Even after the passage of the Affordable Care Act, more than 350,000 Coloradans are still without health insurance, according to one estimate, while costs for people with coverage continue to rise.

So what to do about it?

This fall, Colorado voters have the chance to vote on one proposal that supporters say is the solution and critics say would be a disaster. Here are a few questions and answers on Amendment 69, dubbed ColoradoCare.

Q: What is ColoradoCare?

A: ColoradoCare is a proposed universal health insurance system that would cover every single Colorado resident. It would largely replace private or employer-provided insurance, though it is designed to exist alongside other forms of government insurance such as Medicare.

Q: How would ColoradoCare work?

A: ColoradoCare would be a $36 billion system — dwarfing the size of state government — that would be run eventually by a 21-member board made up of people elected by ColoradoCare’s “members.” A ColoradoCare member is anyone who is age 18 or older and eligible for coverage under the system — this includes not just people registered to vote in Colorado but anyone who lives in the state. Board members would be selected from seven yet-to-be-designated districts spread across the state. The board would be responsible for making decisions about what is specifically covered and how much doctors are paid for their work, though the amendment requires that certain broad categories of care — such as emergency services or palliative care — be covered. The amendment says ColoradoCare would be operated as a “political subdivision of the state,” meaning that it is independent from the state government’s chain of command but must still follow state laws.

Q: What if I was traveling out of state and needed to see a doctor?

A: ColoradoCare should pick up the tab, though the specifics haven’t been worked out. The amendment requires the board come up with policies “to pay benefits for health care services rendered to a beneficiary who is temporarily living or traveling in another state.”

Q: Would there be restrictions on which doctors I could see?

A: The amendment says ColoradoCare “shall allow beneficiaries to choose their own primary care providers.” But, again, the details haven’t been worked out. Much like with Medicare, doctors couldn’t be forced to accept ColoradoCare in their practices, though they might not have very many patients if they didn’t.

Q: Does Medicare go away?

A: No. Neither does TRICARE, the military’s health care plan. The amendment says that ColoradoCare would be a “secondary payor” when a person has another plan, though the details are not spelled out on how Medicare and ColoradoCare would work together. For instance, the amendment says ColoradoCare “shall serve as a state health plan that pays for designated supplemental health care services for Medicare beneficiaries,” but then says that ColoradoCare won’t pay for anything covered by Medicare parts A, B or D unless ColoradoCare enters into an agreement with Medicare that requires it to pay for those services. ColoradoCare could also apply to provide a Medicare Advantage plan, though the amendment doesn’t require it to.

Q: Who pays for it?

A: Taxpayers do. ColoradoCare would impose a new 10 percent payroll tax in Colorado. For people with bosses, the employer would pay two-thirds of the tax while the employee would pay the remaining one-third, or 3.33 percent of the employee’s salary. People who are self-employed would have to pay the full 10 percent, though. All other non-payroll income — from, say, investments or benefits — would also be taxed at 10 percent. Meanwhile, ColoradoCare would also take in money from the state and federal government that currently goes to health care. Lastly, members would likely be asked for copays on some services. People could still pay to have a private health care plan to cover medical costs but doing so wouldn’t get them out of paying the ColoradoCare taxes.

Q: Copays? How much would those run?

A: It’s unclear. The amendment says ColoradoCare can’t charge deductibles but can charge copays except for on certain primary and preventative services. The amendment, though, doesn’t define what exactly it means by those terms, and the services exempt from copays aren’t spelled out, either. This has led to disagreement over how much ColoradoCare would ask members to share in the costs of coverage. ColoradoCare backers say copays would only amount to about 4 percent of the total cost of care. But, in its own analysis of ColoradoCare’s finances, the nonpartisan Colorado Health Institute estimated that members would have to cover 14 percent of the cost of care, which is the average for public and private health care coverage in Colorado currently. It would be up to the yet-to-be-elected board to decide.

Q: Tell me more about these financial analyses. Would ColoradoCare stay solvent?

