The California Senate approved a measure Thursday aimed at establishing a government-run universal health care system in the Golden State.
The system, which would replace Obamacare – or what follows it under the Trump administration – would dramatically overhaul the health care market in California. Approved on a 23-14 vote, it now moves to the Assembly.
“With President Trump’s promise to abandon the Affordable Care Act as we know it, it leaves millions without access to care and Californians are once again tasked to lead,” said Sen. Ricardo Lara, D-Bell Gardens. “Senate Bill 562 will finally enable California to cover all of its residents, creating a healthier and stronger state.”
Lara introduced SB 562 with Sen. Toni Atkins, D-San Diego, earlier this year.
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Under the plan, government would negotiate prices with doctors, hospitals and other providers, acting as the “single payer” for everyone’s health care in the place of insurance companies. All Californians would receive coverage regardless of immigration status or ability to pay.
The bill does not include detailed language about how the state would come up with hundreds of billions of dollars to pay for health care coverage for nearly 40 million residents.
SB 562 would have to return to the Senate floor for another vote if it is amended in the Assembly with a funding plan. If that happens, the bill would require a two-thirds majority in each house to advance to the governor’s desk. In its current form, the bill only required a majority vote to pass.
Senators on both sides of the aisle spoke against the proposal and the lack of a clear way to pay for it.
“I can’t think of a more effective way to cripple the state financially than to charge ahead with what appears to be a reckless plan,” said Sen. Ted Gaines, R-El Dorado Hills.
Sen. Ben Hueso, D-San Diego, said the Senate should have sent the Assembly a more thought-out proposal.
“We are not debating single payer today because we are not debating a funding source,” Hueso said. “We are not debating delivery of service. We are not debating where the health savings will come from. None of that is in the bill. This is the Senate kicking the can down the road to the Assembly and asking the Assembly to fill in all the rest of the blanks.”
Many Democrats who supported SB 562 said they wanted to keep the conversation and idea alive. Some described it as a starting point and expressed confidence that Lara and Atkins would continue to refine the bill and figure out a way to pay for it, among other changes.
Sen. Bob Hertzberg, D-Los Angeles, called the proposal necessary because the health care system “is upside down.”
“Do not judge us based on a vote in a day,” Hertzberg said. “Judge us on our work at the end of the day.”
Atkins said she understood the concerns of her colleagues and described it as a difficult and historic opportunity.
“I took this on because it is a right that I believe people should have,” Atkins said. “I’m more convinced of that today than I ever have been.”
The Senate voted the day after the main supporter of the bill released a funding study conducted by the University of Massachusetts Amherst. The California Nurses Association commissioned the university to examine ways to pay for the program.
Cost has been an insurmountable road block for similar attempts to create a universal health care system in California in the past. The nurses attempted to alleviate financial concerns by laying out a path to pay for the plan using a mix of existing and new tax structures.
Amherst researchers estimated it would cost $331 billion to pay for the plan, a sharp decrease from the $400 billion price tag detailed in a Senate analysis released in May. The nurses’ figure also represents an 18 percent decrease from current health care spending in the state.
The nurses say the Legislature can count on $225 billion in existing federal and state funding used for health coverage for low-income Californians, as well as other tax subsides, to help pay the tab. The study suggests lawmakers also create two new taxes in the state: a 2.3 percent gross tax on businesses revenue above $2 million and a 2.3 percent general sales tax on everything except housing, utilities, groceries and other necessities.