Update on this: I definitely didn't want to have to take the caliper off and try to re-install the piston, so I unscrewed the fluid hose clamp so I had more flexibility in moving the caliper around. I set it on a bucket and used a 24" breaker bar for more leverage to pry the piston. I put the breaker bar through the caliper and leveraged it against the underside of the control arm - or maybe it was the cross member? Anyway, that's all it needed - just a little more muscle. The next issue I had is when slipping the new pads into the caliper with the break pad shims, the rubber boot on the piston would slip off a bit because the tolerance was so tight. I had to re-install the metal ring around the base of the rubber boot a few times, which is not easy when the piston is compacted. I was finally able to get around this issue by installing the pads and shims into the caliper then installing the caliper into position. Not a big deal, but added a few hours to what should have been an easy job.
All of this nonsense because of a broken piston ratchet tool. I need to find a better tool. I like the low or no budget option, but in my case, when you push one piston down, the another one pops up so they all need to be compressed at the same time to make the job easy / quick.