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California Single Payer Legislation AB 1400

Summary: Excitement in California, the most populous state in the US and very progressive: single payer legislation is forging ahead. AB 1400 passed out of committee and is headed to the Assembly floor. It mandates seeking federal approvals, financing details and approval by ballot initiative, and enabling legislation. If all proceeds smoothly, CalCare will begin operation in 2024. A huge effort to support the bill is underway, and will be crucial going forward.

AB-1400 Guaranteed Health Care for All
California Legislative Information
Downloaded 16 Jan 2022

This bill … would create the California Guaranteed Health Care for All program, or CalCare, to provide comprehensive universal single-payer health care coverage and a health care cost control system for the benefit of all residents of the state. The bill would provide that CalCare cover a wide range of medical benefits and other services and would incorporate … the federal Children’s Health Insurance Program, Medi-Cal, ancillary health care or social services covered by regional centers for persons with developmental disabilities, Knox-Keene, and the federal Medicare program. The bill would require … waivers, approvals, and agreements to allow various existing federal health care payments to be paid to CalCare

[Requirements to become operative:] the CalCare Trust Fund has the revenues to fund the costs of implementing the act, the people of California have approved the necessary revenue mechanisms, and the Legislature has approved implementation of the CalCare by statute.

California Nurses Association celebrates major milestone toward winning guaranteed health care in the state
Press Release
January 20, 2022

… AB 1400, the California Guaranteed Health Care for All Act (known as CalCare) that would establish a single-payer health system for the state, passed out of the appropriations committee today and moves to the full Assembly for a vote.

Newsom campaigned on single-payer health care for California. This proposal needs his help
January 21, 2022
BY Sacramento Bee Editorial Board

Gov. Gavin Newsom made guaranteed health care a central piece of his gubernatorial campaign some four years ago, promising specifically to deliver a single-payer system that would give every resident free access to comprehensive treatment.

In an April 2018 interview with the San Francisco Chronicle, however, Newsom … muddied his position by telling the newspaper’s editorial board that “it is not an act that would occur by the signature of the next governor. There’s a lot of mythology about that.”

The real act of political courage would be supporting AB 1400, which enjoys much more legislative backing than previous proposals. Its supporters include Assembly Speaker Anthony Rendon, who let the last single-payer proposal die in 2017.

Perhaps Newsom could take his own advice from that year. As he tweeted, “I’m tired of politicians saying they support single payer but that it’s too soon, too expensive or someone else’s problem.”

Single-payer healthcare is the right system. Can California build it on its own?
Los Angeles Times
JAN. 14, 2022
BY Michael Hiltzik Business Columnist

It’s on the margins … where the system breaks down. “A lot of people with really, really lousy health insurance didn’t know it because they never had to use it,” healthcare commentator Jonathan Cohn told me last year. “If they did get a tragic healthcare problem — a car accident, or cancer, or a child with a congenital problem — for the first time they have to use their health insurance and now they’re discovering what it doesn’t cover.”

The problem of uninsured and underinsured Americans is also largely invisible to hose with coverage, but it should be a concern for everybody. Healthcare is a communal benefit, undermined by the inequities that deprive too many Americans and too many Californians of access to healthcare.

CalCare would address those marginal but significant costs. Yes, it would be audacious, but in the context of a country in which healthcare reform has stagnated and compared with states that appear resolved to move backward in their standards of public health, it could be another policy to make Californians proud.

Comment by: Jim Kahn

AB 1400, known as CalCare, is an excellent single payer bill, with leadership from the California Nurses Association. Recently amended by adding conditions for launching (notably, ballot approval of funding and legislative action for implementation), the bill has broadened legislator support. Passage of this version will be a huge step forward, if not quite the final step.

Support in the press is showing up, as seen in these columns from the Sacramento Bee and Los Angeles Times. (Alas, there are skeptical voices as well.) The upcoming report from the Healthy California for All Commission will be important.

Ongoing education and advocacy efforts are critical. To help, check out these websites:

California OneCare
Health Care for All
CNA / National Nurses United

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