A yellow stethoscope and a red paper heart on a green background. Photo by Karolina Grabowska from Pexels.
Photo by Karolina Grabowska from Pexels

Unfortunately, California lawmakers keep finding excuses to prevent that from happening.

How It Started

In 2017, California Assembly Member Anthony Rendon (Democrat) blocked SB 562. If passed, the bill would have given Californian’s access to single-payer health care. Here are some key paragraphs from the bill:

…This bill, the Healthy California Act, would create the Healthy California program to provide comprehensive universal single-payer health care coverage and a health care cost control system for the benefit of all residents of the state. The bill, among other things, would provide that the program cover a wide range of medical benefits and other services and would incorporate health care benefits and standards of other existing federal and state provisions, including, but not limited to, the state’s Children’s Health Insurance Program (CHIP), Medi-Cal, ancillary health care or social services covered by regional centers for persons with developmental disabilities, Knox-Keene, and the federal Medicaid program. The bill would seek all necessary waivers, approvals, and agreements to allow various existing federal health care payments to be paid to the Healthy California program, which would then assume responsibility for all benefits and services previously paid for with those funds…

…The bill would prohibit health care service plans and health insurers from offering health benefits or covering any service for which coverage is offered to individuals under the program, except as provided. The bill would authorize health care providers, as defined, to collectively negotiate rates of payment for health care services, rates of payment for prescription and nonprescription drugs, and payment methodologies using a 3rd-party representative, as provided…

California Legislative Information website

Blocking the bill sparked an attempt to oust Anthony Rendon via a recall effort in 2017-2018. Ballotpedia provides the following information:

…The recall effort was launched by single-payer proponents after Rendon, who serves as speaker of the California State Assembly, blocked SB 562 – a bill that would have established a single-payer healthcare system in California. It passed the California State Senate on June 1, 2018. Rendon announced on June 23, 2017, that SB 562 would be held in the state Assembly’s rules committee until further notice…

… In the statement, Rendon said that while he supports a single-payer system, he opposed SB 562 because it did not address issues related to funding, delivery of care, or cost controls. Moreover, he said it did not consider the role that the administration of President Donald Trump (R) would have to play for a single-payer system to be implemented. He also said that the bill could be brought back during the 2018 session if the state Senate addressed the issues he identified…


The recall effort against Rendon failed. The proponents had until February 20, 2018, to collect the 22,963 signatures needed to trigger a recall election. They announced the end of the effort on February 8, 2018.

Where it Went

On January 10, 2022, California Governor Gavin Newsom (Democrat) proposed a plan that would offer universal health care to Californians. His proposal would have made California the first in the nation to offer universal access to health care coverage. The plan was described on “The California Blueprint”, Newsom’s list of five things he intended to take on as a state.

From The California Blueprint (under the Tackling The Cost of Living part):

…Create Universal Access to Healthcare Coverage: Governor Newsom’s Blueprint will make California the first state in the nation to offer universal healthcare coverage for all state residents, regardless of immigration status…

The California Blueprint

According to Paso Robles Daily News, (in an article posted on January 12, 2022), the California Blueprint would provide a full expansion of Medi-Cal (the state’s Medicare system) to all eligible Californians regardless of immigration status, including an estimated 764,000 undocumented immigrants. In 2016, California’s Medi-Cal covered all eligible undocumented low-income children regardless of immigration status.

In 2019, Medi-Cal was extended to cover all eligible undocumented young adults up to the age of 26. And in 2021, California became the first in the nation to expand full-scope Medi-Cal eligibility to low-income adults age 50+, regardless of immigration status. Newsom’s blueprint would expand full-scope eligibility to individuals 26-49, making Medi-Cal available to all income-eligible Californians, again, regardless of immigration status.

On January 18, 2022, Cal Matters posted an article titled: “Newsom backs away from single-payer health care pledge”. It was written by Dan Walters. From the article:

…While running for governor in 2018, Newsom pledged to create a single-payer system for California, making the state the sole supplier of coverage…

…That pledge won Newsom the support of single-payer advocates. The California Nurses Association decked out a bus that toured the state with a picture of Newsom’s face and the words: “Nurses Trust Newsom. He shares our values and fights for our patients.”

However, once elected, Newsom did virtually nothing to implement the promise. Instead, as the state’s finances allowed, he extended Medi-Cal coverage incrementally to undocumented immigrants and others lacking private or public coverage…

…The differences between universal coverage and single-payer are more than semantic. The former includes a wide variety of public and private health insurance plans, many of which have coverage limits and patient co-pays, while the latter would provide unlimited benefits free of out-of-pocket costs, much like Great Britain’s National Health Service.

Providing universal coverage, as Newsom defines it, is doable by spending a few additional billion dollars in the state budget. Single-payer, on the other hand, would require the federal government to give the state the $200-plus billion is [sic] now spends on Californian’s health care and the state to raise taxes more than $150 billion a year…

Cal Matters

What the Bill Included:

On January 24, 2022, AB-1400, the Guaranteed Health Care for All bill, was presented to the California Assembly. The bill was introduced by Assembly Members Ash Kalra (Democrat). Alex Lee (Democrat), and Miguel Santiago (Democrat).

