With the health care of millions of Californians at stake if Congress repeals the Affordable Care Act, a state senator is introducing legislation Friday to establish a single-payer system.
Under single-payer, the state would negotiate prices for services and prescriptions with providers, pharmaceutical companies and others.
Sen. Ricardo Lara, D-Bell Gardens, said he intends to introduce a bare-bones measure and begin a conversation with stakeholders about the best way to move forward.
“This is an issue that we need to lead on now more than ever, given the rhetoric we hear in Washington,” Lara said. “Dismantling the Affordable Care Act has been part of (President Donald) Trump’s agenda all along. As California leaders, we will be responsible for the delivery of health care for millions of people.”
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Lara envisions a system that would “cut out insurance company waste and duplication that currently exists.”
“There’s no more out-of-control co-pays and high deductibles,” he said.
Last month at Lara’s urging, California withdrew a request to the federal government for permission to allow undocumented people to obtain health insurance from Covered California, the state’s health care exchange. Lara, linking the decision to concerns about the incoming Trump administration, called it “the first California casualty of the Trump presidency.”
Lara said Thursday that a single-payer health care system would enable the state to extend coverage to undocumented adults. Meanwhile, the current budget included $45 million to provide full Medi-Cal coverage to 185,000 undocumented children.
California lawmakers have considered single-payer and other comprehensive health care measures over the years.
In 2003, then-Gov. Gray Davis signed Senate Bill 2, which created a new employer-funded health care program for people who lacked employer-provided health insurance.
Business groups, though, gathered enough signatures to put the measure before voters, blocking it from taking effect. Proposition 72 narrowly failed in November 2004.
In 2005, then-Sen. Sheila Kuehl, D-Santa Monica, introduced a bill that would have created a single-payer California health care system. A committee analysis projected that it would cost about $167 billion, with about $72 billion of that covered by existing federal, state and local revenue, while the rest would come from various new taxes.
Gov. Arnold Schwarzenegger vetoed the bill in 2006. “Socialized medicine is not the solution to our state’s health care problems,” he wrote in a lengthy veto message.
The next year, Schwarzenegger championed universal health care legislation that required everyone to have a minimum level of health insurance. The proposal, with provisions similar to what would become the federal Affordable Care Act, stalled in the state Senate in 2008.
The following year, then-state Sen. Mark Leno, D-San Francisco, pushed another attempt to create a single-payer system. It passed the state Senate but did not come up for an Assembly vote.
RoseAnn DeMoro, executive director of the National Nurses Association and the California Nurses Association, said political circumstances have changed dramatically since past defeats. The nurses sponsored Lara’s bill and Sen. Toni Atkins, D-San Diego, is a joint author.
“I think there’s been a seismic shift,” DeMoro said. “The debate over the (Affordable Care Act) has brought to light all of the flaws of the health care system.”
Politically, she said, the nurses association will draw on supporters of Sen. Bernie Sanders’ presidential campaign in California.
“These are folks who are willing to engage and hold legislators’ feet to the fire,” she said. “This isn’t just nurses.”