Gavin Newsom slow rollout of single-payer health care action

from Dan WaltersCalMatters

This comment was originally posted by CalMatters. Sign up for their newsletters.

Government-provided universal health care is the holy grail of those on the political left, so its advocates in California cheered — or at least most did — when Gov. Gavin Newsom signed Senate Bill 770 three years ago.

The legislation stems from a commission appointed by Newsom to study how health care can be expanded, saying, “As our march toward universal coverage continues, I am calling on the brightest minds — from the public and private sectors — to serve on the Healthy California for All Commission to improve the health of our state.”

The report of the committee endorsed a “single financing system” as the most efficient way to provide universal health care. But it does not specify a single-payer system, which has angered some advocates of that approach.

SB 770 directed state officials to negotiate with the feds to transfer health care money that now flows from Washington — roughly 50 percent of the state’s total public and private medical spending — to the state.

The federal funds will partially fund a “comprehensive package of medical, behavioral health, pharmaceutical, dental and vision benefits that includes primary, preventive and wellness services.”

The California Nurses Association, the main single-payer advocate, opposed the measure, describing Newsom’s endorsement as “a complete betrayal of nurses’ fight for single-payer health care policy, a fight that seeks to achieve health equity for our patients and our communities.”

During his 2018 gubernatorial campaign, Newsom won the union’s support by stating, “I’m tired of politicians saying they support single-payer, but that it’s too soon, too expensive, or someone else’s problem.”

Once elected, however, Newsom backed away from the pledge, describing it as “ambitious” and citing the inherent difficulty of getting the federal government to cooperate.

Instead, Newsom supported a gradual expansion of Medi-Cal, the state’s health care program for the poor, a goal that appeared to be achieved in 2022, when coverage was extended to all undocumented immigrant adults to take effect in 2024.

“I campaigned on universal health care,” Newsom said in a subtle departure from his single-payer pledge in 2018. “We’re delivering that.”

However, the expansion meant the state had a surplus of nearly $100 billion, which never materializes. By 2025, expansion costs have grown to $6.2 billion more than expected and the state was experiencing multi-billion dollar deficits. Newsom and the Legislature froze enrollment to stem the bleeding.

Last month, legislative leaders were deadlocked Assembly Member Ash Kalra a third attempt to pass a single-payer system called CalCare, rejecting the San Jose Democrat’s system 1900 Assembly Bill without a hearing.

That disappointed the California Nurses Association, which said in a statement: “The failure to advance (AB 1900) shows a lack of leadership and capitulation to the corporate interests of health care.”

However, SB 770, the bill Newsom signed in 2023, has been working on the back burner as the state’s Health and Human Services Agency commissioned a study from UCLA’s Center for Health Policy Research on how a unified health care plan could be implemented.

The 181-page UCLA report was released last month, just as legislative leaders were quietly killing Kalra’s legislation.

They had also asked UCLA, specifically its California Health Benefits Review Program, to evaluate the financial impact of AB 1900. They were told that a single payer will cost $731.4 billion annuallyr — more than three times the state General Fund budget of $238 billion — plus a reserve fund of $109 billion.

Meanwhile, the Office of the Legislative Analyst, in a new reportpredicts that the 2 million Californians without health insurance will likely double by 2030 due to federal and state cuts.

A cynical — or realistic — view of this series of events is that Newsom has been slow to fulfill his 2018 campaign promise by appointing a committee and signing SB 770, ensuring that the single-payer issue can be dragged out until his successor takes office in 2027.

When questioned in forums, some leading Democratic candidates — most notably Tom Steyer and Katie Porter — approved single payer while others offered less drastic alternatives.

It’s deja vu.

This article was originally published on CalMatters and is republished under Creative Commons Attribution-NonCommercial-No Derivatives license.