Election Results 2016 - Health Care in Jeopardy

This blog post is a heartbreaking one to write. One that actually had to be re-written completely in light of national election results.

But first, we must commend our peers at ColoradoCareYES that led the ONLY Colorado ballot measure that was originated and funded by the people of Colorado and not special interests. We've long held that the fight for social justice and equality in health care is a long, multi-year battle. We were hopeful that it would finally come to fruition this year. We are disheartened that it hasn't, but this is a real fight that continues on, and we look forward to working like-minded groups in common cause to eventually succeed.

The future of health care for Colorado and the nation is now in serious jeopardy. With the failure of Amendment 69, Colorado lost its best chance to improve health care for all of our residents. In the closing weeks of the campaign we saw it coming. Thanks to being massively outspent by the private insurers, who used millions of dollars directly from our insurance premiums, the opposition to universal health care was able to convince the public that saving money would somehow cost more.

This blog could be about "what went wrong" with the campaign. But there will be plenty of time for the full campaign autopsy to come. In fact, there are several meetings already scheduled to help understand what happened and how to improve.

Instead, I will cover the "what to expect" aspect of the state and national election outcomes, and how you, HCAC, and other groups can rally together to make real progress.

It's difficult to find a silver lining in all of this, but I think back to messaging that we used even prior to the Affordable Care Act. "Things will get worse before they ever get better." Before the ACA, we knew that premiums and deductibles were rising, and that networks and benefits were shrinking. With the passage of the ACA, while we won some very essential and hard-fought protections (such as no lifetime caps, no pre-existing conditions, and small-group community rating), the reliance on private insurers and no cost containment provisions meant that the ACA was destined for unsustainability. We took one step forward, and are about to take two giant steps back.

We hoped in Colorado that Amendment 69 would allow us to dodge that unsustainability bullet. A bullet that would have arrived after 10 years, assuming no significant changes to improve the ACA were made.

ACA Impacts and Threat of Repeal

This morning, however, we are facing a harsh new reality. With a party that voted to repeal the ACA multiple times now in control of the House, the Senate, and the White House, prospects look bleak. It's as if someone took the gallon of milk (normally good through next week) out of the refrigerator, took a big chug, and left it open on the counter to spoil overnight.

Could the ACA be repealed so easily? Yes, it could.  Trump and Republican members of Congress campaigned on "Repeal and Replace" leaning almost entirely on the "Repeal" part.

Such an event would disrupt subsidies in the state Exchanges and make insurance unaffordable for nearly EVERYBODY. Things will get worse before they get better.

What does "Replace" Look Like?

Looking at the ideas floated for the "Replace" is a Rogues Gallery of demonstrably false and worrisome policies.

• Vouchers for private insurance plans that remain unaffordable.
• Selling cheap underinsurance across state lines.
• Expand HSAs (and those deductibles!) that we already can't afford to contribute to. 
• Roll back Medicaid expansions.
• Bring back expensive high-risk-pools and horribly underfund them, making insurance most expensive for those least able to afford it.

Potentially worst of all is the plan to continue to chip away at Medicare, further privatizing it and exposing seniors to even more cost-sharing. It's not just Republicans to blame, either. Congressional Democrats have even been complicit in this undermining one of the core components of our shared social compact.

What to expect in Colorado

Here in Colorado, we are facing insurance premiums that are already going up 20%, 30%, 40% or more in the individual market in 2017. The PPOs that used to be available are no longer available. Plans are being shifted to limited-network HMOs and highly-restricted-network EPOs, further eroding benefits. I myself am expecting to have to pay over $10,000 more for a plan (over $26,000/year) that doesn't even cover all of my son's essential medical providers. We are speeding on a bullet train with no brakes and nobody at the controls, and for many people the only option is to jump off and risk serious injury or death.

What's next for Colorado and the Health Care Movement

The ColoradoCareYES campaign has already stated that they intend to continue to keep at it and try again. At Health Care for All Colorado, we commend them. We will continue to keep up this fight right along side them. Health care is out of reach and unaffordable for millions of Americans. This momentary setback will undoubtedly negatively affect many of you, and preventable death is a real possibility for some.

The passage of Amendment 71 in Colorado has also made it much more difficult to respond to legislative failures to produce a real alternative to our health insurance nightmare. By increasing signature requirements and raising the threshold for victory, the entry-level cost to launching a citizens' initiative are now in the millions of dollars and the campaign expenses to make it successful have gone up as well. We estimate that it would now take nearly $10 Million to have a chance at success, but the opposition pockets are deep and powerful.

Over the coming weeks and months, we will need your help more than ever.

With your support, Health Care for All Colorado is committing to the following:

• Learning from the campaign successes and failures
• Building a broad coalition of organizations that understand the benefits of universal health care and will work together towards success
• Creating an improved proposal and plan for success
• Helping people understand how to fight back when faced with personal health care injustice (denials, delays, financial barriers, and more)
• Working with state legislators on legislation to increase the odds of success for a future campaign
• Developing new strategies to fund a successful campaign

We ask that you dig deep and renew your support for HCAC and what will become the next phase in our campaign for universal health care in Colorado and the US.

• Pledge the equivalent of one month's insurance premium in 2017
• Donate to HCAC
• Activate or renew a membership to HCAC
• Like us on Facebook
• Follow us on Twitter
• Subscribe to our website (making sure your address and contact info is up-to-date)
• Answer a brief survey about your views and ideas on what you would have done differently and suggestions for the future
• And above all, DON'T GIVE UP!

Success is in our future. Though the road ahead looks rough, we will win.

It's not a matter of "IF," but "WHEN."