California Governor’s race will likely turn on support for single payer proposals

California’s gubernatorial primary will winnow a crowded field today. Though current Lt. Governor Gavin Newsom is the widely projected front-runner in the top two primary, perhaps the most interesting results for the California health care discussion lie in the race for number two and the winner’s stance on single payer proposals.

Because of California’s unique “jungle primary” structure, the top two candidates from today’s election, regardless of party affiliation, continue on to the general election in November. In the strongly Democratic state, this could mean the difference between a relatively easy victory for Newsom, a strong advocate for a single payer, against a Republican challenger like John Cox, or a more nuanced debate on the future of California’s health system, with the most likely Democratic challenger Antonio Villaraigosa.

After an endorsement from Donald Trump last week, Cox, a successful businessman from Illinois, is polling in second placed as of last Thursday with 20% support, successfully seeming to consolidate the Republican vote. Cox staunchly opposes a state run single-payer system stating, “It’s just another very expensive welfare program for people who do not pay into the system.” In opposition he cites the “staggering” 400 billion estimated cost to the state, lack of choice, and lack of accountability.

Meanwhile, the Democratic vote has splintered between Villaraigosa and two other challengers with largely similar stances on health care, State Treasurer John Chiang, and Former state schools chief Delaine Eastin. Though Villaraigosa won and endorsement by the L.A. Times, most recent polling indicates this fracturing puts him in a likely third or even fourth spot and out the race moving forward.

For single payer supporters, a Cox “win” could be a boon as many predict the state’s strong Democratic leanings, and Newsom’s popularity and strong support of single payer will propel him to an easy victory against Cox in November. However, if Villaraigosa can manage to land the number two spot, the discussion could get more interesting.

Villaraigosa has supported the idea of universal healthcare buts  favors a more incrementalized approach.  In a fight against Newsom, his voice could force a more realistic and nuanced discussion as to how the state would pay for a single payer system, projected by some to require the state health care spend to double, and require Medicare and Medicaid waivers, which are not likely give the federal climate on health care. Either way, one implication of today’s vote is clear, the issue of single payer health care in California will lead the debate heading into in November.