Sen. Ricardo Lara on Thursday released some provisions of a proposed single-payer health care system that would drastically alter California’s insurance market, but details about how it would be financed are still pending.
Under the single-payer plan, the state would negotiate prices for services and prescriptions with providers, pharmaceutical companies and others.
Californians would be required to participate in the public program and insurance companies would be barred from offering coverage for services already included in the the plan, according to Lara’s office.
California Insurance Commissioner Dave Jones told The Sacramento Bee on March 8, 2017 that other countries have cheaper insurance and better health outcomes because of their single-payer health care systems.
“With Republicans’ failure to repeal the Affordable Care Act, Californians really get what is at stake with their healthcare,” Lara, D-Bell Gardens, said in a statement. “We have the chance to make universal healthcare a reality now. It’s time to talk about how we get to healthcare for all that covers more and costs less.”
The Healthy California Act, also known as Senate Bill 562, would cover all medical care, including inpatient, outpatient, emergency care, dental, vision, mental health and nursing home care, according to a press release from Lara’s office. The bill would eliminate co-pays and insurance deductibles, allow Californians to choose their doctor and referrals would not be required.
A nine-member unpaid board appointed by the governor and Legislature would oversee the health system. An advisory committee, consisting of doctors, nurses, consumers and other health care providers, also would guide public policy.
The new health care system would be funded through taxes, but Lara’s office is still working out the financial details.
Gov. Jerry Brown expressed deep skepticism about that state’s ability to fund the program last week during a visit to Washington, D.C.
“This is called ‘the unknown by means of the more unknown,’ ” he said. “In other words, you take a problem, and say ‘I am going to solve it by something that’s ... a bigger problem,’ which makes no sense.”
The state would seek waivers from the federal government for Medi-Cal, the Children’s Health Insurance Program, Medicare, and the Patient Protection and Affordable Care Act to offset the cost of the program, Lara’s office said.
California lawmakers have considered single-payer and other comprehensive health care measures over the years, all of which failed to win approval by voters, the Legislature or previous governors.
Former Sen. Sheila Kuehl’s single-payer proposal introduced in 2007 would have cost the state $209.8 billion in the 2011, rising to as much as $252 billion in 2015, according a fiscal analysis by the Legislative Analyst’s Office.
Kuehl’s plan included an 8 percent wage tax on employers and 4 percent on employees.
The total cost of Kuehl’s plan isn’t directly comparable to Lara’s bill given the lack of details available about the new proposal’s funding model, uncertainty over federal waivers, changes in the health care market since the report was written in 2008 and other differences.
Kuehl’s bill was vetoed by then Gov. Arnold Schwarzenegger.
The National Nurses Association and the California Nurses Association sponsored SB 562 and Sen. Toni Atkins, D-San Diego, is a joint author. Lara also recently announced plans to run for insurance commissioner.
Healthy San Francisco, signed into law by Lt. Gov. Gavin Newsom when he was mayor of San Francisco, is expected to serve as a foundation of Newsom’s political platform in the 2018 governor’s race to succeed Gov. Jerry Brown. The effort is prompted