Ballot Measure 2Q: Raising sales taxes to support Denver Health

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If Denverites vote yes, the city’s sales tax would increase the sales tax by .34 percent — that equals an extra 3.4 cents on a $10 purchase — to fund Denver Health, Colorado’s flagship safety net hospital. 

The sales tax for purchases in Denver is currently 8.81 percent, including taxes collected by the city, RTD and the state. If the measure passes, the new sales tax would be 9.15 percent. (Another proposed sales tax increase, Ballot Issue 2R for affordable housing, would bring the total to 9.65 percent if it passes, too.)

The measure will only pass if it gets at least 50 percent of the vote in Denver.

The money would help shore up a gaping hole in the budget of Denver Health, which serves nearly 300,000 people a year. But opponents ask whether more money will solve the problem.

Denver’s city council voted 12-1 in June to refer the question to voters. 

Here’s the language you’ll see on your ballot:

“For an ordinance increasing the sales and use tax by a rate of 0.34 percent and 6 dedicating the revenue derived from the tax rate increase to fund certain services 7 provided by Denver Health and Hospital Authority subject to the approval of the 8 voters at a special municipal election to be conducted in coordination with the 9 state general election on November 5, 2024.”

How would it work?

The purchase price of most products sold in Denver would increase with the higher tax rate. However, food, medicine, diapers, and feminine hygiene products are exempt from sales taxes, according to supporters.

The measure would raise about $70 million annually, based on calculations using 2023 sales tax revenue data, according to the group backing the measure. 

Backers of the proposal say the infusion of funds would let Denver Health invest in improvements to emergency and trauma care, primary care, mental health care, drug and alcohol use recovery and pediatric care for clinics in Denver Public Schools.

Who’s for it?

The group Vote Yes on 2Q, also called Healing Denver, was organized to encourage voters to pass the ballot measure.

A ‘who’s who’ of Colorado’s Democratic heavy hitters is endorsing an affirmative vote, including both its U.S. senators, the congresswoman representing the district where the hospital is located, Denver’s current mayor and four predecessors, more than a dozen state lawmakers and most of the city council, which voted 12-1 to put the decision before voters.

The ‘yes’ case is straightforward: that Denver Health is in a funding crisis that “threatens essential care and programs, putting vital services at risk.” 

Those programs include emergency and trauma care, primary medical care, mental health care, pediatric care and drug and alcohol recovery. Denver Health CEO Donna Lynne said in September that if the ballot measure fails, funding in those areas is at risk.

Health care costs are going up significantly every year, driven by inflation and rising wages. Denver Health has the highest percentage of patients in the Denver area who are on Medicaid, uninsured or pay for care themselves, according to the system. The hospital has seen its uncompensated care costs increase as it serves more people who are homeless, people who were removed from Medicaid last year, as well as immigrants, many from South America. 

Since 2019, Denver Health’s uncompensated care costs have gone up by two and a half times. Overall patient count has doubled in the last 20 years, according to the hospital system. In 2023 alone, it provided more than $100 million in uncompensated care to Denver residents.

Denver Health’s total budget is $1.3 billion, a bit less than the city’s entire general fund and a bit more than that of the Denver Public Schools. It gets funding from the city, state and federal government, but those sources have stayed flat for years.

According to the Denver Campaign Finance Dashboard, backers of the proposal had raised more than $1,585,000 as of October 8.

The top contributor was Heart of Denver, which gave $258,000. Thiry O’Leary Living Trust gave $150,000. Gary Advocacy LLC gave $125,000. Rose Community Foundation and Denver Health CEO Donna Lynne donated $80,000. The Medical Staff Executive Staff Committee Fund, MB Glassman Foundation, James Kelley and Caring for Colorado Foundation all gave $50,000. Healthier Colorado gave $47,500. (See graphic below)

Business organizations endorsing ballot measure 2Q include the Denver Metro Chamber of Commerce, the Downtown Denver Partnership, Colorado Concern, the Colorado Black Chamber of Commerce and the Asian Chamber of Commerce.

The campaign also has support from a number of community groups: the Greater Denver Ministerial Alliance, Re:Vision, Gary Community Ventures, the Denver Foundation, Gold Crown Foundation, MB Glassman Foundation, the Colorado Trust, the Women’s Foundation, Caring for Colorado and Servicios de la Raza.

The Denver Health system, advocates of the measure say, provides a critical role in the community, serving anyone who walks in its doors, regardless of their ability to pay. That includes people who either wouldn’t get that care or would otherwise delay it, perhaps winding up back in an emergency department with more severe health problems if they didn’t receive care from Denver Health.

Denver Health serves about a quarter of Denver’s population each year. That includes a diverse population such as “those experiencing poverty, uninsured, pregnant teens, substance use issues, victims of violence and unhoused populations.” A third of Denver-area babies are delivered there annually.

Denver Health and Hospital Authority was created by the Colorado legislature as a political subdivision of the state. The Authority began operations in 1997 after separating from the city and county of Denver. The city transferred substantially all of the healthcare programs, services and facilities from its former Department of Health and Hospitals to the Authority. The Authority is governed by an eleven-member board responsible for the operation of its health system, including the Denver Health Medical Center.

Who’s against it?

There is no organized opposition to the proposal for now, but one opponent says that she and others will mount a campaign against the measure.

According to the Denver Campaign Finance Dashboard, no one had raised any money against the measure as of October 8.

Councilmember Kevin Flynn, of District 2 on the south side, expressed worry about Denver becoming too dependent on sales taxes to pay for city programs. He made the comments as the city council weighed whether to place the measure on the ballot this fall. “I do feel like someone needs to be the canary in the coal mine, and I guess that’s going to be me,” Flynn said.

“What I’m concerned about is our taxpayers, which is everyone, and people are being taxed more and more, and it’s making it more difficult for them to make ends meet,” said Kim Monson, president of the Colorado Union of Taxpayers

Monson debated Lynne on ballot measure 2Q at a community forum held at a church in North Cherry Creek in mid-September.

“The other elephant in the room is the 40,000 plus illegal immigrants that have come here to the metro area to Denver, and they have not paid a dime into this system,” said Monson. She called it unsustainable. “We need to address that question before we start to ask the taxpayers to pay more taxes on almost everything that they buy every day.”

Lynne said caring for new immigrants is less than 10 percent of the increase in uncompensated care Denver Health has seen over the last several years. “So we would do this measure without the migrants coming because of all those factors in healthcare with rising costs,” she said.

Plus, Lynne said, untreated health problems of any population end up costing the entire community, giving the example of treating cases of communicable diseases so they aren’t transmitted community wide. “We feel like we have a responsibility to care for everyone regardless of their ability to pay,” she said.

Monson told CPR News that she anticipated there would be organized opposition, with paid ads, but didn’t provide details.

Previous Denverite coverage of Ballot Measure 2Q

Why Denver Health is asking voters for $70 million a year from a new sales tax

Denverites will vote on a sales tax to fund Denver Health this fall

Denver Health has a funding crisis. Is a new sales tax the answer?

Denver Health is at a ‘critical point’ due to rising costs and treating uninsured patients, but its city funding is staying the same

A gaping Denver health budget hole and a ‘vicious cycle’ of costs are key issues for mayoral candidates

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