California Proposes Single-Payer Healthcare System

A California Assembly committee recently approved two measures to overhaul the Golden State’s healthcare system with the goal of providing free coverage to all residents.

Well, “free” in the sense that residents wouldn’t have a co-pay, monthly premiums, or any out-of-pocket expenses to see their primary care provider or visit a hospital for major procedures. But, we all know that there is no such thing as a free lunch (or health physical), so who are they proposing pay for all these medical appointments? 

Taxpayers, of course. But only the wealthy ones. This is good if you’re stuck in the middle income brackets, but bad if you’d like to achieve upward mobility in your earnings. Assembly Bill 1400 looks to set up CalCare and the accompanying Assembly Constitutional Amendment 11 seeks to change the state’s tax code to pay for it through a voter referendum. 

State leaders from both parties have theoretically supported the single-payer system. But even Democratic Governor Gavin Newsom hasn’t pledged full support for this pair of bills that would dramatically alter the healthcare system as Californians know it. And even if the plan does pass through the state legislature, a voter referendum to change the tax code would need to be authorized, and that won’t show up on a ballot until at least 2024. 

Other states have tried out single-payer systems before, and all have thrown in the towel before enactment or shortly thereafter. Vermont adopted this type of system in 2011, but it only lasted three years before folding due to rising costs and lagging tax revenue. Colorado and Massachusetts similarly attempted to create a single-payer system, but the bills didn’t pass in either state. 

Even California has tried this system before. In 1994, a proposal appeared on the ballot that would have created a single-payer statewide system, but it didn’t receive enough votes to pass. Then again in 2017, a single-payer system was introduced in the state legislature and passed the Senate, but didn’t get a vote in the assembly due to concerns over its $400 billion cost. 

Supporters say that AB 1400 has worked out the kinks that stymied its passage before. Those who want it to pass say their goal is to obtain health coverage for all Californians, regardless of immigration status. California is home to a large population of immigrants, mostly Hispanic, who travel with the harvest seasons to work the fields as crops are collected from the fields. This demographic is an important part of California’s economy, and the fruit and vegetable supply for much of the country, but since many are undocumented aliens, obtaining healthcare, admission to college, and other benefits of citizenship have long been difficult – if not impossible – for them. 

AB 1400 would give California a taxpayer-funded system like those found in the United Kingdom, Canada, and Japan. The bill’s success or failure in passage and potential implementation will be closely watched by policymakers in other states, as well as the federal government and citizens, as many are faced with growing medical bills or lack of health insurance altogether. 

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