Los Angeles Times Essential Politics
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Single-payer healthcare plan advances in California Senate — without a way to pay its $400-billion tab
Patrick McGreevy June 1, 2017
A proposal to adopt a single-payer healthcare system for California took an initial step forward Thursday when the state Senate approved a bare-bones bill that lacks a method for paying the $400-billion cost of the plan.
The proposal was made by legislators led by Sen. Ricardo Lara (D-Bell Gardens) at the same time President Trump and Republican members of Congress are working to repeal and replace the federal Affordable Care Act.
“Despite the incredible progress California has made, millions still do not have access to health insurance and millions more cannot afford the high deductibles and co-pays, and they often forgo care,” Lara said during a floor debate on the bill.
The bill, which now goes to the state Assembly for consideration, will have to be further developed, Lara conceded, adding he hopes to reach a consensus on a way to pay for it.
Republican senators opposed the bill as a threat to the state’s finances.
“We don’t have the money to pay for it,” Sen. Tom Berryhill (R-Modesto) said. “If we cut every single program and expense from the state budget and redirected that money to this bill, SB 562, we wouldn’t even cover half of the $400-billion price tag.”
Berryhill also said the private sector is better suited to provide healthcare.
“I absolutely don’t trust the government to run our health system,” he said. “What has the government ever done right?”
Lara’s bill would provide a Medicare-for-all-type system that he believed would guarantee health coverage for all Californians without the out-of-pocket costs. Under a single-payer plan, the government replaces private insurance companies, paying doctors and hospitals for healthcare.
The California Nurses Assn., which sponsored the bill, released a fiscal analysis this week that proposed raising the state sales and business receipts taxes by 2.3% to raise $106 billion of the annual cost, with the rest proposed to come from state and federal funding already going to Medicare and Medicaid services.
Sen. Ted Gaines (R-El Dorado Hills) called the plan “reckless” and said the taxes would hurt businesses and families while financially crippling the state government.
“It’s offensive to the people who have to pay for it,” he said.
Some Democrats felt the bill was rushed and undeveloped. Sen. Ben Hueso (D-San Diego) withheld his vote on the bill on grounds it does not provide enough detail of what a single-payer system would look like.
“This is the Senate kicking the can down the road to the Assembly and asking the Assembly to fill in all of the blanks,” Hueso said. “That’s not going to happen this year.”
Lara said action is required because of what is happening in Washington.
“With President Trump’s promise to abandon the Affordable Care Act as we know it — for one that leaves millions without access to care — California is once again tasked to lead,” he told his colleagues.
He said his father recently had heart bypass surgery but went through the emergency room for help after his insurance company initially turned him down.
Even if the bill is approved, it has to go to Gov. Jerry Brown, who has been skeptical, and then voters would have to exempt it from spending limits and budget formulas in the state Constitution. In addition, the state would have to get federal approval to repurpose existing funds for Medicare and Medicaid.