Single Payer Health Care is Back on the Table at the California Capitol


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This week, California lawmakers will make the latest attempt to have all residents of the state covered by the same health plan – an idea called single-payer health care – which has sparked debate on Capitol Hill for the past five years. years.

Under the new plan, dubbed CalCare, all Californians would be insured by the same entity and could access any doctor, regardless of the network. Supporters argue it will reduce price hikes and give all residents equal access to care.

AB 1400 is sponsored by the California Nurses Association, which single payer legislation was first introduced in 2017. At the time, the proposal had an estimate Price of $ 400 billion and no source of funding.

After its failure, an Assembly committee gathered to discuss options for reforming the state health care delivery system. The committee made recommendations on how to make coverage more affordable and accessible for all Californians, which informed the legislation that emerged in the following years.

The new proposal would create a tax to fund the single-payer option. The tax would apply to businesses making more than $ 2 million, businesses with 50 or more employees, and individuals making more than about $ 150,000 per year.

Carmen Comsti, senior regulatory policy specialist with the nurses association, says the tax will generate between $ 160 billion and $ 170 billion per year.

“We are talking about ensuring that everyone receives full benefits with no copayments or deductibles,” Comsti said.

Opponents argue that a single-payer system eliminates choices for those who might prefer to stay on a private plan, and that lawmakers should instead work to make sure everyone is insured and all coverage is affordable – a often called model universal health care.

A coalition that includes the California Association of Health Plans, the California Hospital Association and the California Medical Association released a statement on the new proposal.

“Californians need and deserve a stable health care system they can count on at all times, especially now,” wrote coalition spokesperson Ned Wigglesworth. “We urge lawmakers to reject this legislation that will jeopardize the health care of residents of our state when they need it most.”

The coalition also expressed concern that the proposed tax structure places an economic burden on Californian families.

Comsti said taxes are necessary to reform an “unsustainable system”.

“We are already paying all of the health care costs in California,” she said. “With single-payer health care, we could pay less overall. “

Governor Gavin Newsom was a proponent of single-payer healthcare during his campaign, but more recently, he has advocated for options that build on the current system.

Chairman of the Assembly Health Committee Jim Wood (D-Santa Rosa) announced Thursday that he will vote to move the proposal forward, citing frustration over high drug prices, insurance company profits, denial of claims and other problems with the current and fragmented healthcare system.

People are angry, ”Wood told CapRadio. “They are frustrated, they are afraid of getting sick and the system is broken.

Wood said the proposal had “a long way to go” and that he would put his concerns in writing for the bill’s mover, Ash Kalra (D-San Jose). He said the main reasons single payer failed in the past were cost and opposition from health plans and other business interests.

He said it’s important to keep discussing all potential solutions, even if they ultimately don’t cross the finish line.

“For me, no is not the answer,” said Wood. “We are going to have to fix this problem and we are going to have to make improvements to the system because it is not going to go away..

Wood is also proposing his own bill, AB 1130, which would establish an office of healthcare affordability to analyze spending across the healthcare system and come up with ways to reduce costs related to plans, hospitals. and prescription drugs.

To move forward, AB 1400 must pass the health committee by January 14 and pass the assembly by January 31.


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