California Could Be on the Verge of Passing Single-Payer Health Care

[BeckyDem]

Posted on January 28, 2022 by Yves Smith

Imagine living in a society where a medical diagnosis does not trigger crippling fears of the cost of treatment and prescription drugs, where switching jobs or being laid off didn’t include considerations around health insurance coverage, where trips to the emergency room don’t generate thousands of dollars in bills, and where the out-of-pocket cost of seeing a doctor is zero.

If two-thirds of California’s state legislators choose to cast votes in favor of Assembly Bill 1400, they could soon make such a society a reality for the residents of the nation’s most populous state.

The bill, introduced by State Assemblyman Ash Kalra in early January and sponsored by the California Nurses Association, would establish a publicly funded system in California guaranteeing free-of-charge health care to all residents, including immigrants. The system, dubbed CalCare, would cover medical, dental, and vision care, as well as mental health care. There would be no monthly premiums, co-pays or deductibles. Health care providers would simply bill the state government rather than insurance companies or patients.

Excerpt: Yet the naysayers are up in arms with utterly depressing predictability. Los Angeles Times columnist George Skelton, who has a history of excoriating single-payer health care policies, wrote yet another screed, dubbing AB 1400 “contentious” and complaining on behalf of for-profit corporations that “insurance companies would be shoved aside” if CalCare were to become a reality.
https://www.nakedcapitalism.com/2022/01/california-could-be-on-the-verge-of-passing-single-payer-health-care.html

( Yea, we should worry about preserving the profits of insurance companies...can you imagine thinking that never mind writing it in a column to defend them? )

[JohnSJ]

1. This is far from a sure thing. It failed last time in 2017 because they didn't allocate a way to

pay for it.

https://calmatters.org/newsletters/whatmatters/2022/01/california-single-payer-health-care-vote/

"The bill is now slated to go before the entire Assembly for a vote — and it must pass by Jan. 31 in order to stay alive. That possibility was foreclosed in 2017, the last time a single-payer proposal came up for consideration, when Assembly Speaker Anthony Rendon shelved the measure without a hearing, protecting Democrats from a politically sensitive vote on a progressive priority with no plan to pay for it.

But, as CalMatters political reporter Alexei Koseff notes, lawmakers who have gladly dodged the issue for five years will now have to take a position — and there’s a price tag attached. A legislative analysis released Thursday estimated single-payer could cost California between $314 billion and $391 billion annually, financed by a series of tax hikes on businesses, workers and high earners. Single-payer supporters, however, say that sum is smaller than what Californians pay for private insurance."

[BeckyDem]

2. This kind of legislation will not be a sure thing in any state until we see at least one break

through.

Fingers crossed and all that.

[ColinC]

3. Right. Something needs to be proven to work as a blueprint for others...

[Hoyt]

4. Raising taxes in California has been tough in recent years. I'd bet that Gov Newsom's plan

-- the universal health coverage -- will have a better chance right now because it requires the state to pay for all low-income people’s health care costs.

Would love to see California enact a plan that covers everyone, but it won't be cheap because of adding in dental, vision, and removing copays/deductible.

[JohnSJ]

5. There needs to be more details, such as do people on Medicare have to pay into it, and what about

those who are happy with their employer healthcare plans?

https://calmatters.org/newsletters/whatmatters/2022/01/health-care-taxes-california/

"Here’s a closer look at how state lawmakers are proposing to pay for universal health care, which state analysts in 2017 estimated could cost about $400 billion annually:

A 2.3% excise tax on businesses after their first $2 million in income.
A 1.25% payroll tax on employers with 50-plus workers.
An additional 1% payroll tax on wages for resident employees earning more than $49,900.
A progressive income tax starting at 0.5% for Californians earning more than $149,500, up to 2.5% for people making about $2.5 million annually. (Those rates would also be adjusted for inflation.)"

and while all that sounds reasonable, because of the high costs to live here, more Californians and businesses are moving out of the state, and if that continues, there might be a problem

[LoisB]

6. Good questions. I am on Medicare and would love to be able to opt into something that would

cover dental and vision at no or very reduced cost.

[JohnSJ]

7. Here is more information I found on the proposed taxes

https://calmatters.org/newsletters/whatmatters/2022/01/health-care-taxes-california/

"Here’s a closer look at how state lawmakers are proposing to pay for universal health care, which state analysts in 2017 estimated could cost about $400 billion annually:

A 2.3% excise tax on businesses after their first $2 million in income.
A 1.25% payroll tax on employers with 50-plus workers.
An additional 1% payroll tax on wages for resident employees earning more than $49,900.
A progressive income tax starting at 0.5% for Californians earning more than $149,500, up to 2.5% for people making about $2.5 million annually. (Those rates would also be adjusted for inflation.)

But the funding source — taxes — proposed in a separate bill will likely face an uphill battle. Tax hikes must be approved by two-thirds of lawmakers in both the state Assembly and Senate — a tall order, especially in an election year — and a majority of voters to go into effect. And the doctors’ lobby, insurance industry and business groups are already mobilizing against the bill."

and while all that sounds reasonable, because of the high costs to live here, more Californians and businesses are moving out of the state, and if that continues, there might be a problem

It is too bad we cannot implement a National Single Payer Plan. Also, I am not sure if people are aware that single payer does not mean no cost to the insured, just like Medicare is not free.

[LoisB]

8. Thank you. Yes, this is going to be an uphill battle. I can't imagine the 1% payroll tax on

employees earning more than $49,900 even the $149,500 being something individual taxpayers would accept. $49,900 is poverty level wages in CA.

[JohnSJ]

9. it sure is

[MichMan]

10. My guess is that there would no longer be anymore employer provided heathcare

Can't see too many employers getting hit with payroll taxes for single payer continuing to pay for their employees health care on top of that

[Hoyt]

11. Dang. Apparently the Bill did not get a vote on floor.

“ California's single-payer dreams have been dashed again.

Legislation to create what would be the nation’s first government funded state-run health care system failed to get a vote Monday on the Assembly floor, effectively ending the push for single-payer this session. . . . . .”

https://www.politico.com/news/2022/01/31/californias-single-payer-bill-dies-00003924

[BeckyDem]

12. Oh my goodness, so many were looking forward to the vote.

Thank you for posting the update.

[Hoyt]

13. Just read it. Knew it would be tough, but hoped for better results.

[BeckyDem]

14. Yep. A constant fight, we must stay vigilant.

[Aristus]

15. Imagine a world in which uncompensated emergency room care isn't written off by the hospital,

and passed on to the tax-payer.

That's just one of many thousands of benefits everyone could enjoy under a single-payer system. But as long as stupid loud-mouths keep screaming "SOCIALISM!!!", we're never going to have those benefits.