DENVER, Co. – In case you missed it, in a recent op-ed published in Reason, Veronique de Rugy, a senior research fellow at the Mercatus Center at George Mason University, examines why decades of efforts to establish government-run health care systems have repeatedly failed to produce a workable model capable of delivering on promises of lower costs and expanded coverage.

The article highlights a critical point Colorado policymakers should seriously consider. Citing Jessica Riedl, an economist with the Brookings Institution, de Rugy notes that supporters of government-run health care have not identified either “a provider payment system that actually saves money” or “a financing mechanism” capable of funding expanded coverage without shifting costs elsewhere in the system. As de Rugy writes, “Despite hundreds of legislative proposals and multiple presidential campaigns built around the issue, no one has met the challenge.”

De Rugy further points to several state-level examples that illustrate these challenges. In 2014, Vermont lawmakers abandoned their single-payer effort after determining the payroll and income taxes required to sustain the program would be “politically unsurvivable.” And, in 2022, a California legislative analyst reported that the proposed single-payer system would cost between $494 billion and $552 billion annually.

These examples are particularly relevant in Colorado, where policymakers have already expanded the state’s role in the individual and small-group health insurance markets through the Colorado Option.

Since 2023, insurers operating in Colorado’s individual and small-group markets have been required to offer standardized Colorado Option plans designed by the state and meet state-established premium reduction targets. Four years after implementation, the Colorado Option has repeatedly fallen short of its goal of lowering premiums in the individual market. In 2026, all Colorado Option plans failed to meet the state’s required premium reduction targets for bronze, silver or gold plans across the state.

But the program’s affordability challenges extend beyond its failure to meet state-mandated targets. In 2026, Colorado Option plans are more expensive than non-Colorado Option plans for 85 percent of Coloradans seeking coverage in the individual market. In other words, for the vast majority of consumers shopping for individual-market coverage, the state-designed option is the more expensive choice.

The Colorado Option’s affordability challenges are compounded by the expiration of enhanced federal premium tax credits. According to Connect for Health Colorado, the expiration reduced or eliminated federal financial assistance for approximately 78,000 Coloradans, with customers paying an estimated $19 million more per month in premiums compared with 2025. With the state being forced to step in to offset the loss of federal assistance, the state’s affordability pressures continue to grow.

The disappointing results of the Colorado Option stand in stark contrast to the policy’s goal of improving affordability. Consumers were promised a new option designed to drive down premiums and increase competition, but four years later, most Coloradans shopping in the individual market can still find lower-priced coverage outside of the program. The results cast doubt on whether one-size-fits-all government mandates are a solution to the state’s health care affordability challenges.

The Colorado Option program has also failed to deliver on another of its central promises: improving consumer choice and increasing competition. In fact, the vast majority of Colorado counties experienced up to a 75.5 percent reduction in the number of available plans in 2024. On average, the number of plans available decreased by 37.7 percent across most Colorado counties in the second year of the Colorado Option. Introducing a single-payer system would, by definition, remove all consumer choice and competition from the market in Colorado.

Lawmakers should carefully consider the known failures of the Colorado Option before pursuing policies that would further expand government’s role in health coverage. Expanding the Colorado Option or moving forward with a single-payer system would ultimately create new financial risks for taxpayers, patients and providers without addressing the underlying drivers of health care costs.

Read the full Reason op-ed HERE.