Scripture, Tradition, and Reason: Perspectives on Amendment 69, ColoradoCare
By Anna Wadsworth
Kevin is a slight, middle-aged man with a neatly trimmed beard and bright, dark eyes, which hint that he has seen more than his share of trouble. He’s a regular at the Network Coffeehouse at 14th and Pearl, where the homeless in Denver’s Capitol Hill neighborhood gather for free coffee and camaraderie. On a recent Tuesday, our conversation ranges all over the map — from a book Kevin is reading about the Civil War to health care policy. He mentions that his health insurance is great and fishes out of his billfold his plastic Medicaid card, which clearly carries symbolic importance to him. He depends on a portable oxygen tank, and access to health care is his lifeline.
Many Coloradans cannot afford the health care they need, and like Kevin, some of them face chronic illness. Recently, concerned citizens successfully petitioned for a ballot initiative addressing health care in our state. In November, Coloradans will vote on Amendment 69 to the state constitution. If adopted, the amendment guarantees health care for all Coloradans and creates ColoradoCare, a program similar to Medicare. The legislation is challenging and, for some, controversial. As Anglicans, we are much informed by approaching it through our three pillars of scripture, tradition, and reason.
In the Gospels, numerous stories show the mercy and love of Jesus for those in need of his healing word or touch. He heals blind Bartimaeus. Jairus’ daughter, given up for dead, Jesus restores to life. The hemorrhaging woman, who merely touches his cloak, is healed. He heals the slave of a Roman centurion who says Jesus only needs to speak the word and it will be done. In one Gospel account, Jesus is surrounded by such a crowd that the friends of a paralytic man must lower the man through the roof to be healed. Jesus tells him to take up his bed and go home, and when he does, the crowd is amazed. Whatever we make of these miracle stories, their sheer number in scripture emphasizes the significance that Jesus placed on caring for the sick. He commissions his followers to do the same, sending out his core group of disciples to cast out “unclean spirits” and “to heal every disease and every infirmity” (Matthew 10:1).
Following Jesus’ example, the Church since its inception has offered healing to all people, the poor as well as those who could afford care. The nursing profession had its beginnings in Christian orders of women who ministered in various ways, including caring for the sick. About A.D. 300, deaconess Fabiola, a member of such an order, organized the first charity hospital in Rome. Shortly thereafter, the church began to establish hospitals in cathedral towns. In medieval times, monks practiced the healing arts by studying the available literature on anatomy and medicine, cultivating roots and herbs for healing, and offering rooms for the sick.
In the 20th century, members of The Episcopal Church in Denver opened the Church Convalescent Home to serve poor women and children. The home eventually was sold, and the proceeds were used to build a new convalescent center, which became the Spalding Rehabilitation Hospital.
In 2009, a year before the Affordable Care Act (ACA) became federal law, the House of Bishops and the House of Deputies of The Episcopal Church passed Resolution 2009-C071, supporting comprehensive health-care coverage. The resolution calls on congregations to undertake discussion of the issue, including “the Gospel message of concern for others, which extends to concern for their physical as well as spiritual well-being.” Discussion is also intended to address the responsibility of each parish “to attend to the needs (including health-related needs) of others, both other members of the parish family and those of the wider community, the nation and the world.” The resolution goes even further, stating: “The Episcopal Church urges its members to contact elected federal, state, and territorial officials encouraging them to . . . establish a system to provide basic health care to all.” Yes, we are called to advocate for basic health care for all.
Well-rooted in scripture and church tradition, The Episcopal Church’s stance calls those of us faced with the ballot proposal to become more educated about health care in Colorado. We can look at the issues addressed by ColoradoCare and use reason — that third, familiar Anglican tool — to consider the program’s merits and drawbacks.
Eight years in the making, ColoradoCare has been designed as a nonprofit cooperative to be owned and operated by all Colorado residents. Guided by an elected, 21-member board, ColoradoCare would finance health care for all residents of our state. One supporter describes it as “platinum-level” coverage for all.
Under ColoradoCare, residents receive a health-care card and are able to choose individual doctors and specialists without regard to whether they are “in network” or “out of network.” There are no insurance premiums or deductibles, but there may be a small copayment, which is waived for those in financial need. The plan is comprehensive, including coverage for dentistry, vision, hearing, maternity care, mental health, and end of life care. Residents who receive Medicare or VA benefits as well as those who choose to purchase other insurance plans may use ColoradoCare as supplemental coverage.
