Diane Mitsch Bush sup­port­ed Medicare for All before she was against it.

Lau­ren Boe­bert doesn’t have a health care plan, only vague goals and a his­to­ry of crit­i­ciz­ing the Afford­able Care Act.

With few­er than 80 days to go before the Nov. 3 elec­tion, health care has emerged as a top issue in Colorado’s close­ly ed 3rd Con­gres­sion­al Dis­trict. It’s not a big sur­prise, giv­en that both health insur­ance and health care are par­tic­u­lar­ly expen­sive and hard to access on the West­ern Slope and in oth­er parts of the far-flung district.

It is Boe­bert, a Repub­li­can, who has placed the issue front and center.

“Diane Mitsch Bush is a lying social­ist who sup­ports social­ized med­i­cine,” the nar­ra­tor in a recent Boe­bert ad states. “Nobody likes a liar, Diane. Nobody.”

On at least two occa­sions in 2018, Mitsch Bush, a Demo­c­rat, stat­ed on social media that she sup­port­ed a sin­gle-pay­er, Medicare for All sys­tem in which the gov­ern­ment pro­vides health care cov­er­age, rather than pri­vate insur­ers. But on July 29, she flat­ly told KREX in Grand Junc­tion, “I don’t sup­port Medicare for All.”

Boe­bert has seized on that reversal.

“Can you hear her poll­sters and polit­i­cal hacks explain­ing to her she can’t win on her social­ized med­i­cine scheme, so she had bet­ter just lie about her posi­tion and try to scare peo­ple about me?” Boe­bert wrote in a Pueblo Chief­tain op-ed Aug. 8.

Mitsch Bush said in a state­ment Thurs­day that she has “nev­er sup­port­ed the elim­i­na­tion of pri­vate insur­ance” but instead sup­ports “allow­ing peo­ple to buy into Medicare or a pub­lic option.” Dur­ing a 2018 debate, how­ev­er, she tout­ed a spe­cif­ic piece of leg­is­la­tion — HR 676, the Expand­ed and Improved Medicare for All Act — that would “vir­tu­al­ly elim­i­nate pri­vate med­ical insur­ance,” accord­ing to an analy­sis and at least one of the bill’s sup­port­ers in Congress.

Boebert’s cam­paign, mean­while, says that Chief­tain op-ed is the total­i­ty of her health care plan at this stage in the race. There are no specifics in the opin­ion piece, only a series of aspi­ra­tions: price trans­paren­cy, pro­tect­ing peo­ple with pre-exist­ing con­di­tions, mak­ing health care afford­able, increas­ing access to care.

“I will nev­er vote for leg­is­la­tion that will leave Col­oradans with­out health care cov­er­age,” she wrote.

Pro­tec­tion for peo­ple with pre-exist­ing con­di­tions is already required under cur­rent law, the decade-old Afford­able Care Act. Mak­ing health care more afford­able, more trans­par­ent and more eas­i­ly acces­si­ble are vague goals both polit­i­cal par­ties strive for with vary­ing suc­cess. Near­ly all leg­is­la­tion, includ­ing the exist­ing Afford­able Care Act and Repub­li­cans’ ACA repeal efforts, do leave or would leave some Col­oradans with­out health care coverage.

Boebert’s cam­paign spokes­woman declined to say whether Boe­bert believes the ACA, a 2010 health care over­haul col­lo­qui­al­ly known as Oba­macare, should be repealed. But Boe­bert has repeat­ed­ly crit­i­cized Rep. Scott Tip­ton, the Cortez Repub­li­can she defeat­ed June 30, for fail­ing to repeal the ACA while in Congress.

“You know, we had an oppor­tu­ni­ty in 2017 to repeal Oba­macare and once again my oppo­nent (Tip­ton) vot­ed no,” Boe­bert told an online show called “Steel Truth” in May. “He had a chance to put a yes vote to that and he said no and he’s sup­posed to be a conservative.”

Boebert’s claim was false — Tip­ton sup­port­ed the Amer­i­can Health Care Act, a Repub­li­can ACA repeal effort, in 2017 — but her remarks make clear that she sup­ports a repeal of Obamacare.

Repeal­ing the Afford­able Care Act with­out a replace­ment would leave the 159,338 Col­oradans who receive health insur­ance through the state’s ACA mar­ket­place with­out cov­er­age, among oth­er dis­rup­tions to the health care system.

“My oppo­nent has no plan to make health care more afford­able for peo­ple in the 3rd (Dis­trict), and instead she wants to take health care away from hun­dreds of thou­sands of peo­ple dur­ing a nation­al health care and eco­nom­ic cri­sis,” Mitsch Bush said Thurs­day. “We can’t let that happen.”

Some of Colorado’s high­est rates of unin­sured peo­ple are in north­west Col­orado, along the I‑70 cor­ri­dor and in south­west Col­orado — all part of the 3rd Dis­trict, said Lin­da Gann, a Mon­trose-based out­reach direc­tor with Con­nect for Health Col­orado, which over­sees the state’s indi­vid­ual insur­ance marketplace.

“It’s about two things: cost and access,” Gann said. “Both are a prob­lem out here.”

More peo­ple on the West­ern Slope buy their insur­ance off the indi­vid­ual mar­ket­place than else­where in the state, which is more cost­ly than receiv­ing it through an employ­er, and insur­ance rates are gen­er­al­ly high­est there, accord­ing to state health care experts.

“There’s usu­al­ly just one hos­pi­tal that’s at all con­ve­nient to a town, and that hos­pi­tal can charge pret­ty high prices to insur­ers,” said Joe Hanel , com­mu­ni­ca­tions direc­tor for the non­par­ti­san Col­orado Health Institute.