2016 Colorado Amendment 69

Amendment 69 was an initiated constitutional amendment that appeared on the November 8, 2016, ballot in the state of Colorado. The measure aimed to create a universal healthcare scheme for state residents by establishing ColoradoCare, which would be paid for through the introduction of a 10% payroll tax.^[1]

The amendment received bipartisan opposition and was rejected by Colorado voters in a landslide, failing to pass in each of the state's 64 counties.^[2]

Background

Amendment 69 was a citizen-initiated constitutional amendment that would have established ColoradoCare, a statewide program to provide universal healthcare coverage for state residents. It was placed on the November 2016 ballot after receiving 156,000 signatures in support, meeting the minimum of 99,000.^[3][4] ColoradoCare would have operated as a cooperative, with members^[a] electing 21 trustees to oversee operations and vote on tax increases to allocate additional funding to the program.^[1][5]

ColoradoCare would have been primarily funded through the introduction of a 10% payroll tax, with two-thirds paid by employers and one-third paid by employees. Provisions in the Affordable Care Act mean that Colorado could have received federal funding towards the universal healthcare system.^[6][1] A portion of Social Security and retirement income — up to $33,000 for individuals and $60,000 for couples — would have been exempt from the ColoradoCare tax. High-income earners would have only paid ColoradoCare taxes on income below $350,000.^[5]

In 2013, over half of Colorado's population were insured through their employers, while another 12% were covered by Medicaid. The state's uninsured rate was identical to the national rate of 13%.^[7] The introduction of ColoradoCare would not have prevented residents from purchasing private health insurance,^[1] and the Colorado Health Institute estimated that 83% of Colorado's population, or around 4.4 million people, would have been eligible for primary health insurance coverage through the system, while the remaining 17% would be covered by Medicare, military, or other federal government insurance.^[1][5]

Campaign

Support

The campaign in favor of Amendment 69 was primarily led by the organization ColoradoCare YES.^[8] State senator Irene Aguilar, who The Guardian called the "chief architect" of ColoradoCare, claimed that a "disconnect" existed between "the powers that be and the people" in relation to healthcare coverage.^[8] Aguilar defended the proposal against economic concerns, pointing out that residents already pay $25 billion yearly – the estimated cost of ColoradoCare – in the form of a penalty tax for not having a healthcare plan, much of which is used to fund ObamaCare subsidies.^[9][10]

Bernie Sanders was the lone U.S. senator in support of Amendment 69, telling The Colorado Independent that the state could lead the way to improve healthcare, adding that the United States was "the richest nation on earth" and should therefore make healthcare a right for all citizens.^[9]

After the Colorado Health Institute conducted a study estimating deficits of over $8 billion after a decade of ColoradoCare,^[5] the Colorado Foundation for Universal Health Care came out in support of the program and stated that the Health Institute's study failed to include revenue from Medicaid or account for the slowed growth of health care inflation from a single-payer system.^[11] The foundation conducted their own study, concluding that ColoradoCare was financially feasible and would result in a net positive impact on the state's economy.^[12] The ColoradoCare YES campaign also released an analysis, which estimated the state would save $6.2 billion in administrative costs while residents would see a $4.5 billion reduction in expenses.^[4]

Boulder-based newspaper The Daily Camera described efforts to understand the effects of Amendment 69 as "a little like looking at the outline of a novel and trying to imagine the finished book."^[13] Nonetheless, the paper's editorial board narrowly voted to endorse the measure, urging Colorado residents to cast a protest vote in support of a better healthcare system. In their endorsement, the board said that voting "no" implies approval of the current healthcare system.^[13]

Opposition

Amendment 69 received opposition from national and state politicians from both major parties, with the group Coloradans for Coloradans (also referred to as No on 69) leading the opposition campaign.^[1] ColoradoCare YES claimed most of Coloradans for Coloradans' funding came from corporations. Sean Duffy, a spokesperson for Coloradans for Coloradans, told The Guardian that the group had spoken to numerous companies who have said that the amendment would hurt their ability to operate.^[8]

Opponents, including hospitals and insurers, raised more than $5 million, significantly overshadowing the $900,000 raised by supporters of the amendment.^[1][14] Health insurance provider Anthem (now known as Elevance Health), spent over $1 million opposing Amendment 69.^[15]