Here are some interesting parts of AB-1400:

  • Every resident of the state shall be eligible and entitled to enroll as a member of CalCare.
  • A member shall not be required to pay a fee, payment, or other charge for enrolling in or being a member of CalCare.
  • A member shall not be required to pay a premium, copayment, coinsurance, deductive, or any other form of cost sharing for all covered benefits under CalCare.
  • A college, university, or other institution of higher education in the state may purchase coverage under CalCare for a student, or a student’s dependent, who is not a resident of the state.
  • An individual entitled to benefits through CalCare may obtain health care items and services from any institution, agency, or individual participating provider.
  • The board shall establish a process for automatic CalCare enrollment at the time of birth in California

The CalCare Board would govern CalCare. The board would be made up of 9 voting members with demonstrated and acknowledged expertise in health care, plus the Secretary of California Health and Human Services or their designee as a nonvoting, ex officio member. The bill would provide the board with all the powers and duties necessary to establish CalCare, including determining when individuals may start enrolling into CalCare, employing necessary staff, negotiating pricing for covered pharmaceuticals and medical supplies, establishing a prescription drug formulary, and negotiating and entering into necessary contracts.

The bill would also provide for participation of health care providers in CalCare, including the requirements of participation agreement between a health care provider and the board, provide for payment for health care items and services, and specify program participation standards. The bill would prohibit a participating provider from discriminating against a person by, among other things, reducing or denying a person’s benefits under CalCare because of a specified characteristic, status, or condition of the person.

On or before July 2024, the board shall conduct and deliver a fiscal analysis to determine both of the following:

  • Whether or not CalCare may be implemented
  • Whether revenue is more likely than not to be sufficient to pay for program costs within eight years of CalCare’s implementation
  • The board shall contract with one or more independent entities with the appropriate expertise to conduct the fiscal analysis.
  • After the board has determined whether or not CalCare may be implemented and if program revenue is more likely than not to be sufficient to pay for program costs within eight years of CalCare’s implementation, CalCare shall not be further implemented until the Senate Committee on Health, Assembly Committee on Health, Senate Committee on Appropriations, and Assembly Committee on Appropriations consider, and the Legislature approves, by statute, the implementation of CalCare.

What Happened?

CBS8 posted an article on February 1, 2022, titled: “Why single payer died in the California Legislature, again”. It was written by Alexi Koseff (CalMatters). From the article:

Despite, or perhaps because of, an aggressive last-minute push by progressive activists ahead of a crucial deadline, legislation to create a government-run universal health care system in California died Monday without coming up for a vote.

The single-payer measure, Assembly Bill 1400, was the latest attempt to deliver on a longtime priority of Democratic Party faithful to get private insurers and profit margins out of health care. Because it was introduced last year, when it stalled without receiving a single hearing, it needed to pass the Assembly by Monday to continue through the legislative process…

…After several tense hours Monday afternoon, during which a scramble of meetings took place just off the Assembly floor, Assemblymember Ash Karla, the San Jose Democrat carrying AB 1400, announced that he would not bring up the measure for a vote

National United Nurses (California Nurses Association) posted a statement regarding AB 1400:

“…Today, elected leaders in California had the opportunity to put patients first and set an example for the whole country by passing AB 1400, the California Guaranteed Health Care for All Act, in the State Assembly. Instead, Assembly Member Ash Kalra, the main author of the bill, chose not to hold a vote on this bill at all, providing cover for those who would have been forced to go on the record about where they stand on guaranteed health care for all people in California.

“Nurses condemn this failure by elected representatives to put patients above profits, especially during the worst surge of Covid-19 yet, at a time when it’s more clear than ever before that health care must be a right, not just a privilege for those who can afford it…”

National Nurses United

Bloomberg Quint posted an article that was updated on February 1, 2022, titled: “Single-Payer Health Bill Fails to Get California Assembly Vote”. It was written by Laura Mahoney. From the article:

…Assemblymember Ash Kalra (D) and Speaker Anthony Rendon (D) acknowledged they didn’t have enough votes to form a majority of members to pass the bill (A.B. 1400) despite Democrats holding more than two-thirds of seats in the legislature’s lower chamber. The system, called CalCare, would have made California the single payer for health insurance for state residents and take the place of employer-provided plans…

…The proposal faced stiff opposition from business groups and legislative Republicans, but its failure Monday was because of a lack of support from within the Democratic Party. Opponents objected to the tax increases that would be necessary to fund the system – an estimated $163 billion in new taxes that would require voter approval through a separate measure…

Bloomberg Quint

Where Do We Go From Here?

Californians need to keep pushing our legislature to enact single-payer health care. One of the ways to do that is to contact you California Senator and/or Representative and make it abundantly clear that you are in favor of single-payer health care.

As mentioned in the article from CalMatters, single-payer health care would provide unlimited benefits free of out-of-pocket costs, much like Great Britain’s National Health Service. Universal health care includes a wide variety of public and private health insurance plans, many of which have coverage limits and patient co-pays – and that could turn out to be too expensive for many Californians to afford.

California Needs Single Payer Heath Care is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites.

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