If GOP ends or at least kneecaps Obamacare, what stops CA from doing single payer?

[yurbud]

Or some other state level improvement?

I recall that the state legislature passed single payer a couple of times when Arnie was governor, only to see him veto it.

Once Jerry Brown was in office, state Dems said to hold off to give Obamacare time to work.

Work or not, Republicans are taking the machetes to it, so California ought to set the example of how to replace it AND show what Democrats will (or at least should) do if they regain control of Congress and eventually the White House.

[KPN]

1. Oregon might even join CA in that.

I would certainly encourage elected officials here and the Dem Party here in OR to pursue it.

[DinahMoeHum]

4. Same with New York.

There's already been a proposition running around the state government, courtesy of NY State Assembly rep Richard Gottfried, to establish a universal healthcare plan.

http://assembly.state.ny.us/leg/?default_fld=&bn=A05389&term=2013&Summary=Y&Memo=Y&Text=Y

http://www.democratandchronicle.com/story/news/2014/12/08/universal-healthcare-newyork-proposal/20096259/

[KPN]

7. Excellent!

There's no reason that States can't actually pool if they so choose. Of course, the devil's in the details -- would be far simpler to construct at a national level -- but that obviously ain't gonna happen in the next few years.

[littlewolf]

2. nothing stopping them other states have tried it.

it didn't work out very well … but CA is free to
try … they have a large enough population ..
it could work .. would be interesting to see.

[yurbud]

5. What were the problems elsewhere?

[littlewolf]

12. to small a user base I think

they tried it in VT but it was too expensive …
they spend something like 2.7 billion in the state
for EVERY program they have ..
single payer was gonna cost in the area
of 2.5 billion alone ….
so they had to canx the program

[SunSeeker]

18. No, single payer died due to political cowardice by Vermont politicians, including Bernie.

The costs were still cheaper than private insurance, but would have entailed eye-popping tax increases on everyone, namely 9.5% income tax increases on the middle class:

Asking the legislature to approve a new 11.5% payroll tax on employers and income taxes on households as high as 9.5% to finance Green Mountain Care would have increased the size of Vermont's 2015 state budget, set at $5.6 billion, by 45%. Even though the taxes would have replaced private insurance premiums that employers and individuals currently pay, and even though the Internal Revenue Service had agreed that the taxes would be federally deductible, in political terms it would have been a mammoth increase that would have been glaringly evident on every Vermonter's tax bill, unlike employer-based health insurance premiums, which most workers fail to notice.

http://www.nejm.org/doi/full/10.1056/NEJMp1501050?query=TOC&utm_campaign=KHN%3A+Daily+Health+Policy+Report&utm_source=hs_email&utm_medium=email&utm_content=17254971&_hsenc=p2ANqtz--hC-SV5xWnbS12zKBh6WxT4cvwWmnIPzz1sEfv_eYvDKifDWu514AjG_ZiBsQrCGK11crxQ8byykFH46XMi2XVMN4Hbg&_hsmi=17254971&

Bernie was all over TV and radio talking up VT single payer...until that number came out. Then he clammed up. All the politicians shyed away, despite the fact that the single payer system would be much cheaper for workers over all, since they pay much more than that for healthcare now. Among ACA marketplace enrollees with incomes between 300 and 400 percent of poverty ($35,310 to $47,080), half face total spending that’s greater than 14.5 percent of their income. https://www.google.com/amp/khn.org/news/study-some-marketplace-customers-spend-25-percent-of-income-on-health-expenses/amp/

Single payer will have to come from the grass roots. Politicians don't have the guts.

[hedda_foil]

8. One other state was Vermont, which was too small to do it as a single state.

I don't remember hearing of any other states trying it since the ACA kicked.

[ProfessorPlum]

10. Vermont never implemented it

they decided the costs would be too high to get it started.

[SunSeeker]

19. No, the politicians got cold feet.

See my post #18: http://www.democraticunderground.com/?com=view_post&forum=1040&pid=15815

[ProfessorPlum]

9. No other states have tried it

Single payer has never been implemented anywhere in the US, including Vermont

[ProfessorPlum]

11. Actually, I should qualify this with the fact that Medicare is of course a single payer system

and it is beloved by those who use it, has very little overhead cost compared to health insurance, and is widely considered a huge success.

So, including all the younger and (generally) healthier people in Medicare would be a great thing.

[golfguru]

3. CA would be a great place to experiment single payer.

I would love to watch the results. If successful, it could start a stampede.

[California_Republic]

6. My hope is California takes over it

My hope is California takes over it and runs it in California style

[n2doc]

13. $$$

For example, under the ACA medicaid expansion was 95% covered by the Feds.

Taxes would have to go up a lot, and there would not be a commensurate decrease in fed taxes for most californians under Trump. The rich will get theirs.

[Ohioblue22]

14. they alreadu knee capped it with the destruction of the risk corridors

[mopinko]

15. medicaid for everyone.

if you are too poor to qualify, buy in to the medicaid program.
no need to reinvent the wheel, just open the doors.

there was some talk of state level single payer when the aca was debated, and iirc bernie was one who fought for that when the public option died.
illinois would be a good state to try it, but we now have a stupid thug of a gov.

[marybourg]

16. I'm pretty sure you mean

Medicare for all. Medicaid is a crippled and unlovable program.

[mopinko]

20. medicaid is a state program.

states are free to make changes in their own eligibility standards.
medicaid is keeping more than one friend of mine alive. yeah, it can be a pain, and it doesnt cover everything.
but the whole thing would be enhanced by adding healthy, paying customers to the pool. said customers would not put up w some of the crap that poor people accept as their lot in life. so, win-win.

[Auggie]

17. Insurance companies?

I expect they'd pull out all stops in lobbying, political donations and obstructionist politics to defeat it.

[SunSeeker]

21. Our cowardly legislators would stop it. It would have to be done as a ballot initiative.

Sadly, even though we had a Dem supermajority state legislature AND a Dem governor, single payer failed in CA in 2012, albeit by just 6 votes. http://m.dailykos.com/story/2012/1/27/1059102/-

But regardless, single payer is a ballot fight one way or the other. Even if we win it in the legislature, the insurance industry will put repeal on the ballot. We should go ahead and get started on a ballot campaign.