‘We Did Not Have The Votes’: California Single-Payer Bill Dies
Assembly Bill 1400 aimed to create a so-called single-payer health care system in California that would essentially replace private insurance with a state-run health system.
It faced intense opposition from a coalition of powerful health care organizations, including the California Medical Association representing doctors and the California Association of Health Plans representing insurance companies. The bill threatened the existence of private insurance companies and would have overhauled the health care system, prompting fierce push-back from many parts of the industry.
The bill by Assemblyman Ash Kalra, D-San Jose, outlined the policy framework for a single-payer system. To fund it, lawmakers would have also needed to pass a separate bill to increase taxes on people making more than $49,900 per year. The taxes Kalra proposed would also require voter approval.
"Despite heavy opposition and substantial misinformation from those that stand to profit from our current healthcare system, we were able to ignite a realistic and achievable path toward single-payer and bring AB 1400 to the floor of the Assembly," Kalra said in a statement. "However, it became clear that we did not have the votes necessary for passage and I decided the best course of action is to not put AB 1400 for a vote today."
Kalra said the fight for single-payer health care won't die with AB 1400. Lawmakers could craft a different bill to implement such a system in the future.
The bill's failure represents a blow to the California Nurses Association, which had backed the bill.
"Assembly Member Ash Kalra, the main author of the bill, chose not to hold a vote on this bill at all, providing cover for those who would have been forced to go on the record about where they stand," the union wrote in a statement. "Nurses condemn this failure by elected representatives to put patients above profits."
Assembly Speaker Anthony Rendon also criticized Kalra for not bringing the bill up for a vote.
"I'm deeply disappointed that the author did not bring this bill up for a vote today," the Lakewood Democrat wrote in a statement. "With time, we will have better and more successful legislation to bring us closer to this goal."
This isn't the first time a bill to create a single-payer system has died in the Assembly. The Senate advanced a similar bill in 2017, but it died in the Legislature's lower chamber.
Gov. Gavin Newsom did not weigh in publicly on Kalra's bill before the San Jose Democrat announced its demise. Newsom has said he supports single-payer health care, although he has not backed a plan to put the system in place since becoming governor.
California is already poised to become the first state to make health care coverage available to everyone regardless of immigration status. That proposal is part of Newsom's state budget plan. But although the vast majority of Californians theoretically have access to health insurance, millions still don't have coverage, primarily due to high costs, according to a study by UCLA researchers released Monday.
Supporters of single-payer health care say consolidating health care costs into one government program and moving away from private insurance would save many people money in the long run, despite higher taxes to pay for the program up front.
But higher taxes are a tough sell, even in the California Legislature where Democrats hold a super-majority. Many people called into a committee hearing earlier this month to criticize the proposed taxes. Democratic and Republican lawmakers alike raised serious concerns about the bill during the hearing, although most Democrats on the Assembly Health Committee voted to advance it.
Assembly Republican Leader Marie Waldron of Escondido cheered the bill's failure in a statement Monday, and criticized those who had supported it.
"The fact that a proposal for a government takeover of our state's entire health care system even made it this far shows just how out of touch the Democratic party is from the needs of everyday Californians," she wrote.
Fiscal analyses estimate the bill could cost between $314 billion and $391 billion per year if it were implemented. That would dramatically increase total state spending; California's current budget is $262 billion.
To pay for it, Kalra proposed taxing businesses 2.3% of their income after the first $2 million through a proposed amendment to the California Constitution. His proposal would also have imposed a 1.25% payroll tax on employers of 50 or more people and an additional payroll tax on wages for California residents over $49,900 per employee.
The measure would have added progressive income taxes starting at .5% for people making more than $149,500, up to 2.5% for people making more than about $2.5 million per year.
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