A: That, again, depends on whom you ask. ColoradoCare supporters point to an analysis that says the system would run in the black for at least nine years, by which time the system would have built up billions of dollars in surplusses. The Colorado Health Institute says ColoradoCare would fall $253 million short in its first year and that annual deficit would grow to nearly $8 billion by the 10th year. The pro-ColoradoCare campaing says the Colorado Health Institute didn’t take into account ColoradoCare’s ability — as a massive health care provider — to restrain future growth in health care expenses. But the big difference has to do with federal health care dollars and whether the state would continue to get the max amount from the feds after the amendment passes. ColoradoCare proponents say the state would, while the Colorado Health Institute isn’t so sure. No one at the federal level has commented, so it’s impossible to know right now which side is correct.

Q: What happens if ColoradoCare can’t pay its bills?

A: One of two things: Either the board can cut benefits or it can put a tax increase up for a vote of the members. The board can’t raise tax rates without winning permission from members.

Q: What other concerns are there about ColoradoCare?

A: The costs and the unknowns are the big points that the anti-ColoradoCare group Coloradans for Coloradans hit in its campaign literature. The group says the amendment would give Colorado the highest income tax rates in the country and that businesses could end up leaving the state because of the payroll taxes. The group also says doctors might leave if ColoradoCare doesn’t pay them enough, though the amendment’s supporters say the system would logically have to pay doctors better than Medicare does. Liberal groups have also expressed some of these concerns as well as one other: A 1984 constitutional amendment that bans government money from being used to fund abortions in Colorado. Because ColoradoCare would be a political subdivision of the state, NARAL ProChoice Colorado has said the system would be subject to the ban. ColoradoCare’s supporters have dismissed the concern, and a court fight may be required to settle it if Amendment 69 passes.

Q: So what are the arguments in favor of ColoradoCare?

A: Proponents say, basically, that the current system is broken — they point to the 20 percent jump in premiums of Affordable Care Act plans in Colorado that will happen next year — and that only a big, universal system can fix it. ColoradoCare wouldn’t be run with a profit motive, they say. And the Colorado Health Institute did find that ColoradoCare would cut billions of dollars in administrative costs and insurance company profits from the current system. Supporters also say ColoradoCare, by controlling so much of health care spending in the state, could slow the growth of health care costs here, though the Colorado Health Institute and others have disputed that. Lastly, supporters say ColoradoCare would ensure that everyone in the state has health insurance and receives the care they need. By providing regular preventative care to all people early on, supporters say, the state will save billions of dollars in down-the-line emergency care.

Q: How have the endorsements stacked up?

A: Opponents of Amendment 69 have racked up endorsement after endorsement from big-name politicians, but supporters have won endorsements from other influential figures. On the No side, former governors Bill Ritter and Bill Owens are opposed, as are four of the state’s current members of congress; the state’s treasurer, secretary of state and attorney general; 48 members of the state legislature from both parties; former Denver Broncos quarterback John Elway; and the Denver Metro Chamber of Commerce. On the Yes side, state lawmakers such as Sen. Irene Aguilar, D-Denver, and Rep. Jonathan Singer, D-Longmont, have come out in favor. But the splashiest endorsements have come from U.S. Sen. Bernie Sanders of Vermont and feminist writer Gloria Steinem.

Q: What about campaign finance?

A: According to Colorado Secretary of State records, the pro-ColoradoCare campaign, which is called ColoradoCareYES, has raised a little over $800,000 in its lifetime, which includes money spent to get the measure onto the ballot. The largest contributors are two Colorado psychologists, Lyn Gullette and Ivan Miller, who have each chipped in about $110,000 each. In opposition, Coloradans for Coloradans has raised more than five times as much, a little over $4 million. Health care companies such as Anthem, Kaiser Permanente, UnitedHealthcare, Centura Health and Healthone are the biggest donors. Anthem is the largest single contributor, having put in $1 million.

More details about Amendment 69 can be found in the Colorado Blue Book.