SACRAMENTO — In a surprise move that further complicates President Donald Trump’s push to repeal and replace the Affordable Care Act, two California lawmakers today plan to introduce legislation that would create a single-payer health care system covering all 38 million Californians — including its undocumented residents.
The universal health care plan, called the Healthy California Act and being proposed by Sens. Ricardo Lara, D-Bell Gardens, and Toni Atkins, D-San Diego, doesn’t offer much in the way of detail right now. Yet over the years, the idea has periodically gained traction in the Golden State and elsewhere in the U.S., though critics say such plans would require hefty tax increases.
Proponents refute that notion, however, saying taxes would replace insurance premiums, and savings would come from eliminating the huge administrative costs of insurance companies.
The timing is critical for Lara and Atkins: Today is the last day new bills can be submitted during the 2017 legislative session.
As Atkins said in a prepared statement: “In light of threats to the Affordable Care Act, it’s important that we are looking at all options to continue to expand and maintain access to health care. The Healthy California Act is an essential part of that conversation.”
Data this week related to the stunning impact of the 2010 health care law, better known as Obamacare, may help single-payer advocates like Atkins and Lara.
The U.S. Centers for Disease Control and Prevention reported that California’s uninsured rate has dropped from 17 percent in 2013 to 7.1 percent in 2016, a record low for the state. The national uninsured rate is at an all-time low of 8.8 percent, down from 14.4 percent in 2013.
The senators said in a statement that their vision of the bill will be outlined “in the weeks ahead with the people of California.’’
As a starting point, they cite Trump’s Jan. 20 executive order aimed at beginning the process of repealing the Affordable Care Act. The order states that the federal government should “provide greater flexibility to states and cooperate with them in implementing health care programs.”
Proponents say the new bill, which is backed by the California Nurses Association, would ensure:
- Every California resident has one health plan and more choice.
- Californians — not health insurers — can pick their doctors.
- Health care funds would be pooled in a publicly run fund, using the bargaining power of the seventh largest economy.
- Insurance companies’ waste and duplication would end.
- Prescription drug costs would be managed, and out-of-control co-pays and high deductibles would disappear.
“Everyone has a right to health care,” Lara said in a prepared statement. “I look forward to bringing a bill that Californians can support and the governor will sign.”
Late Thursday night, a spokesman for Gov. Jerry Brown declined to comment on the pending legislation.
One issue is that the state relies on about $22 billion of federal funding annually to cover private insurance subsidies linked to plans purchased through the state’s health insurance exchange. It also pays for a provision of the law that greatly expanded Medicaid, the federal and state health care program for the poor (called Medi-Cal in this state), to include adults without dependent children. What would happen to those funds is unclear.
But Brown may be able to lean on public opinion for support for a single-payer system: A Pew Research report last month showed that 60 percent of Americans — up from 51 percent last year — say the government should be responsible for ensuring health care coverage for all Americans, compared with 38 percent who say it should not be the government’s responsibility.
The belief that the government shoulder that responsibility has particularly spiked among lower- and middle-income Republicans, the report said.
Currently, the Pew researchers found, 52 percent of Republicans with family incomes below $30,000 say the federal government has a responsibility to ensure health coverage for all, up from 31 percent last year.
Lara is no stranger to health care legislation, especially on behalf of the state’s poor and undocumented.
Last year, Gov. Brown signed into law the senator’s Health4All Kids bill, which allocates almost $280 million in the coming fiscal year to cover health care costs for 185,000 undocumented California children up to age 18.
Brown also signed a Lara bill that would have allowed undocumented Californians to buy insurance through Covered California, the state’s health insurance exchange, regardless of their immigration status. The legislation would have cost taxpayers little or nothing because the undocumented wouldn’t have been entitled to any government subsidies, and the state filed for a federal waiver under the Affordable Care Act seeking to implement it. But last month, after it was delayed by the Trump administration, Lara withdrew the waiver request.
Anthony Wright, executive director of the nonprofit advocacy group Health Access California, said late Thursday that his group has supported a number of efforts to put in place a single-payer health care system in California. That included Proposition 186, which voters rejected overwhelmingly in 1994, as well as former state Sen. Sheila Kuehl’s single-payer bills that passed the Legislature in 2006 and 2008 but were vetoed by then-Gov. Arnold Schwarzenegger. Wright’s group also backed a 2012 push for a single-payer health care system by former Sen. Mark Leno, D-San Francisco.
While he said he was aware of talk surrounding the new measure bill, he is waiting to see more details.
“California’s health care system is stronger when everyone is included,” Wright said, “and we first need to fight to make sure Congress doesn’t take California further from that goal.’’
California lawmakers to introduce single-payer health care plan today