While Republicans in Washington work to scale back government’s role in health care, Democrats in Sacramento are moving forward with a single-payer proposal that would virtually eliminate health insurance companies in California and put a $370-billion statewide system in bureaucrats’ hands.
The plan going to the state Senate Appropriations Committee on Monday could cost Californians more and faces substantial hurdles to enact. But it promises to provide everybody in the state — including those here illegally — with care that in most cases would be superior and easier to access than what they have now.
“It’s the only way to guarantee health care for every Californian in a sustainable way, especially given efforts in Washington to roll back coverage,” said Michael Lighty, director of public policy for the California Nurses Association. The union is sponsoring the measure.
Unlike Obamacare or the GOP proposal to replace it, there would be no out-of-pocket expenses — no deductibles or co-pays. Californians could visit any doctor without a referral and the plan would include dental, vision, mental health and nursing home coverage.
But huge questions loom about costs. The Democrat-backed bill, known as SB 562 or the Healthy California Act, passed the Senate Health Committee on a party-line vote in April although it lacked a detailed financial analysis or a comprehensive funding plan. Lighty said more details will be presented to the Appropriations Committee on Monday, although funding possibilities to be unveiled will be designed to “start the conversation” rather than provide definitive solutions.
That’s not good enough for Sen. Janet Nguyen, who is vice chair of the Health Committee and voted against the measure last month.
“I believe it won’t work and that’s why there aren’t any details,” the Fountain Valley Republican said. “I think (Democrats) think it will just all work out. But this is people’s health. We can’t take this lightly and hope it will all work out.”
Nadereh Pourat, director of research at UCLA’s Center for Health Policy Research, agreed there were thorny details to be resolved but suggested a wait-and-see approach as the proposal is fleshed out.
“This says, ‘We’re going to completely overhaul everything,’” Pourat said. “It’s ambitious and that makes the path to approval uphill. The broad brush strokes are there. But the question is how it’s going to navigate a very complex health care system.”
Allure of single-payer
The California Legislature twice before approved a single-payer health plan — in 2006 and 2008 — only to watch then-Gov. Arnold Schwarzenegger veto both. In doing so, he cited cost, financial burdens on employers and the complicated task of transitioning to a huge new bureaucracy.
At least 10 other states have pursued the idea, but only Vermont actually put a plan in place. That effort lasted less than three years before being abandoned in 2014. An