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People rally in favor of single-payer healthcare for all Californians outside the office of California Assembly Speaker Anthony Rendon, June 27, 2017 in South Gate, California.

People rally in favor of single-payer healthcare for all Californians outside the office of California Assembly Speaker Anthony Rendon, June 27, 2017 in South Gate, California. (Photo: Robyn Beck/AFP via Getty Images)

Single-Payer Bill Leaps First Major Hurdle in California

Committee passage was heralded as "big news," but an uncertain path forward remains.

Andrea Germanos

Single-payer advocates cheered Tuesday after legislation in California to create a first-in-the-nation universal healthcare system took a decisive step forward.

"As the single-payer movement continues to gain momentum, we signal to corporate interests that enough is enough."

The California Guaranteed Healthcare for All Act (AB1400)—which would establish CalCare for all state residents—passed the Assembly Health Committee in an 11-3 vote. The California Nurses Association, which is sponsoring the legislation, welcomed the measure clearing the "major hurdle" ahead of its next stop at the Assembly Appropriations Committee.

"As the single-payer movement continues to gain momentum, we signal to corporate interests that enough is enough," Assemblyman Ash Kalra (D-San Jose), who introduced the bill, said in a statement. "Healthcare is a human right and it's high time we reform our broken healthcare system."

Noted healthcare activist Ady Barkan, founder and co-executive director of the Be A Hero PAC, was among those who testified at the health committee in support of the legislation, saying that his experience with ALS made clear the healthcare system is "broken."

"California can lead the nation to a more just future like we have done on environmental protection and marriage equality," he told the committee Tuesday. "We should do the same on healthcare."

On Tuesday, Barkan also posted a video to social media featuring nurses, patients, and high-profile backers of AB1400:

As part of the legislative push, Kalra last week introduced Assembly Constitutional Amendment 11, which would establish the funding mechanism for the CalCare plan. According to CapRadio:

The new proposal would create a tax to fund the single-payer option. The tax would apply to companies earning more than $2 million, businesses with 50 or more employees and individuals making more than roughly $150,000 a year.

Carmen Comsti, lead regulatory policy specialist with the nurses association, says the tax will generate somewhere between $160 and $170 billion annually.

"We are talking about ensuring that everybody gets comprehensive benefits without copays or deductibles," Comsti said.

This funding mechanism sets the new proposal apart from a previous failed single-payer proposal in California in 2017, though voters would need to pass the tax hikes, which may not happen until 2024, according to Kalra.

AB1400 also comes amid a global pandemic—a crisis that, according to Rupa Marya, an associate professor of medicine at UC San Francisco, and member of the Healthy California for All Commission, has shown a clear need "to reimagine healthcare" including through the establishment of a single-payer program.

In an op-ed published Monday at the Los Angeles Times, Marya wrote, "More than 70% of the nation’s largest health insurers have ended their Covid treatment cost waivers, leaving even insured and vaccinated patients with potentially astronomical bills if they require treatment," and that could lead to "financial ruin."

"AB 1400 proposes to curb costs by eliminating administrative bloat and setting prices, which as the world's fifth-largest economy, California can do," Marya added. "Further financing would come through new corporate and progressive taxation."

Marya called this "the scale of systemic solution that is needed in this moment, because entire systems are suffering. As a hospital medicine physician at UC San Francisco, I am watching the pandemic crush our healthcare system and the people inside it, providers and patients alike."

The measure needs to pass the Assembly by the end of the month, and, as the Associated Press reported, is still "a long way from becoming law."

"Formidable opposition has already started mobilizing," Politico's "California Playbook" noted Wednesday.

"The California Chamber of Commerce branded its first 'job killer' labels of the year on A.B. 1400 and its companion funding measure," the outlet noted, and "the California Medical Association linked arms with Assembly Republicans in demanding Democrats hold off until they have a cost analysis."

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