California’s Progressive Caucus recently hosted the Healthcare is a Human Right forum to discuss Assembly Bill 1690 and Senate Bill 770, which if passed, would advance the effort to establish universal healthcare coverage in the state.
Irene Kao, executive director of Courage California, highlighted SB 770, a unified healthcare financing bill. The bill builds on the recommendations and findings of the Healthy California for All Commission and describes desired features of a state-based healthcare financing system.
“This bill was developed by senior peer advocates, who have worked on every single single-payer bill since 1994—and that includes CalCare—because we believe that single-payer best achieves the goal and principles outlined in the Healthy California for All Coalition.”
— Kao
SB 770 would direct the California Secretary of Health and Human Services to hold discussions with the federal government about waivers that are necessary for California to secure a full share of healthcare funds for a new state healthcare system. It would establish a diverse working group of healthcare stakeholders to assist with resolving healthcare delivery issues. A complete set of recommendations for single-payer waiver application elements must be submitted no later than June 1st, 2024.
“In summary, SB 770 really just establishes tangible steps on a very concrete timeline for the Newsom administration to work with the legislature, and a full range of community stakeholders to design a unified financing system, and again, for us, that means single-payer,” Kao said.
Single-payer advocates view SB 770 as a pathway to include CalCare, or California Guaranteed Health Care For All, into the process. Kao said it’s crucial to engage with Gov. Gavin Newsom, and to incorporate key reform organizations, labor unions, and frontline organizations from Black and Brown communities.
“The healthcare insurance industry in the California Chamber of Commerce are opposing SB 770. They are using the same arguments against SB 770 that they used against CalCare. They are our common enemy in our fight for single-payer healthcare in California.”
— Kao
Assemblymember Ash Kalra (D – San Jose) is a long-time proponent of single-payer healthcare, and spoke on AB 1690, which he is sponsoring. He brought up challenges with the recent AB 1400, which failed to pass in the previous legislative session. He said the bill received vehement opposition during hearings, and expects AB 1690 to experience similar challenges.
“Once enacted, it brings single-payer healthcare to every single person in California. That means there are no copays, there are no premiums, there’s no payment at point of service at all for anyone in our great state. The process to get there is certainly going to be challenging—we know this.”
— Kalra
Kalra added that he will take as many punches as it takes until single-payer healthcare becomes a reality in the state of California. He believes the greatest obstacle in getting single-payer healthcare legislation passed is political will, and will not settle for other forms of health insurance that allow for profit-grabbing or private insurers. He said what excites him the most is that there are now more state legislators in support of a single-payer system than ever before.
Ryan Skolnick, a representative from the California Nurses Association (CNA)—which has led the fight for single-payer healthcare since 1994—said nurses understand the failings of the for-profit healthcare system and reject the notion that profits should come before patients. Skolnick said CNA wishes to transform the system from a profit-seeking one to a healing one, which includes full healthcare coverage from birth until death, and expanding benefits to include comprehensive care as determined by a provider rather than insurance companies.
“This is why CNA unapologetically supports a single-payer system, outlined in CalCare,” Skolnick said. “California can lead the nation in guaranteeing healthcare to everyone as a right. The nurses of CNA will not settle for less.”
The forum panelists were provided opportunities to address comments from the public, including how they will address and overcome opposition to the legislation. Cindy Young, vice president of the California Alliance for Retired Americans, said corporations claim SB 770 would raise taxes and will require workers to give up private insurance coverage.
“Corporate insurance uses healthcare to manipulate workers because what would any of us do to keep our families healthy? We will do anything to keep our families healthy,” Young said, adding that there is plenty of money in the current system to fund everyone’s healthcare. “Seventy percent of what we spend on public healthcare is public dollars.”
Young said the public needs to be educated on what a single-payer system would look like in California, and that it would provide California residents the full-freedom of choice, including seeing any doctor one wishes without having to deal with insurance barriers such as the provider being out-of-network.
“I don’t think there’s a problem with people giving up their private insurance if we can explain that they’re not going to lose benefits—they’re going to gain. Insurers are denying or creating barriers to care, where 50 percent of Californians didn’t get or postponed care last year because they couldn’t afford it.”
— Young
State of Reform reached out to the California Association of Health Plans (CAHP) about the two bills, who shared a letter of opposition to SB 770 that it submitted to members of the Assembly Health Committee in June. The conclusion of the letter follows:
“California has made incredible strides improving access to affordable coverage. The vast majority of Californians are satisfied with their healthcare and want private coverage options. They want the legislature to build on the progress we’ve made, not overhaul our healthcare system, especially while we are still dealing with the ramifications of the pandemic.
SB 770 seeks authority California doesn’t need to pursue a new healthcare system Californians don’t want. We urge the legislature to build on the progress we’ve made and pursue constructive, viable solutions to further improve access to affordable healthcare.”
According to the California Health Care Foundation, private health insurance accounted for the greatest amount of healthcare spending at a total of $125 billion in 2020. During that year, healthcare spending in California averaged $10,299 per person. From 2015 to 2020, California’s per capita spending on healthcare grew at an average annual rate of 5.2 percent—more than one percentage point faster than that of the entire country (4.1 percent).
The Peterson-KFF Health System Tracker shows that in 2021, health spending per person in the US was $12,914, or over $5,000 more than any other high-income nation, including Austria, Canada, France, and Sweden. Higher healthcare spending and costs means that more individuals are struggling to pay for rising medical expenses, copays, and even rent or food.
“[The opposition paid] literally hundreds of lobbyists … they bought out almost every firm in Sacramento,” Kalra said. “There’s a reason why the opposition is very scared of CalCare, and you don’t see that same fear with any other legislation that’s been introduced, and it’s because they know that CalCare is a comprehensive, single-payer legislation that answers the questions as to how we move forward with a single-payer bill.”
In order to finalize funding for a single-payer system, several panelists agreed that the state needs to gain legislative authority by passing a single-payer bill prior to seeking federal waivers. As of yet, AB 1690 is an “intent bill” and will receive a floor vote next year, as will SB 770.