This isn’t the first time Assemblymember Ash Kalra has tried to create a single-payer health coverage system in California.
The San Jose Democrat first introduced Assembly Bill 1400 about three years ago. Called Guaranteed Health Care for All, it sought to create CalCare — a universal, single-payer health care coverage and cost control system for the state.
It made it through the Assembly’s Health and Appropriations committees, reaching the floor of the Assembly in February 2022. It died without a vote.
That bill was followed about a year ago by Assembly Bill 1690. Also introduced by Kalra, the bill states that the Legislature intended to “guarantee accessible, affordable, equitable, and high-quality health care for all Californians through a comprehensive universal single-payer health care program.”
It never reached a committee hearing and died Feb. 1 when it missed a crucial deadline.
Kalra this week followed that legislation with Assembly Bill 2200, called the California Guaranteed Health Care for All Act. It seeks to enact a framework of benefits, standards and cost controls for single-payer health care.
Lawmakers were quick to offer differing opinions.
“The status quo needs to change and inaction is not an option,” Kalra said in a statement. “AB 2200 will start the necessary process of revolutionizing health care access in this state and asserting that health care is truly a human right.”
State Senator Brian Dahle pushed back this week.
“This will be disastrous, and patients will die while waiting for care,” the Bieber Republican posted on X, formally Twitter.
Kalra’s move to implement a single-payer system is supported by the California Nurses Association.
“From our experiences caring for patients, nurses have known the need for and fought for decades for everyone to have guaranteed health care through a system like CalCare,” said Cathy Kennedy, a registered nurse and a president of the California Nurses Association, in a statement. “The Covid pandemic just underscored the desperate societal need for this program now. CalCare will ensure that public health — not profit — is the priority of our health care system.”
Kalra pointed to a lack of change since he first introduced legislation to create a single-payer system. Wealth, occupation and where someone lives play significant roles in a person’s health outcomes. That means disadvantaged people have a bigger chance of facing bankruptcy, illness and death.
The California Guaranteed Health Care for All Act improves upon its predecessors, Kalra said. Among other changes, it lists gender-affirming care and a large offering of reproductive care as benefits. It requires more investment by health care providers into recruiting and retaining health care workers. And it requires physicians and medical doctor representation on the CalCare board.
Funding for the act would come from different sources.
Existing federal health care payments would go to CalCare. It would then take responsibility for paying for those benefits and services. Additionally, the bill would create the CalCare Trust Fund in the state treasury, which would hold federal and state dollars intended for the health care system.
However, the problem with that funding is it would require governmental waivers and potentially federal legislation, said Richard Scheffler, professor of health economics at UC Berkeley. That makes the bill appear “aspirational.”
“Single-payer might be a good idea, but the key question is — how do you finance it?” Scheffler said.
Scheffler was appointed by Governor Gavin Newsom in December 2019 to serve on the Healthy California for All Commission. The commission studied a single-payer system and reached that conclusion: a good idea, but money is lacking.
According to Scheffler, the bill cleverly states that its enactment would hinge on state officials determining how they’d finance it. Newsom could sign it, which would signal his health policy during a potential presidential run more than anything.
“It’ll be interesting to see if he signs it,” Scheffler said.
The bill’s future is cloudy, as any bill introduced this year must pass its house or origin by May 24. That gives lawmakers just over three months to address it along with the hundreds of other bills introduced since the legislative session reconvened on Jan. 3.
Additionally, legislators and Newsom are wrangling over a budget deficit of what the Legislative Analyst’s Office says is $68 million, or $38 million, according to the governor. Newsom vetoed several bills last year that would have impacted the budget, pointing to state finances as a main reason.
Kalra introduced his new attempt at creating a single-payer system in California about a week before the Feb. 16 deadline to file bills.
Other bills lawmakers will address, or potentially shelve, include two bills focused on the therapeutic use of psychedelics in treatment.
Assembly Bill 941 — written by Assemblywomen Marie Waldron, a Valley Center Republican — would create a workgroup to study psychedelics in therapy. Senate Bill 1012 — introduced by Senator Scott Wiener, a San Francisco Democrat — would allow adults who are at least 21 to use psychedelics in a therapeutic setting. It doesn’t allow personal use or sale outside of that therapy.
Newsom vetoed a related bill last year, saying a regulated framework should be included in any legislation. Wiener said his new bill is a reponse to the governor.
Senate Bill 954 — introduced by Senator Caroline Menjivar, a San Fernando Valley Democrat — would require public schools to make free condoms available to students in ninth through 12th grade.
Newsom vetoed a similar bill written by Menjivar last year. The senator’s office said that the new bill focuses on condoms only and doesn’t include the human papillomavirus vaccine aspect in the other bill. Supporters will address financial concerns in a companion bill.
Assembly Bill 2205 — introduced by Assemblymember Joe Patterson, a Rocklin Republican — would require the state Public Utilities Commission to reduce the kilowatt-per-hour electricity rate for ratepayers by at least 30%.
“I know this will take a Herculean effort,” Patterson posted on X. “But we need to stop talking about shifting around costs and start talking more about bringing the price of electricity down.”
Senator Steve Min, an Irvine Democrat, introduced Senate Bill 929. It would require the California secretary of state to determine whether a candidate for president or vice president meets the qualifications for the office. If they determine a candidate doesn’t, that person’s name would be prohibited from being on the ballot.
Min’s bill came about a month after the Colorado Supreme Court ruled that former President Donald Trump couldn’t appear on that state’s ballot, as it determined he was ineligible due to the constitution’s insurrection clause. The issue of whether Trump can appear on that state’s ballot was argued Thursday before the U.S. Supreme Court.