In Colorado, Polis, who opposed a single-payer ballot initiative in 2016, rolled out ads this year touting his support for Medicare for all. | Getty Single-payer, once shunned, makes a comeback in Colorado governor's race

DENVER — Two years ago, 79 percent of Colorado voters rejected a ballot initiative to create a single-payer health system.

Today, the idea — rechristened "Medicare for all" — has become a raison d’etre for Democratic candidates such as five-term Rep. Jared Polis, who recently beat back a crowded gubernatorial primary field in the purple state to take on Republican nominee Walker Stapleton.


Colorado squarely encapsulates how the Democratic base is quickly embracing the decidedly progressive idea of a universal health system — as well as the big gap between their fervor and the realities of creating such a system. The ballot measure failed in part because of well-funded industry opposition, questions over financing the plan and the politically dicey question of whether abortion would be covered.

Despite the lessons learned, the political enthusiasm for single payer may still be outpacing the policy. That schism is what drove over a 100 single payer activists to a Denver-area union hall on a recent Saturday to strategize about how to capitalize on the political momentum.

“I live in a very red county and everyone basically thought it was ‘socialized medicine,’” said Dr. Madeleine Jacobs, a retired physician who lives in Fremont County, which Donald Trump carried with 69 percent of the vote, and who advocates for single-payer health care. “But in the last couple years, there has been a change.”

Single payer would remain a long shot, even if Democrats retake a chamber of Congress in the mid-term elections this fall. Trump and Republicans in Congress staunchly oppose the idea, branding it “government-run health care” that would restrict patient choice, ration care and bankrupt the Treasury.

The Trump administration has come out particularly strongly against the idea, a possible acknowledgment of the Democratic groundswell. CMS Administrator Seema Verma has slammed the idea as a “socialized system,” adding that any efforts to give Medicare to all “would become Medicare for none.”

And the debate will take on enormous significance ahead of the 2020 presidential race, with a wide open Democratic field that could force candidates to use the issue to differentiate themselves on issues like health care.



“It’s not a fringe idea. It’s not a radical idea any longer,” said Sen. Chris Murphy (D-Conn.).

In Colorado, Polis, who opposed the 2016 ballot initiative, rolled out ads this year touting his support for Medicare for all.

“Jared believes that a well-designed universal health care system will ultimately be the best solution to improve quality, expand access, and reduce health care costs for both Colorado families and small businesses,” said his spokeswoman, Mara Sheldon. “Amendment 69 [the 2016 ballot measure] did not meet that standard, which is why many people and organizations who support the concept of universal health care generally, including Jared, did not support that specific initiative.”

Polis wants to team up with other western states on some kind of universal health system, Sheldon said.

The 2016 ballot measure faced several big obstacles.

The wording on the ballot was required to disclose how the system, called ColoradoCare, would result in a $25 billion tax hike in the first year — likely a significant turn-off for voters. And abortion rights groups ended up opposing the effort because under other Colorado laws, the plan would have banned coverage of abortion and possibly other reproductive health services. Opponents ended up outspending supporters by about 10-to-1.

Nationwide, Democrats are divided on whether reviving the idea this year is too dramatic and too fast, particularly when Obamacare is still under constant attack by the Trump administration.

“A number of us spent buckets of blood, sweat and tears trying to pass the Affordable Care Act and get it implemented and defend against its repeal,” said Rep. Gerry Connolly (D-Va.). “So my view is I’m pretty focused on that fight. Should that fight fail, then I’m all for it.”

House Democratic Leader Nancy Pelosi and Democratic Whip Steny Hoyer aren’t keen to support Medicare for all, even after a group of 70 House members started a caucus in support of the idea. Pelosi said the idea should be “evaluated” if Democrats retake the House in the mid-term elections.

“I think everyone is looking at November and no one wants to do something that can stop the momentum right now,” said Rep. Mark Pocan (D-Wis.), who supports the effort. “If I was in leadership I probably would want to change nothing from the current course even if they like the idea.”

The long-term political calculus is nonetheless tempting.

Pocan, who did town hall meetings in his own Madison-area district as well as the southeastern Wisconsin district of House Speaker Paul Ryan, said the idea was a top applause line in both.

“The Republicans [efforts last year] in trying to take away things made people realize what they don’t want to give up,” he said.

After Sen. Bernie Sanders’ 2016 presidential campaign, some Democrats worried that single payer would hand Republicans an opportunity to lay bare the divisions between moderates who are skeptical of the idea and liberals who wildly support it.

Democrats put up firewalls to prevent that. They issued a series of proposals to expand national health programs, giving their candidates a platform to show support for expanding health care without having to embrace the Sanders’ bill or a similar plan in the House. There is legislation that would expand Medicare to everyone, expand it so people age 55 and over can buy in, to set up a program similar to Medicare that's available to anyone, as well as expand Medicaid.

“The theory was that we can create a number of points on the board that would be solid progressive places for members to land and I think that’s exactly what happened,” Murphy said.

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