What’s New in Colorado and Beyond

There’s a growing national push to make one-payer health care a reality through state-level ballot initiatives. A group called One Payer States is leading the charge. Their strategy is bold: get several states on the ballot at once in a single election year. The goal is to overwhelm the financial and political resistance from big insurance and pharmaceutical companies.

T.R. Reid, a retired journalist turned campaign organizer, puts it plainly. He believes Congress won’t move toward universal coverage anytime soon because lawmakers are too tied up with industry lobbying. So instead, states like Colorado, Oregon, and Washington are being seen as the places where real reform could start to happen.

How It Would Work

The idea is to create a state-run health insurer that covers everyone under 65. Seniors would stay on Medicare. People enrolled in these plans wouldn’t pay premiums or deductibles. Private insurance companies like UnitedHealth and Aetna could still offer plans, but the state option would likely be cheaper.

Why? Because administrative costs would be lower. The target is around 5 percent for the state plan, compared to 18 to 20% for private insurers.

Supporters say this would drastically reduce medical bankruptcies and expand access to dental, mental health, reproductive, and hospital care.

Why It’s Gaining Momentum

Changes at the federal level are adding pressure. New legislation, known as H.R. 1, is expected to introduce work requirements and stricter eligibility checks starting in January 2027. That could affect millions of Medicaid recipients. Many fear large coverage losses and mounting financial stress unless states step up.

Lydia Guzman, who heads Health Care for All Colorado, says it outright: people are dying or going bankrupt because of medical costs. A state-managed system could be a lifesaver, literally and financially.

History of Resistance

Colorado has tried this before. In 2016, voters rejected Amendment 69 by a 4-to-1 margin. That plan would’ve taxed employers around 7 percent and employees about 3 percent to raise $25 billion each year. Supporters promised lower drug prices and administrative savings, but critics worried about the economic fallout.

The Big Question: Is It Feasible?

Colorado lawmakers are now pushing for a new study. Senate Bill 45 would require the Colorado School of Public Health to design draft legislation and deliver a detailed report by December 31, 2026. That study would cover all the big questions, how to fund it, how to pay doctors, how it affects private insurers, and what legal hurdles it might face.

Here’s the key part: the study must be paid for with grants and donations. No state tax dollars will be used.

Still, critics argue the process could be biased. In Oregon, similar proposals would’ve needed major payroll and income taxes. Insurance and hospital groups say these studies often lean toward rosy outcomes without fully accounting for the real costs.

What Comes Next

The next few years will be crucial. Everything depends on whether states can align their ballot campaigns and back them with serious public research. If that happens, and if voters respond positively, this could kick off a wave of reform.

Here’s the thing. If it works, it could completely reshape how health care is funded and delivered in the US. But it’s a high-stakes game, and Colorado is just getting started. Now we wait to see how they handle the politics, the math, and the messaging.