Colorado voters on Tuesday rejected [Politico results] Amendment 69 (ColoradoCare) [text, PDF], which would have created the state’s first universal health insurance program, with 80 percent of voters voting against the initiative. According to Coloradans for Coloradans [advocacy website], ColoradoCare would be an even bigger burden on the state’s already strained budget. Coloradans for Coloradans also claim that the increase in income taxes needed to afford ColoradoCare would make Colorado the state with the highest income taxes in the nation. The Denver Metro Chamber of Commerce [advocacy website] voted unanimously against Amendment 69, believing it would have an adverse effect on small businesses due to the hefty tax burden. Supporters of the initiative had hoped it would have collectively saved [advocacy website] Colorado individuals and businesses over $4.5 billion, without deductibles or co-pays for primary care.

Health care reform remains a contentious issue across the nation. The Affordable Care Act (ACA) [JURIST backgrounder] has generated legal controversy and a series of court challenges since its passage. In January the US Congress sent a bill [HR 3762] to repeal the ACA to President Barack Obama, which he vetoed [JURIST report]. The National Conference of State Legislatures [official website] reports that between 2010 and 2015, at least 21 states have enacted laws attempting to challenge or completely opt out of mandatory provisions of the ACA. Most recently the ACA was amended by the Protecting Affordable Coverage for Employees Act [text], which allows states to consider employers with 51 to 100 employees as large employers, removing certain restrictions on small employers from those employers in this category. Last year the US Supreme Court ruled [JURIST report] in King v. Burwell [SCOTUSblog materials] that tax credits available to those who buy health insurance through state exchanges are also available to those who buy it through the federal exchange. In 2011 Vermont Governor Peter Shumlin signed [JURIST report] a health care reform law that promised to create a single-payer system.