Coloradans for Coloradans hired the Democratic consultant firm Global Strategy Group, who were simultaneously working with Priorities USA Action, a super PAC associated with Hillary Clinton's presidential campaign.^[8] Clinton briefly mentioned Amendment 69 at a 2015 campaign rally in Boulder, but did not explicitly make a case for or against the measure.^[8] In October 2016 as part of the Podesta emails, WikiLeaks released email correspondence between Clinton campaign staffers warning against mentioning ColoradoCare in speeches. Campaign manager Robby Mook purportedly wrote that the campaign were "avoiding ... [healthcare coverage] because of the single payer referendum,"^[16] to which deputy communications director Kristina Schake responded, "[Clinton's state campaign manager] Brad [Komar] asked us not to do health care tomorrow in Colorado because of the ballot initiative. Said it won't be helpful there."^[16]

Despite the Colorado Democratic Party's 2016 platform featuring support for Amendment 69,^[17] many of the state's prominent Democrats, including governor John Hickenlooper and senator Michael Bennet, opposed the measure.^[18][19] Abortion rights group NARAL Pro-Choice, now known as Reproductive Freedom for All, also opposed Amendment 69.^[20] While the organization reiterated their support for universal healthcare, they argued that a 1984 constitutional ban on the use of public funds for abortions would prohibit ColoradoCare from covering the procedure, limiting access for low-income earners.^[20] The Rocky Mountains chapter of Planned Parenthood endorsed against the measure for the same reason.^[21] ColoradoCare YES criticized this position, claiming that Amendment 69 would supersede the 1984 ban, which was enshrined in the state's constitution.^[22][23]

Polling

An August 2016 poll by Magellan Strategies found broad opposition to Amendment 69,^[25] with the ballot measure failing to gain net approval from any age group, gender or political affiliation.^[27][25]

Results

By county

Analysis

Amendment 69 failed in each of Colorado's 64 counties,^[28] including the 22 counties won by Hillary Clinton in the concurrent presidential election.^[2][29] The ballot measure performed best in San Miguel County, with a 44.93% "Yes" vote, though Clinton carried the county by 45 points.^[2] Washington County recorded the highest "No" vote at 93.66%, outpacing Donald Trump's performance by almost 10 points.^[29]

The public policy think tank Third Way partially attributed the landslide defeat of Amendment 69 to public opposition to ColoradoCare from prominent Democratic politicians, including governor John Hickenlooper, Michael Bennet, and former governor Bill Ritter.^[28] They noted an August 2016 poll that showed 41% of Democrats supported Amendment 69, while 45% opposed it.^[28][27]

Aftermath

Reactions

Irene Aguilar, a lead supporter of Amendment 69, responded to the results by saying "[w]in or lose, the issue of guaranteed access to healthcare for everyone without financial barriers was finally brought before the voters." Lyn Gullette, a ColoradoCare YES staffer, promised to continue campaigning for universal healthcare,^[14] while the group's spokesman Owen Perkins criticized the language used to describe Amendment 69 on the ballot, arguing that it omitted their estimates that ColoradoCare would save money long-term.^[14] He also said that the "Yes" campaign was defeated by some of "the biggest multi-billion dollar corporations in the country."^[30]

The Colorado Hospital Association said it was pleased that Amendment 69 was rejected by voters. "It was too risky, too uncertain and unaffordable for Colorado," the association wrote in a statement.^[14] Dr. Katie Lozano, president of the Colorado Medical Society, who largely opposed ColoradoCare, clarified that the amendment's failure does not show approval for the state's current healthcare system.^[14]

Journalist T. R. Reid, who supported Amendment 69, attributed the landslide loss to lopsided campaign spending, and told Colorado Public Radio that supports of ColoradoCare were "viciously outspent by the insurance companies",^[31] referencing large donations to the "No" campaign by insurance companies UnitedHealth, Anthem, Kaiser and Cigna.^[31]

See also

• 2002 Oregon Ballot Measure 23
• 2017 Maine Question 2
• 2018 Idaho Proposition 2
• 2020 Missouri Amendment 2

Notes

1. ^ Eligible residents who have chosen to use ColoradoCare
2. ^ Key:
   A – all adults
   RV – registered voters
   LV – likely voters
   V – unclear

