A Bridge to Health Care for All
Could Colorado use a similar method to fund universal health care to the method it is using to fund critical bridge repairs?
Visions of the Minneapolis disaster were still vivid for Coloradans when the report on our failing bridges was made public. The hundreds of millions needed to repair failing Colorado bridges far exceeded state financial resources because our economy was also collapsing. Colorado’s strict TABOR (Tax Payers Bill Of Rights) constitutional limitations on tax increases seemed to block any comprehensive approach to solving the bridge repair problem. The TABOR limitations also inhibit our efforts to create a system of universal access to health care in the Colorado and the consequences of perpetuating our failing health care system are even more serious than failing bridges.
The solution to funding the repair of bridges was found within the TABOR law itself. The law allows the Colorado to establish “enterprises” which function much like a business, receiving revenue from use fees and providing services to the users who pay the fees. TABOR enterprises must be established by the state legislature, must operate within specific restrictions and are governed by an appointed or elected board of directors. TABOR enterprises do not require a approval of Colorado voters in an election. In 2009 Colorado established the “Bridge Enterprise” and added new vehicle license registration fees to fund the replacement or repair of failing bridges. Initially drivers complained about the new license fees, however, the program has been highly successful. The Bridge Enterprise has also been opposed by the TABOR Foundation, the group who pushed for approval of the TABOR law in 1992. A law suit filed by the TABOR Foundation will be heard in May, 2013. Meantime, the Bridge Enterprise has been very successful. The 2012 Bridge Enterprise report to the state legislature reported that 72 bridges had been repaired or replaced, 22 were under construction and another 40 were in design or had design completed. The Bridge Enterprise had raised and expended over $130 million and, most importantly, our bridges are safer.
Colorado actually has hundreds of TABOR enterprises. They include the University of Colorado Medical Center, E-470 Toll Road, the University of Colorado and most other state universities and state colleges, and the Colorado Division of Wildlife. Without these important educational, health, transportation and environmental institutions Colorado would be quite a different place.
The Health Care for All Colorado Single-Payer Taskforce believes that the TABOR Enterprise approach may be a viable option for funding universal single-payer health care in Colorado. To make this a reality the Colorado Legislature will need to pass a bill to create a “Colorado Universal Health Care Enterprise”. The authorizing legislation will define the scope of services to be provided, the method of collecting fees to fund the health care services, and the makeup of the governing board. Individuals and employers will pay health care premiums into the health care enterprise fund and the fund will pay health care providers. The health care premiums should be about 20% lower in cost that current commercial health insurance premiums because of lower administrative costs and improved control of health care costs and better quality of health care services. Premiums will also be scaled to income and family size and every person in Colorado will have access to comprehensive health care services. A significant advantage of this approach is that the program can be administered as a part of the Colorado Department of Health Care Policy and Financing, just as the Bridge Enterprise operates within CDOT.
Safe bridges prevent accidents and save lives. Universal health care saves lives, saves money and results in a healthy and prosperous community.
The TABOR enterprise solution to funding bridge repairs could be Colorado’s “bridge to health care for all.”