Amendment 63 - Health Care Choice Question

By: KKCO Email
By: KKCO Email

MESA COUNTY, Colo. (KKCO) - All registred voters are eligible to vote yes or no on the following amendment.

Shall there be an amendment to the Colorado constitution concerning the right of all persons to health care choice, and, in connection therewith, prohibiting the state independently or at the instance of the United States from adopting or enforcing any statute, regulation, resolution, or policy that requires a person to participate in a public or private health insurance or coverage plan or that denies, restricts, or penalizes the right or ability of a person to make or receive direct payments for lawful health care services; and exempting from the effects of the amendment emergency medical treatment required to be provided by hospitals, health facilities, and health care providers or health benefits provided under workers’ compensation or similar insurance?

NOTE: Ballot issues referred by the general assembly or any political subdivision are listed by letter, and ballot issues initiated by the people are listed numerically. A ballot issue listed as an “amendment” proposes a change to the Colorado constitution, and a ballot issue listed as a “proposition” proposes a change to the Colorado Revised Statues. A “yes” vote on any ballot issue is a vote in favor of changing current law or existing circumstances, and a “no” vote on any ballot issue is a vote against changing current law or existing circumstances.

Analysis of Amendment 63 (Health Care Choice) as offered by the 2010 State Ballot Information Booklet or Voter Blue Book.
Amendment 63 proposes amending the Colorado Constitution to:
- add health care choice as a constitutional right;
- prohibit the state from requiring or enforcing any requirement that a person participate in a public or private health coverage plan; and
- restrict the state from limiting a person's ability to make or receive direct payments for lawful health care services.

Summary and Analysis
Amendment 63 adds health care choice as a right listed in the bill of rights in the Colorado Constitution. The measure specifies that the right to health care choice limits the ability of state government to either require health insurance or any other type of health care coverage, or to restrict direct payments for health care services.

Health care coverage requirements. Colorado law does not require a person to have any type of health care coverage. A person may purchase coverage from a private insurer; participate in an employer-provided health plan; choose to enroll in a public program such as Medicaid and Medicare, if eligible; or have no coverage.

If a person does not have health care coverage, or if his or her plan does not cover a specific service, services may be paid for out-of-pocket.

In March 2010, a package of federal health care laws was adopted by the United States Congress and signed by the President. Beginning in 2014, most people are required to provide proof of acceptable health care coverage to the Internal Revenue Service. Persons without coverage are subject to a federal tax penalty.

Payments for health care services. Currently, health care services can be paid for by health insurance companies, the government, patients, or some combination of these sources. When an individual has coverage, a third party, such as an insurance company or the government, negotiates with the provider to establish a price for health care services. Direct payments refer to when a person pays a provider directly, without seeking approval or reimbursement from a third party. No state or federal law prohibits a person from seeking services outside of a health care plan and paying a provider directly.

Effects of Amendment 63. Amendment 63 does not change current health care coverage requirements, but it places restrictions on what the state may require in the future. For example, the state may offer new health coverage plans but, under Amendment 63, could not require a person to join a plan. The measure prohibits the state from: requiring a person to obtain health care coverage, regulating direct payments, or penalizing a person for either participating or not participating in any particular plan. The measure does not apply to workers' compensation insurance or mandatory emergency medical care.

Amendment 63 also prohibits the state from enforcing health care coverage requirements at the direction of the federal government. However, the measure does not impact the federal government's ability to enforce the coverage requirements created by federal health care laws. Coloradans are still required to have acceptable coverage under federal law beginning in 2014.

1) Making decisions about health care is a basic right. Decisions about how to pay for health care, and what health care to pay for, are better left to individuals rather than to the government. Any government requirement to have health care coverage interferes with a person's ability to manage his or her own health care and spending. Amendment 63 maintains a person's right to choose the most appropriate coverage for his or her situation and prevents the state from requiring a person to join any specific health care plan.

2) Amendment 63 protects the ability of each person to determine how to pay for health care services, including making direct payments to providers. This measure prevents the state from requiring that only the government or health insurance companies control payments and approval for all services. Preserving the ability to pay for services directly allows a person to receive care at his or her choosing, even if the government or insurance companies place limits on health care services.

3) This measure is a statement in opposition to government-controlled health care. It reinforces the pending lawsuits challenging the federal government over the new health care laws and is in line with the actions of six states that have adopted measures similar to Amendment 63. The measure affirms Colorado as a state that values freedom of choice in health care services.

Arguments Against:
1) Amendment 63 limits the state's options to improve access to health care coverage, which could hurt the people who need it the most and increase costs for everyone. In Colorado, over 750,000 people, or approximately 15 percent of the population, do not have health insurance. Expanding health insurance coverage prevents the insured population from having to cover the costs of the uninsured, increases access to health care, and decreases the rate of medical bankruptcy. Society benefits when more people have health care coverage.

2) Health care is a vital service and the delivery of these services may be further complicated by the effects of the measure. By establishing an undefined right in the constitution, the state will have to spend time and resources interpreting the meaning. Current and future health care laws and regulations could also be challenged if they conflict with the measure. Ultimately, the courts will interpret what the right to "health care choice" means.

3) A state constitutional amendment cannot overturn federal law. Amendment 63 may mislead voters into thinking they can opt out of federal health care coverage requirements. Regardless of whether this measure passes, federal law still requires Coloradans to have coverage beginning in 2014. This measure is primarily a statement in opposition to federal health care reform. Further, this measure is unnecessary because people can already pay doctors directly for health care services, and no law restricts this practice.

Estimate of Fiscal Impact:
Amendment 63 is not expected to affect state or local government revenue or spending.

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