References

1. ^ "Colorado Creation of ColoradoCare System, Amendment 69 (2016)". Ballotpedia. Retrieved October 29, 2025.
2. ^ "Colorado Amendment 69 — Create State Healthcare Systems — Results: Rejected". The New York Times. August 1, 2017. Retrieved December 1, 2025.
3. ^ Daley, John (October 23, 2015). "Universal Healthcare Supporters Deliver Ballot Signatures In Ambulance". Colorado Public Radio. Retrieved January 10, 2026.
4. ^ Corcoran, Michael (October 20, 2015). "Will Colorado Become the First State to Implement Single-Payer Health Care?". Truthout. Retrieved January 10, 2026.
5. ^ "ColoradoCare: An Independent Analysis". Colorado Health Institute. Retrieved December 1, 2025.
6. ^ "Text of Initiative 20 (Amendment 69)". Colorado Secretary of State. Retrieved October 29, 2025.
7. ^ "Health Insurance Coverage of the Total Population | KFF State Health Facts". KFF. Archived August 10, 2015 at the Wayback Machine. Retrieved December 1, 2025.
8. ^ Hesse, Josiah (May 20, 2016). "ColoradoCare: universal healthcare plan has Democrats divided". The Guardian. Retrieved December 1, 2025.
9. ^ Hutchins, Corey (October 26, 2015). "Bernie Sanders: Colorado could "lead the nation" with its universal healthcare ballot measure". The Colorado Independent. Retrieved December 2, 2025.
10. ^ "Higher Fines, More Compliance: Fewer Coloradans Pay ACA Penalty". Colorado Health Institute. Retrieved January 10, 2026.
11. ^ Fixler, Kevin (October 26, 2016). "ColoradoCare spurs debate between docs on Western Slope". Aspen Times. Retrieved January 10, 2026.
12. ^ "Universal Healthcare Plan 2016". Healthcare-NOW!. Retrieved January 10, 2026.
13. ^ "Editorial: A protest vote for Amendment 69". Boulder Daily Camera. November 5, 2016. Retrieved December 2, 2025.
14. ^ "Colorado rejects universal healthcare initiative, but supporters aren't giving up". Physicians for a National Health Program. Retrieved December 2, 2025.
15. ^ Marcus, Peter (December 8, 2016). "Lopsided campaign spending, lopsided vote against ColoradoCare". Colorado Politics. Retrieved December 2, 2025.
16. ^ Miller, Blair (October 12, 2016). "Wikileaks dump: Clinton avoided health care talk". Denver 7 Colorado News (KMGH). Retrieved December 1, 2025.
17. ^ "2016 Colorado Democratic Party Platform". Colorado Democratic Party. p. 26. Archived from the original on August 23, 2016. Retrieved January 10, 2026. To that end, we strongly support a "YES" vote on ColoradoCare (Amendment 69) on the ballot in November 2016. Colorado, with our innovative and entrepreneurial spirit, can lead the way to better health care with ColoradoCare, Amendment 69.
18. ^ Daley, John (January 26, 2016). "Hickenlooper Opposes Single-Payer Ballot Measure". Colorado Public Radio. Retrieved January 10, 2026.
19. ^ Hutchins, Corey (April 21, 2016). "Sen. Michael Bennet comes out against ColoradoCare". The Colorado Independent. Retrieved October 29, 2025.
20. ^ "Would Amendment 69 limit access to abortion in Colorado?". The Denver Post. June 24, 2016. Retrieved December 3, 2025.
21. ^ Matthews, Dylan (September 14, 2017). "Single-payer health care failed miserably in Colorado last year. Here's why.". Vox. Archived May 4, 2025 at the Wayback Machine. Retrieved December 3, 2025.
22. ^ Andrews, Becca. "Here's why abortion advocates won't vote for universal health care in Colorado". Mother Jones. Retrieved January 10, 2026.
23. ^ "Colorado-Care-Memo". DocumentCloud on behalf of ColoradoCare YES. Retrieved December 3, 2025.
24. ^ "Summary of Poll Findings". Colorado Mesa University. Retrieved October 29, 2025.
25. ^ "AMENDMENT 69 / COLORDOCARE SURVEY FINDINGS". Magellan Strategies. Retrieved October 29, 2025.
26. ^ "Polling, Amendment 69". Magellan Strategies. Retrieved October 29, 2025.
27. ^ "Amendment 69 Opinion Polling". Magellan Strategies. July 24, 2020. Archived from the original on November 8, 2016. Retrieved January 8, 2026.
28. ^ "Single-Payer Health Care: A Tale of 3 States". Third Way. Retrieved January 8, 2026.
29. ^ "Colorado Election Results 2016". The New York Times. August 1, 2017. Retrieved January 8, 2026.
30. ^ Yoanna, Michael de (November 9, 2016). "Colorado Election Doesn't Change Much -- Except Minimum Wage And Medical Aid In Dying". KUNC. Retrieved January 8, 2026.
31. ^ Daley ·, John (October 19, 2016). "When It Comes To Spending, The ColoradoCare Fight Has Been Lopsided". Colorado Public Radio. Retrieved January 8, 2026.