What the 2026 CA gubernatorial candidates would do on health care

from Ana B. IbarraCalMatters

This story was originally published by CalMatters. Sign up for their newsletters.

Every day, Californians struggle to afford medication or wait weeks or months for mental health appointments. Thousands of the “sandwich generation” combine caring for elderly parents with raising children.

These are the main problems of health care. Californians want to see a speech from the next governor according to a recent survey. The candidates vying to succeed Gov. Gavin Newsom offered their views — and addressed the Trump administration’s impending cuts to safety net programs — at recent forum at UC Riverside, hosted by Philanthropic Foundations.

“The reality is that too many Californians face barriers to health and wellness in our state,” said Richard Tate, president and CEO of the California Wellness Foundation, one of the event’s sponsoring organizations. He said the forum is planned to be held in the Inland Empire, where residents experience some of the greatest disparities in health outcomes.

The forum featured four candidates, all Democrats. Former U.S. Health and Human Services Secretary Xavier Becerra, state Superintendent of Public Instruction Tony Thurmond, former Los Angeles Mayor Antonio Villaraigosa and former state Comptroller Betty Yee agreed that the state’s response to federal cuts will require them to push for efficiencies in the health care system — and look for new sources of revenue. They disagreed on how to fund the state’s response.

To better understand health care issues in the nascent governor’s race, CalMatters also reached out to front-runners who weren’t in attendance: former Congresswoman Katie Porter, Riverside County Sheriff Chad Bianco and former Fox News host Steve Hilton. All three are welcomed in a recent study by the California Wellness Foundation. None of them returned interview requests or responded to questions about their health policy priorities or vision by deadline.

Becerra touted his attempt to oppose Trump

If elected, Becerra promises to be the state’s “health governor,” a title Gov. Gavin Newsom has also often assumed.

Becerra, 67, touted his experience responding to a public health emergency and negotiating lower drug prices in President Biden’s office. It did this for drugs like blood thinners, diabetes drugs and others as part of a Medicare drug negotiation program. And as a former attorney general he sued the previous Trump administration 123 times. He has positioned himself as a strong opponent of federal health care cuts.

“We’re not going to bow the knee to what Donald Trump has done to health care,” Becerra said. “We’re not going back.”

An estimated 3.4 million Californians will lose coverage as a result of the Trump administration’s cuts to the Medicaid program approved in this year’s federal spending plan. And if Congress doesn’t renew increased premium subsidies for the Affordable Care Act by the end of the year, another 400,000 who buy health plans through Covered California could be cut out.

Closing those gaps is a tall order for the state, but he said it’s worth overhauling the tax code to make sure billionaires pay their fair share to help fund the safety net.

“We can be rational when it comes to our tax book. But then let’s put the money where it needs to be for health care,” Becerra said. “I can tell you right now, too much money is being wasted.”

That’s because spending should prioritize preventive care and keeping people healthy first, he said.

“We need to secure (people) at the front door, not the emergency room.”

Thurmond proposes a single-payer system for California

Among Thurmond’s boldest visions is that of creating a single-payer government system, where a public entity manages health care financing — acting as an insurer, paying providers and covering medical costs for everyone. That’s an idea once released by Newsombut abandoned due to its cost and complexity.

Thurmond, 57, says his support for the single-payer system stems from watching his brother die of a rare liver disease. His brother couldn’t afford health insurance, he said, and stopped going to the doctor even though he was sick.

But such a system would take years to create, hundreds of billions of dollars, and require federal approval.

Rather, Thurmond said he would seek legislation to expand requirements for employers to provide quality health care to their workers. “We have a lot of employers in this state that require their employees to get health care through public assistance. And if you do that as an employer, you’re going to be held accountable,” Thurmond said. “On the other hand…If you do the right thing, we’ll reward you with tax credits.”

Like Becerra, Thurmond also supports the idea of ​​taxing the wealthy to increase health care funding.

If elected, Thurmond has pledged to work with Congress to restore cuts to Medicaid and other safety net programs that the Trump administration made in its latest federal spending plan.

Villaraigosa: ‘Focus on the basics’

Villaraigosa, 72, says he wants to get back to basics. In the state budget, that means prioritizing public safety, health and education in that order, he said.

Villaraigosa presents himself as more pragmatic than his opponents. It does not support a single-payer system; he argued that was unrealistic because the state could not afford the upfront costs and because the Trump administration, which must approve such plans, would reject it.

The state’s response to a federal administration gutting the safety net, he said, will require innovative solutions and a health care system that is more efficient — exactly what that will look like remains to be determined.

“I’m not going to sell you snake oil. It’s going to be difficult to provide that care, but I’m absolutely committed to it,” Villaraigosa said.

Alone among the panelists, Villaraigosa was less interested in raising taxes to generate more revenue, sidestepping the issue and saying only that he would like to look for ways to “grow the pie.”

“We already have the highest taxes in the United States of America and the highest cost of living,” he said.

But like his opponents, Villaraigosa said he wants to grow the mental health workforce — to do that, you have to incentivize people with adequate pay, he said. “The problem is access because people can’t find a doctor to give them care when they get seven dollars for that visit,” he said.

Yee wants strict accountability

Betty Yee, a 68-year-old former state inspector, wants to be an accountability manager.

Like his opponents, Yee has made improving access to mental health a high priority. Part of the reason Californians struggle to find appropriate care, she said, is that regulatory agencies do not strictly enforce the state’s Mental Health Parity Act, which requires insurers to cover physical and mental health equally.

“We’re not looking at our health systems in terms of whether they continue to build a robust network of providers to address the mental health of our diverse populations,” Yee said. “So we actually need better oversight of what is currently the law here in California.”

Yee is an advocate of growing what works. Anti-poverty programs like the Earned Income Tax Credit and the Young Child Tax Credit have been successful in putting extra dollars in the pockets of low-income Californians, Yee says. She says she would like to be “bolder” with these refundable tax credit programs and expand them to help ease some of the financial burden on caregivers, especially those of the sandwich generation.

Yee said California can’t replace federal cuts with loans alone; she supports raising taxes on top earners to fund the safety net.

“But before we do that,” Ee said, “I want to make sure that we’re making our health care system much more efficient and that we’re really going to have a much better chance of increasing access and affordability for Californians.”

Supported by the California Health Care Foundation (CHCF), which works to ensure that people have access to the care they need, when they need it, at a cost they can afford. Visit www.chcf.org to learn more.

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