IMPORTANT VOTING INFORMATION
Background: The Democratic candidates each put forward their own health care plan -- but whether it can win approval in a gridlocked Congress is a question that remains. If the next administration fails to pass its health care initiative, expect states like Colorado to continue to try their hand at state-level programs. Colorado is working on a public option plan run by private insurers, while a handful of other states have expressed interest in developing government-run, single-payer plans. But the hurdles to state efforts abound, including receiving federal approval and figuring out how to pay for it.
Favors public option that could cover state Medicaid population
A: He favors a public option “like Medicare.” The Biden campaign did not respond to questions, so it’s unclear how he would respond to a state single-payer system in Colorado. But Biden’s health plan does include one provision that could affect Colorado’s public option push. Biden says states that expanded Medicaid under the Affordable Care Act -- as Colorado did -- could move the expansion population to a “premium-free public option” run by the federal government, as long as states continue to pay a share of the cost. It’s not clear whether this would help Colorado.
Colorado’s rejection of single-payer shows public option is better
A: Bloomberg is not a fan of a single-payer system and prefers a public option that competes against private insurance. He even points to the fact that Colorado “backed away from single-payer proposals after realizing how expensive and difficult they would be to implement” -- a reference to Amendment 69, the failed 2016 ballot measure known as ColoradoCare. In response to Colorado’s current public-option efforts, the candidate suggested the state can apply for a waiver, but didn’t say whether his administration would approve it. Still, he added, he would encourage states to experiment with new approaches “as long as they have strict guardrails to protect patients and health care outcomes.”
Public option run through Medicare is way to go
A: Buttigieg supports a public option insurance plan for those who need it, administered through Medicare. His campaign didn’t respond to questions about a state-based system.
Plan could help Colorado reinsurance program
A: Her health care plan expresses support for a federal public option, but doesn’t specify whether to offer it through Medicaid or Medicare, or how it would impact coverage in Colorado. One particular aspect of her plan could help the state. Colorado just implemented a temporary reinsurance program and Klobuchar wants to make it easier for states to offer.
Supports single-payer, government plan at federal level
A: Sanders supports a single-payer system run by the government, what he calls “Medicare for All,” which he pledged to introduce in his first week in office. The idea failed at the state level in Vermont, but Sanders has suggested any effort short of single-payer is the wrong approach. In its response, the campaign did not address Colorado’s efforts.
Public option will increase competition and lower prices
A: Steyer supports a public option, rather than “Medicare for All,” saying he opposes a single-payer system “because I don’t like the idea of telling Americans who are getting their health care through their employer that they don’t have a choice.” Steyer did not respond directly to the question about whether his administration would assist state-run plans. But his stance suggests he may be more supportive of a state-level public option, like what’s being pushed in Colorado, than a state-run, single-payer system. At the federal level, he argues that competition from the government will drive down the cost of private insurance, drugs and hospital care.
A transition to “Medicare of All” over time
A: Warren has proposed transitioning to a “Medicare for All” system within her first three years in office. Her plan would immediately lower the eligibility age of Medicare to 50. Children under 18 and families making less than double the federal poverty level would be able to opt-in to Medicare for free, while everyone else can buy in. After this trial period, Warren proposes adopting Medicare for All by her third year in office.
At the state level, Warren has proposed allowing state single-payer innovation waivers that would allow states to start experimenting with single-payer programs of their own. Colorado voters rejected a single-payer plan on the 2016 ballot, but Gov. Jared Polis is pushing for a public option with terms mandated by the state.
Background: In a bid to reduce prescription drug costs, Colorado state health officials are developing what would be one of the nation’s first drug importation programs. But the state can’t do it alone. Under a 2003 law, federal approval is required and no state has received it. President Donald Trump supports drug importation, but even if the state received the go-ahead by the end of 2020, the next administration would still play a role. One major hurdle that could demand the next president’s attention: Canadian officials have concerns about the idea, and could unilaterally block drug exports to the U.S. before such a program can get off the ground.
Federal importation but unclear on state drug purchasing programs
A: How he would respond to a state importation plan remains unclear. He supports allowing consumers to buy prescription drugs from other countries, but only if federal health officials certify the drugs are safe. The certification step could hamper state-level efforts.
His six-point plan is not clear on state drug imports
A: The candidate’s six-point plan to reduce prescription drug prices includes the ability of the federal government to “allow imports of safe drugs from abroad.” But he doesn’t offer specifics about what would qualify under his approach -- nor does he clarify whether he would allow states to import drugs on their own.
Pushed legislation to allow drug imports from Canada
A: Her health care agenda includes legislation she sponsored in the U.S. Senate to allow individuals to buy drugs from Canada, if they purchased from a licensed pharmacist and are the same as those approved in the U.S. Canada has expressed concern about such ideas and Klobuchar doesn’t address getting drugs from other countries.
Introduced legislation to import drug from Canada
A: The candidate has long favored drug importation, at least from Canada and introduced legislation on the topic. He pledged on his first day in office to order his health department and the Federal Drug Administration to allow patients, pharmacists and wholesalers to purchase Canadian drugs that are FDA-approved. It’s not clear how he would respond to a more robust state effort.
FDA-approved drugs OK’d for importation
A: Steyer says he’s in favor of allowing Americans to buy drugs internationally -- as long as they’re FDA-approved. “As a businessman,” he said, “I understand the value of a competitive and innovative marketplace and know that choice is a fundamental American value that drives markets to respond to consumer demands.” Even though he didn't specify whether he supports state-level drug importation programs, his definitive stance suggests his administration wouldn’t get in the way. However, FDA approval is the tricky part. The American pharmaceutical industry has long argued that FDA safety protocols to track drugs through the supply chain and prevent counterfeits would be difficult to replicate with international imports.
Supports buying prescription drugs from other countries
A: Warren supports importing prescription drugs from other countries “that sell the same medicines and meet strong safety standards, but that charge their citizens a fraction of our costs.” She has introduced legislation in the U.S. Senate to use public funding to manufacture drugs at a lower cost to consumers. If a drug importation doesn’t advance at the federal level, her stance suggests she would support a state-based push to do the same.