoradoCare. These new taxes would be in addition to the state’s current income tax of 4.63%. The table below breaks down the tax rates:

Initial Tax Rates Full Tax Rates
Wage Income

Employee Tax Rate

Employer Tax Rate










All Other Non-wage Income Including all self-employment Income           .9%         10%

The measure would also exempt ColoradoCare from having to seek approval for tax increases in a regular election. According to page 6 of the blue book, “the measure exempts ColoradoCare from the existing constitutional requirements to seek approval of tax increases at a regularly scheduled November election. Instead, tax increases for ColoradoCare must be approved at a ColoradoCare election scheduled by the board of trustees. The board of trustees may request a tax increase no more than once a year.” This statement is a little bit ambiguous. What exactly is a ColoradoCare election? Do voters get a chance to decide, or is the ColoradoCare election one which takes place among the board members themselves?

Arguments For Amendment 69

The proposed constitution change would provide health care for all Coloradans. This gives residents access to healthcare regardless of their ability to pay. No deductibles reduce financial barriers to care and helps ensure individuals and families won’t face bankruptcy to pay for healthcare. Furthermore, administrative costs would be lowered which helps to reduce overall healthcare costs.

Arguments Against ColoradoCare

Proposing a 10% tax increase on all income could harm the Colorado economy. It adds a huge tax burden to individuals, companies, and could eliminate jobs. The tax increases proposed for Amendment 69 nearly doubles the state’s current spending budget. For the first several years, taxpayers will contribute roughly $2 billion dollars a year without receiving any benefits. Additionally, many individuals and businesses will pay more with the new taxes than they are already paying for health care. These taxes MUST be paid by everybody–even those who carry private insurance. With such steep tax rates for businesses, it could very well discourage businesses from operating in Colorado.

We must also consider the fact that Amendment 69 makes no guarantees that patient care will be improved or that the overall costs of health care will decrease. Coloradans may never receive the benefits promised under the proposal if federal approval is not granted or revenue isn’t sufficient. Furthermore, whatever revenue is raised is not refunded to residents even if federal approval isn’t granted. Furthermore, it leaves out critical details about how the program will be implemented with no date set for when it will begin.

The 21-member board of trustees will have the control to make important decisions about individual health care needs, yet there is limited accountability for them. Additionally, the board members are not required to have any experience in health care.

If Colorado fully switches to ColoradoCare and it fails, it could take years to re-establish health care and private markets and government programs. Additionally, taxpayers will have paid in billions of dollars for a failed program with absolutely no recourse. For a full list of pros and cons for Amendment 69, check out the bluebookAlso visit the Colorado Secretary of State’s website for more information.

Where Would the Tax Increase End?

Where it stops, nobody knows because Amendment 69 would be the first of its kind. Technically, the tax could be increased at any time for any reason without voters having a say and the initial 10% tax is simply a starting point. There is absolutely no cap on the amount of tax that can be imposed on taxpayers. So the 10% initial increase is literally just a starting point. Who’s to say it won’t increase to as much as 20%, or even 30%? What we do know is that national companies who provide benefits to workers all over the country may find themselves in a bit of a bind having to offer different coverage to their employees in Colorado. It means that employers may have to consider purchasing supplemental plans to make sure all employees are treated fairly.

There are definite pros and cons to Amendment 69. First of all, the initiative could make Colorado a leader in our country in terms of taking care of its residents. Second, it could set precedent for other states to follow suit. Also, it has the ability to take some of the control away from the national level health coverage program, which many people would favor. Of course, there are some negatives, too. The 10% tax increase is just a starting point, which could mean much higher taxes. Amendment 69 has also failed to gain the support of both republican and democratic leaders. Governor Hickenlooper, former Governor Bill Ritter, as well as Michael Bennet oppose the proposed amendment. It is ultimately up to us to decide.

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