In Historic Vote, California Senate Passes Single-Payer Bill to Provide Comprehensive Health Care to All Residents

A work-in-progress? A model for the nation? Or a step off the fiscal cliff?

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The California Senate voted Thursday to approve a statewide single-payer health care system. The 23-14 vote, mostly following party lines, came after a lengthy debate in which Democratic backers admitted the bill’s details were far from finalized, while Republicans bemoaned creating a government-run system they predicted would leave the state in ruins.

“SB-562 will establish a state-based universal care system and provide comprehensive care coverage to every single Californian. This bill, I know, is a work-in-progress—Sen. Atkins and I know there is a lot more work to do,” said Sen. Ricardo Lara, D-Bell Gardens, the bill’s co-sponsor, primarily referring to its lack of a financing mechanism.

“This legislature believes it can fund a $400 billion bureaucracy—it seems glib to me that it’s ‘a work-in-progress,’” said Sen. John Moorlach, R-Costa Mesa. “I don’t know how we complain about Washington, D.C. making changes to health care and saying they’re vague, when we’re vague… I see this is as being on the wrong road heading straight for a fiscal cliff.”

The bill passed the Senate, where Democrats hold a 27-13 majority, though did not say how the estimated $400 billion cost in providing comprehensive health care to every resident would be paid for. Currently, the combined state and federal government health care subsidies add up to $225 billion annually. The rest, if it replaces private insurance premiums for individuals and businesses, would need to come from some combination of revenue-raising measures.

What’s been proposed so far are two vastly different approaches. The Senate Appropriations Committee staff said it could come from a 15 percent hike in the state payroll tax, essentially doubling it. The bill’s sponsors and the largest institutional supporter, the California Nurses Association, released an analysis Wednesday that said single-payer would cut statewide coverage costs by $60 billion from the current system, and could be paid by raising two taxes by 2.3 percent each: the gross receipts tax paid by businesses after their first $2 million in income, and a similar-sized increase in the sales tax.

The Senate floor debate did not discuss these details, but mostly focused on whether the state legislature needed to keep working on the bill or not. Everyone agreed that Friday’s crossover deadline—when bills have to pass from one body to another to possibly become law—was unfortunate. However, most Democrats said that the issue was too important to stop.

“I see a zillion holes in it, but I am going to vote for it today because I think at the end of the day the question is worth debating,” said Sen. Bob Hertzberg, D-Van Nuys. “At the end of the day we are a legislative branch of government and our job is to deliberate. Our job is to ask hard questions. Our job is to take a look at what is coming at us and try to figure it out. And the message to those people who say we’re irresponsible, I tell you do not judge us based upon a vote in a day; judge us based upon our work at the end of the day.”

Republicans took the opposite position, saying single payer would be a disaster and repeating the health care industry’s talking points.

“This bill, as written, will force people out of their current health care system and embracing a purely governmental-run system, run by government bureaucrats who have failed us too often,” said Sen. Jeff Stone, R-Indio. “For those of my constituents that have Kaiser, if this law gets passed, Kaiser said at the committee hearing they will close their doors here in California. Aetna will leave. HealthNet will leave. Blue Cross, Blue Shield, non-profit hospitals. So much for freedom of choice.”

Some Democrats, however, said the bill is premature.

“As its supporters said, it is a work-in-progress,” said Sen. Steven Glazer, D-Orinda. “And for me, rather than rushing to pass it before it’s complete, we should keep it here and finish the work. The voters will ultimately have to have a final say on any plan of this scope because it conflicts with existing provisions in the [state’s] constitution. My view is we should finish the policy work, pair it with real sustainable funding sources, and then we should put it on the ballot in 2018.”

Senate president Kevin De Leon, D-Los Angeles, closed the debate by saying the process was at a midway point and it did not have a funding mechanism—which would require a super-majority to pass—to keep the proposal moving through the legislative process.

“But I’m not sure if we had this fully cooked, if in fact, everyone would actually vote for this measure. That’s another issue unto itself,” he said. “We are at a halfway point with this measure. If we move this measure, we will engage still with our colleagues, our friends on the Assembly side. And I invite my Republican friends and colleagues to be part of this discussion.”

The California Nurses Association was quick to praise the Senate's vote.

“This is a banner day for California, and a moral model for the nation,” said RoseAnn DeMoro, executive director of the California Nurses Association and National Nurses United, lead sponsor of SB 562, the Healthy California Act. “California senators have sent an unmistakable message today to every Californian and people across the nation. We can act to end the nightmare of families who live in fear of getting sick and unable to get the care they need due to the enormous cost. We’ve shown that health care is not only a humanitarian imperative for the nation, it is politically feasible, and it is even the fiscally responsible step to take.”

Steven Rosenfeld covers national political issues for AlterNet. He is the author of several books on elections, most recently Democracy Betrayed: How Superdelegates, Redistricting, Party Insiders, and the Electoral College Rigged the 2016 Election (March 2018, Hot Books).


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