The campaign in Colorado to create the nation’s first state-based “single payer” health insurance system, providing universal coverage and replacing insurance premiums with higher taxes, has barely begun.

But business interests in Colorado are not taking anything for granted, and many of the largest lobbying groups around the country and in the state are raising funds to defeat Amendment 69, the single-payer ballot question going before voters this November.

The Council of Insurance Agents & Brokers, a national trade group, is mobilizing its member companies to defeat single payer in Colorado. “The council urges Coloradans to protect employer-provided insurance and oppose Proposition 69,” the CIAB warns. The group dispatched Steptoe & Johnson, a lobbying firm it retains, to analyze the bill.

Lobby groups that represent major for-profit health care interests in Colorado, including hospitals and insurance brokers, are similarly mobilizing against Amendment 69. The Colorado Association of Commerce & Industry — a trade group led in part by HCA HealthOne, a subsidiary of HCA, one of the largest private hospital chains in the country — is soliciting funds to defeat single payer. The business coalition to defeat the measure also includes the state’s largest association of health insurance brokers.

The proposal calls for the Colorado legislature to pass new laws raising $25 billion a year from a mix of employer payroll taxes, a 3 percent tax on employee gross pay, and a new tax on self-employed net income. The money would be used for a new health care system that would cover all premiums and out-of-pocket costs for health and dental care. The state would also be charged with negotiating with providers and for better drug prices. Supporters of the plan say the system would save $4.5 billion a year.

I asked Sean Duffy, a spokesperson for “Coloradans for Coloradans,” an ad hoc coalition against the single-payer ballot measure, how the state should address high health care costs and those struggling to afford health insurance premiums.

“We are focused on sharing with Coloradans the numerous questions, ambiguities, and concerns with Amendment 69,” said Duffy. He noted that “motivations for universal coverage are shared by many in Colorado” but that making Colorado a “one-state experiment, and the cost of doubling our state budget, potentially diminishing the accessibility and quality of care and creating an unaccountable, massive bureaucracy is just not a good idea for Colorado.”

The U.S. is the only wealthy nation without a publicly financed universal health care system — and spends far more than every other industrialized nation on health care costs. America also has one of the highest infant mortality rates of countries ranked by the Organization for Economic Cooperation and Development.

Patients using Medicare, the single-payer program for the elderly set up by President Lyndon Johnson, consistently tell pollsters that they prefer Medicare over private insurance. But expanding the system has proven difficult over industry opposition. Profit-driven health care industries and professional medical societies have blocked cost-saving reforms for decades, and in recent years, spent tens of millions of dollars to shape the outcome of President Barack Obama’s Affordable Care Act. The health insurance industry in particular lobbied aggressively to shape public opinion and block proposals to expand single payer over the last decade.

As other states consider proposals to lower costs and expand coverage, health care interests keen to protect some of the largest profit margins in the economy will be sure to mobilize quickly to snuff them out.