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After ambitious single-payer health plans fail, a new California bill tries an incremental approach

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A new bill introduced in the California State Senate aims to lay the foundation for a universal statewide health care system, proposing an incremental approach that moves away from recent radical and unsuccessful efforts to reshape the way that Californians get care.

Under the measure by State Sen. Scott Wiener (D-San Francisco), California would begin the process of seeking a waiver from the federal government to allow Medicaid and Medicare funds to be used for a single payer, a first in the nation. Health Care System.

“In the wake of the devastation of COVID-19, and as costs for workers have skyrocketed, the need to provide affordable health care to all Californians has never been greater,” Wiener said in a statement. He touted his move as “tangible steps on a concrete timeline to achieve universal and more affordable health care in California.”

The legislation would require the California secretary of health to provide recommendations on the development of the federal waiver by June 1, 2024.

Advocates say single-payer health care, which would cover all California residents and be funded entirely by state funds (including reused federal dollars), is more efficient than our current system, in which care Available and cost depend on whether a person has private insurance. , are enrolled in a public plan like Medi-Cal, or do not have insurance.

Universal health care is a top priority for progressives, who have rallied around the “Medicare for All” plan championed by Sen. Bernie Sanders (I-Vt.) during both of his presidential runs. A 2017 California bill to establish a single-payer system passed the state Senate but was shelved by Assembly Speaker Anthony Rendon (D-Lakewood).

The setback galvanized the left wing of the Democratic Party, which saw single-payer as a litmus test for political candidates, and Gov. Gavin Newsom embraced the cause during his 2018 campaign.

On his first day in office in 2019, Newsom called on Congress and the White House, then occupied by President Trump, to change federal laws that would allow California to pursue a single-payer system.

But Newsom has focused more on expanding coverage in California for people living in the country illegally. Meanwhile, his 2019 budget created a commission to explore steps to achieve universal healthcare; that panel issued its final report last year.

Newsom declined to weigh in on the latest major legislative push for single payer, a bill by Assemblyman Ash Kalra (D-San Jose). That measure was abruptly withdrawn by Kalra last year after fellow Democrats balked at the price, which ranged from an estimated $341 billion to $391 billion.

The leading advocate of a single-payer system, the California Nurses Association, criticized Kalra for refusing to bring the bill to a vote on the floor of the Assembly. But they are partnering with Kalra again this year in a renewed effort to pass universal healthcare, which they called CalCare.

Kalra’s bill is sparse on details at this time, indicating that the bill’s sponsors anticipate an extended campaign to build support among both lawmakers and grassroots activists. The Nurses Union is sponsoring 45 events across California this weekend to rally support for their effort.

Wiener’s legislation takes a decidedly more modest tack, focusing solely on the federal waiver process. Sal Rosselli, president of the National Union of Healthcare Workers and a supporter of the bill, said this approach reflects lessons learned from the failure of two more comprehensive and highly contested measures.

“From my point of view, this is not controversial at all,” Rosselli said. “Our governor, the administration, the Senate, the Assembly, the majority of our elected leaders support this system to fix our health care.”

Still, he acknowledged that fierce opponents of single-payer, largely healthcare industry major interests, may have a different opinion.

“I don’t expect the industry to support this at any level,” he said.

Preston Young, a policy advocate for the California Chamber of Commerce, said the business group was wary of the plan.

“Regardless of the incremental approach, the fact remains that a state-operated, single-payer health care system will cost taxpayers hundreds of billions of dollars annually,” Young said.

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