2016 Colorado Amendment 69 was an initiated constitutional amendment that appeared on the November 8, 2016, ballot. The measure aimed to create universal healthcare for state residents by introducing ColoradoCare, which would be paid for through the introduction of a 10% payroll tax.[1]
The amendment was rejected by Colorado voters in a landslide, failing to pass in each of the state's 64 counties.[2]
Background
ColoradoCare would have been primarily funded through the introduction of a 10% payroll tax, with two-thirds paid by employers and one-third paid by employees. Provisions in the Affordable Care Act mean that Colorado also could've received federal funding towards the universal healthcare system.[3][1] A portion of Social Security and retirement income would be exempt from ColoradoCare taxes — up to $33,000 for an individual and $60,000 for couples. High-income earners would only pay ColoradoCare taxes on income below $350,000.[4]
In 2013, over half of Colorado's population were insured through their employers, while another 12% were covered by Medicaid. The state's uninsured rate was 13%, equal to the national rate.[5] Amendment 69 would not have prevented people from purchasing private health insurance, though the Colorado Health Institute estimated that 83% of Colorado’s population, or around 4.4 million people, would have been eligible for primary health insurance coverage through the system.[4] ColoradoCare would have operated as a cooperative, with members voting for a 21-member board of trustees to oversee operations. Members would have also voted for potential tax increases to increase funding for the program.[4]
Campaign
Opponents, including hospitals and insurers, raised more than $5 million, significantly overshadowing the $900,000 raised by supporters of the amendment.[1][6] Health insurance provider Anthem (now known as Elevance Health), spent over $1 million opposing Amendment 69.[7]
Support
The campaign in favor of Amendment 69 was primarily led by the organization ColoradoCare YES.[8] State senator Irene Aguilar, who The Guardian called the 'chief architect' of ColoradoCare, claimed that a "disconnect" existed between "the powers that be and the people” in relation to healthcare coverage.[8] Aguilar defended the proposal against economic concerns, calling the funding model a “shifting of funds,” rather than a new tax. Referencing Colorado's 5% income tax used to fund the state government, she claimed that “Coloradans are going to pay $25 billion anyway— it’s just how it’s collected.”[9]
Bernie Sanders was the lone U.S. senator in support of Amendment 69, telling The Colorado Independent that the state "could lead the nation in moving toward a system to ensure better health care for more people at less cost," adding that the United States was "the richest nation on earth" and that "no one should go bankrupt or skip getting the care they need because they cannot afford it."[9]
Boulder-based newspaper The Daily Camera described efforts to understand the effects of Amendment 69 as "a little like looking at the outline of a novel and trying to imagine the finished book."[10] Nonetheless, the paper's editorial board narrowly voted to endorse the measure, urging Colorado residents to cast a protest vote in support of a better healthcare system. In their official endorsement, the board wrote that "we are unwilling to simply say no, knowing this means tacit approval of a status quo we abhor."[10]
Opposition
Amendment 69 received opposition from prominent national and state politicians from both major parties, with the group Coloradans for Coloradans leading the opposition campaign.[1] ColoradoCare YES claimed most of Coloradans for Coloradans' funding came from corporations. Sean Duffy, a spokesperson for Coloradans for Coloradans, told The Guardian that “[w]e have a number of companies from both sides of the aisle, particularly small businesses, who have said that this amendment will hurt their ability to run and grow a business.”[8]
Coloradans for Coloradans hired the Democratic consultant firm Global Strategy Group, who were simultaneously working with Priorities USA Action, a super PAC associated with Hillary Clinton's presidential campaign.[8] Clinton briefly mentioned Amendment 69 at a 2015 campaign rally in Boulder, but didn't explicitly make a case for or against the measure.[8] In October 2016 as part of the Podesta emails, WikiLeaks released email correspondence between Clinton campaign staffers warning against mentioning ColoradoCare in speeches. Campaign manager Robby Mook purportedly wrote that the campaign were "avoiding ... [healthcare coverage] because of the single payer referendum,"[11] to which deputy communications director Kristina Schake responded, “[Clinton Colorado campaign manager] Brad [Komar] asked us not to do health care tomorrow in Colorado because of the ballot initiative. Said it won’t be helpful there.”[11]
Abortion rights group NARAL Pro-Choice, now known as Reproductive Freedom for All, opposed Amendment 69.[12] While the organization reiterated their support for universal healthcare, they argued that a 1984 constitutional ban on the use of public funds for abortions would prohibit ColoradoCare from covering the procedure, limiting access for low-income earners.[12] The Rocky Mountains chapter of Planned Parenthood endorsed against the measure for the same reason.[13] ColoradoCare YES criticized this position, claiming that Amendment 69 would supersede the 1984 ban, which is enshrined in the state's constitution.[14]
Amendment 69 failed in each of Colorado's 64 counties, including the 22 counties won by Hillary Clinton in the concurrent presidential election.[2] The ballot measure performed best in Boulder County, with a 38.2% 'Yes' vote. Clinton carried the county by 48 points.[2]
Irene Aguilar, a lead supporter of Amendment 69, responded to the results by saying "[w]in or lose, the issue of guaranteed access to healthcare for everyone without financial barriers was finally brought before the voters." Lyn Gullette, a ColoradoCare YES staffer, promised to continue campaigning for universal healthcare, saying that while "we wish we had done better, there’s no way we’re going to stop working."[6] ColoradoCare YES spokesman Owen Perkins criticized the language used to describe Amendment 69 on the ballot, arguing that "nowhere did it say what state residents would save [money] in the long run."[6]
The Colorado Hospital Association said it was pleased that Amendment 69 was rejected by voters. "It was too risky, too uncertain and unaffordable for Colorado," the association wrote in a statement.[6] Dr. Katie Lozano, president of the Colorado Medical Society, who largely opposed ColoradoCare, said the amendment’s failure does not show approval for the state's current healthcare system. "Our members expressed deep dissatisfaction with the current system, for their patients and their practices ... there are too many barriers to good care and too many hoops to jump through to get insurance to cover care for patients."[6]
↑Menconi has since distanced himself from the Green Party and registered as a Democrat
↑Fiorino ran for U.S. Senate that same year as an 'unaffiliated candidate', but remained a registered Republican. He served as Business Chair of the Colorado Republican Party from 2002 until 2004
↑Since 2021, Hickenlooper has represented Colorado in the U.S. Senate
↑Gardner was later elected to the Colorado State Senate representing the 12th district, serving from 2017 to 2025
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