Under the proposal, ColoradoCare is funded from several sources. Under the Affordable Care Act, or ACA, waiver funds are available to states that design their own plans to meet or surpass the goals of the ACA. Other funding includes Medicaid waiver funds. Much of the funding is from increased taxes. Amendment 69 allows for a new payroll tax of 3.3% for workers and 6.7% for employers, as well as a 10% tax on investment income, self-employment earnings, and some small business income. The tax is intended to replace premiums paid for health insurance by employers or by consumers.
Insurance companies, some doctors, and chambers of commerce are mounting a vociferous, well-organized, and generously financed campaign to oppose ColoradoCare. They oppose the high cost, which at $25 billion a year would nearly double the state’s entire budget. Proponents argue the tax increase saves money for most Coloradans by eliminating premiums paid to insurance companies, whose high profit margins gouge consumers without providing any reciprocal health benefit. ColoradoCareYES claims that the program can result in annual savings of $4.5 billion for Colorado individuals and businesses.
Is there a true need for ColoradoCare? Since the ACA was passed, the number of uninsured Coloradans has fallen, but in 2015 it remained at 353,000. Colorado Health Institute, a research organization funded by hospital-affiliated foundations, says thus far our state has only been “chipping away” at this number. This is not fast enough, according to Judith Burke, a parishioner at Saint John’s Cathedral. A retired registered nurse who practiced in Colorado from 1967 to 2015, Judith is concerned not only for the uninsured but also for thousands more who are underinsured. For them, lower-priced, high-deductible policies make even routine visits to the doctor and preventive care effectively unaffordable.
Michelle Lucero, general counsel at Children’s Hospital Colorado, is worried that ColoradoCare could threaten research dollars or drive away doctors. ColoradoCare advocates counter that the program reduces the administrative overhead of health-care providers by eliminating the frustrating maze of various insurance plans they currently must navigate.
ColoradoCare opponents fear an economic burden to the state. The New York Times quoted Walker Stapleton, state treasurer and co-chair of Coloradans for Coloradans, a campaign against the amendment: “If you think legalized pot brought a lot of people to Colorado, you should try free health care.” But to amendment supporters the increased number of residents receiving health care under ColoradoCare is a plus. A healthier state. They point out that, despite spending more than twice as much of our national gross domestic product as other developed nations on health care, the United States remains the only industrialized country without universal health coverage.
This spring, during a meeting held by the League of Women Voters at Montview Presbyterian, an audience member asked presenter Irene Aguilar how ColoradoCare would affect the insurance industry in our state. Aguilar, a physician and a state senator, said she had asked the appropriate state agency to estimate the job loss in Colorado. The number, she said, seemed too low to her. But she recognized that this number is difficult to calculate because insurers operating here often employ out-of-state workers. A ColoradoCareYES publication states that the program will “redirect out-of-state spending to in-state spending” and that there “would be a net gain of 25,749 jobs in Colorado in 2019.”
Among resources for parishes that would like to explore the issue of health-care coverage, two stand out: The first is an eight-minute video that introduces the basics of Colorado’s proposed amendment, available at faithperspectiveamendment69.org. The second is Health-Care Coverage for All: Discussion for Churches, at episcopalhealthministries.org.
Almighty and most merciful God, we remember before you all poor and neglected persons whom it would be easy for us to forget: the homeless and the destitute, the old and the sick, and all who have none to care for them. Help us to heal those who are broken in body or spirit, and to turn their sorrow into joy. Grant this, Father, for the love of your Son, who for our sake became poor, Jesus Christ our Lord. Amen.
Book of Common Prayer, p. 826
Book of Common Prayer
“ColoradoCare: How It Would Work.” Prepared for ColoradCareYES by Ivan J. Miller.
“Colorado Weighs Replacing Obama’s Health Policy With Universal Coverage.” Jack Healy. New York Times, April 28, 2016.
Health-Care Coverage for All: Discussion Guide for Churches, available at episcopalhealthministries.org. Prepared by the Bioethics Committee of The Episcopal Diocese of East Tennessee.
Anna Wadsworth is a parishioner at Saint John’s Cathedral, a longtime educator, and an advocate for, among other things, affordable health care.