The answer carries significant political stakes. Colorado’s U.S. Sen. Michael Bennet, who is running for president and offering an alternative public option proposal, says a Democrat who supports Medicare for All can’t win Colorado — a bit of stern guidance for his party’s high-stakes bid to unseat Republican U.S. Sen. Cory Gardner in 2020.
“One sure way of losing a Senate race in Colorado would be to be for Medicare for All,” Bennet told The Colorado Sun last week.
Meanwhile, former Gov. John Hickenlooper, another presidential contender, has cautioned that supporting such a plan gives Republicans a lane of attack to label Democrats socialist. He said the party “might as well FedEx the election to Donald Trump” if they don’t heed his warning.
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In Colorado’s Democratic primary for U.S. Senate, at least two candidates support a single-payer government plan that covers everyone through Medicare, including the best-known candidate in the race, Andrew Romanoff.
“A lot of folks find when they change jobs, quit their jobs, when they get fired or their employer goes out of business, they lose their coverage,” said Romanoff, former speaker of the Colorado House. “So if we are serious about guaranteeing health care to all Americans, making sure that’s not just a paper promise but real access to health care, then I think we’ve got to rethink the way that the system works. It’s a false promise to tell folks that their coverage is secure under an existing system.”
The other candidate is Stephany Rose Spaulding, who says that health care should focus on taking care of people and not making money for private insurance companies. “I would make the public option so great that people would find no need for private insurance,” the Baptist pastor and University of Colorado-Colorado Springs professor said.
The stance aligns the two with the policy’s champion in the Democratic presidential primary, Bernie Sanders. The Vermont senator supports a plan that would essentially get rid of private insurance in favor of government coverage for doctor appointments, prescriptions and more. His rival, Massachusetts Sen. Elizabeth Warren, agrees with the idea, as do four other candidates, though they leave room for private insurance.
Romanoff’s plan differs from Sanders’ model in a key way. He thinks people should be able to supplement their Medicare coverage with private insurance if they wish, mirroring how the government-run health care system works today. That, he believes, would allow people to have more choice in their care but also protect them from losing care all together.
“I wish a public option had been added to the Affordable Care Act when this debate began 10 years ago,” he said. “I think a public option would be an improvement on the status quo. I just don’t want to lose sight of the end goal here, which is to get to a place of health care for all.”
Gardner sees health care issue as line of attack
Gardner is using Sanders’ embrace of Democratic socialism and Medicare for All as fodder for attack against the crowded field of Democrats seeking to unseat him. It’s a key part of his campaign.
“Socialized medicine means less choice, higher taxes and longer wait times and more government control,” Gardner said during the Western Conservative Summit in downtown Denver last month. “It means losing the health care that you have at your job and having it replaced with government-run healthcare. It’s so free that it’s unavailable. … We know that Democrats’ Medicare for All will actually result in Medicare for none.”
Romanoff and Spaulding reject Gardner’s argument and brush off Bennet’s argument.
“Is this argument going to make it easier for the insurance industry and the drug companies to bankroll Cory Gardner’s campaign and beat up on any Democrat that dares to take them on? Then the answer to that question is yes,” Romanoff said. “But there are more people who are committed to getting a place of universal health care then there are insurance companies and drug companies intent on killing the plan.”
Spaulding said people who call Democrats socialist for supporting Medicare for All are “just trying to trigger people’s emotions.”
“I would say to Bennet that more than 70% of Americans are advocating for a health care system that everyone can have access to,” she said. “So I don’t think we are alienating anyone.”
How the policy lands with Colorado voters may help define the race.
Colorado rejected a single-payer health care system — Amendment 69 — at the ballot box in 2016 by a wide margin. The board of Mental Health Colorado, an organization which Romanoff led at the time, didn’t take a stance on the question. Romanoff said he believes that he did not cast a vote on that issue when filling out his ballot because he was “intent on honoring the board’s position.”
The measure’s failure is partly why Bennet said Medicare for All wouldn’t sell in Colorado. He pointed to how much it would increase taxes to cover the cost. Sanders and other backers argue that under the proposed plan, households would no longer spend hundreds or thousands of dollars in health insurance premiums and co-pays each month, which would offset any income tax increase required to pay for the plan.
Despite Bennet’s warning for 2020 Democrats, the state elected a backer of Medicare for All as governor in 2018. Jared Polis co-sponsored the policy as a congressman in 2017 and used the issue to win support in the Democratic primary for governor. He pledged to fight for Medicare for All, calling it “the best solution to our rising health care costs.” At one point, his campaign even made signs touting his position.
Still, by the time of the general election, Polis made the issue less prominent, instead focusing on a public option that he could make work at the state level.
“It just wasn’t the boogeyman (in 2018) that some people will try to make it by the end of this election,” said Shad Murib, a Democratic political consultant who worked as policy director for the Polis campaign.
Where the rest of the field stands
Others in the Democratic field running to unseat Gardner support a government-run health insurance option that could operate alongside the Affordable Care Act but would allow people to keep their private provider.
“I think a public option is very much wanted across America,” said Alice Madden, a former Colorado House Majority leader. “My view is, it’s about choice. I think if it’s done well in 10 years, maybe private insurance does go away because everyone sees this is the way to go. But if someone is fearful and it totally flips them out (to lose their private insurance) why would you make them do that?”
As for why she thinks Medicare for All is the wrong way to go, Madden says: “I don’t know if it’s necessary and would maybe end up wasting some taxpayers dollars where you don’t need to.”
Dan Baer, an Obama-era diplomat, calls his version of the public-option plan “Medicare for All who need it” or “Medicare for All who want it.”
“I think it makes sense to start with targeting the people who don’t have care right now or people who don’t have access to affordable care,” Baer said.
Mike Johnston, a former state senator who finished third in the Democratic primary for governor in 2018, sees the opt-in proposal as a way to preserve the ability for people to keep their employer-based insurance.
“The idea is that there ought to be a public option for people to be able to buy into Medicare at any age, any stage in their life, any geography,” he said, saying it would provide more competition and choice for consumers to reach universal access.
John Walsh, Colorado’s former U.S. Attorney, and state Sen. Angela Williams also are generally on the same page as their Democratic rivals when it comes to endorsing a public option.
“I think that we have before us a system that could work and should work if we repair it,” Walsh said of the Affordable Care Act.
Williams said she’s “not ready to take away people’s choices, but we want to ensure that people who don’t have healthcare coverage — that we take care of them with an option.”
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She doesn’t foresee the divide on health care becoming a serious divide in the large field. “I think that there are a lot of talented people running in the Senate race, and I believe that we’re all going to be as cordial as possible in running this race,” she said. “Because divisiveness, we might disagree on our views, on issues, but Colorado doesn’t like negative campaigning.”
Baer echoed that sentiment. “I’m proud to be part of the party that is trying to solve a problem that is facing too many Americans,” he said. “And I think we are having a healthy policy discussion.”