A Background History of SB 810—The California Universal Healthcare Act (Sen. Mark Leno)

1998	Health Care for All-California (HCA) helps draft Senate Bill 2123, which calls for a universal single payer health care system. The authors are Senators Barbara Lee (Oakland) and Diane Watson (Los Angeles). HCA initiates a statewide campaign to pass SB 2123. After the bill is revised and passed by the Senate Health and Human Services Committee, it calls for a comparison of different models of financing universal health care, including single payer. HCA helps draft Senate Concurrent Resolution 100, which calls for a study to compare different models of financing universal health coverage. Each model must provide the same high quality benefits, which are defined in the bill. The content of SCR 100 is authorized by Senate President, John Burton, and supported by leaders of the Senate and Assembly.
1999	HCA helps draft SB 480, which requires: 1) a process for stakeholders to address the issues facing the state in providing universal health coverage; 2) a report from the California Health and Human Services Agency (CHHS) to the legislature on the results of the process and the universal health coverage study; and 3) enactment of universal health coverage for all California residents by a "date certain," July 1, 2003. The author is Sen. Hilda Solis (Los Angeles). HCA initiates a statewide campaign to pass SB 480. After the date certain language is removed, the bill passes the Senate and Assembly. HCA initiates a campaign to lobby Gov. Gray Davis. Newspaper editorials and op-eds call on the governor to sign SB 480, and Davis does.
2000	By the authority of leaders of the Assembly and Senate, a panel of national health care experts, the Universal Health Care Technical Advisory Committee (UHCTAC), meets to review the status of the study, evaluate different proposals for conducting the study, and issue a report of recommendations. The UHCTAC report draws on HCA's own recommendations, which include: the government should be the client for the study; advocates of a particular model of universal health coverage should devise that model; methods and assumptions used for the study should be transparent; there should be competitive bidding by modelers; and the quality criteria defined in SCR 100 should be applied to each model. HCA initiates a statewide campaign to augment the budget so that CHHS can implement SB 480. The legislature approves $600,000. Gov. Davis authorizes $200,000. HCA initiates a statewide campaign to have Gov. Davis apply for a federal grant from the Health Resources and Services Administration (HRSA) to conduct a comparative analysis of different models of universal health coverage. The funds would enable implementation of SB 480. HRSA’s budget can only fund 11 of the 20 proposals HRSA approves. California is one of nine states not awarded a grant. HCA leads a statewide campaign to augment the federal budget. With support for the campaign from U.S. Rep. Nancy Pelosi (San Francisco), Congress increases HRSA's budget by $15 million. California's “Health Care Options Project” (HCOP) receives $1.2 million.
2001	HCA initiates a statewide campaign to guarantee full participation by representatives of the Legislature and health care stakeholders in the SB480/HCOP process, and to have CHHS utilize the recommendations of the UHCTAC report. The Senate and Assembly budget subcommittees for health hold hearings about implementation of SB480/HCOP and support HCA's goals. CHHS creates the Advisory Group for the SB480/HCOP process. There are representatives of state and local governments and a broad range of health care stakeholders. CHHS approves nine proposals for the study. There are three universal single payer proposals -- including HCA’s own plan, Cal Care -- and six proposals that increase coverage through public program expansions, employer and/or individual tax credits, subsidies and/or mandates, or combination approaches.HCA initiates a campaign to have CHHS contract for an analysis of how well each proposal satisfies health care quality measurements, in addition to how much each proposal expands health coverage and how much the expansion costs. CHHS contracts with The Lewin Group to analyze and compare the cost and coverage impacts of the nine proposals, using a micro-simulation model. CHHS also contracts with AZA Consulting to analyze the quality and access impacts of the proposals.
2002	CHHS and the California State Library/California Research Bureau sponsor five public symposia, which are held in Fresno, Oakland, Manhattan Beach and Sacramento (twice). The authors describe their proposals, and The Lewin Group and AZA Consulting report their findings. The authors use public input to revise their proposals. The Lewin Group and AZA Consulting submit their final documents to CHHS. At the end of his presentation at the last symposium at the capitol, John Shiels of The Lewin Group says, “One of the major claims of the single payer advocates for a long time has been that we could cover more people, for more services, for less money. Our study is showing that, for these very carefully designed plans, that's true. To the best of our ability to estimate it, that's true.” HCA convenes monthly meetings in Sacramento with a wide range of organizations to lay the basis for a grassroots movement to support a single payer bill in the 2003 legislative session. Several Assembly Members and Senators compete to be selected by the organizations as the author of the bill. Sen. Sheila Kuehl (Santa Monica) is chosen. The legislation is developed from recommendations from the public, health care stakeholders and features from the three HCOP single payer proposals.
2003	Sen. Kuehl introduces SB 921, The Health Care for All Californians Act. The Health Care for All Californians Campaign is created, comprising many statewide organizations. Regional meetings are held to involve local groups in the campaign. A large lobbying campaign helps to get passed SB 921 by the Senate, but the bill is reduced to “intent” language.
2004	The Assembly Health Committee passes SB 921. The bill goes no further. It has 26 co-authors (6 Senators and 20 Assembly Members) and more than 500 statewide or local organizations are endorsers. HCA raises $90,000 to hire The Lewin Group to analyze the financial impact of SB 921 (April 2004 version).
2005	Sen. Kuehl releases The Lewin Group report. The findings show the model on which SB 921 was based can cover every Californian with a comprehensive health plan that reduces costs and controls health cost inflation. If the model were implemented in 2006, the cumulative savings between what would be spent without the plan and what would be spent under it would be $8 billion in the first year and $343.6 billion from 2006-2015. Sen. Kuehl introduces SB 840, the California Health Insurance Reliability Act, which substantially amends SB 921. Advocates garner hundreds of endorsements from organizations, thousands of letters of support from individuals, and place op-eds in many newspapers. The Senate passes SB 840.
2006	A huge lobbying campaign by advocacy organizations and unions helps get SB 840 passed by the Assembly. Due to amendments in the Assembly version, SB 840 is returned to and passed by the Senate for concurrence. It has 43 co-authors (13 Senators and 30 Assembly Members). It is the first single payer universal health care plan in U.S. history to be passed in a state legislature and brought to a governor’s desk. Gov. Arnold Schwarzenegger’s op-ed in the San Diego Union-Tribune explains why he will veto SB 840. It generates a lot of press coverage, as well as criticism by advocates of SB 840. On Aug. 12, the 365-City Campaign is launched in Morro Bay. Each following day there is an event in a different city in support of SB 840. The 365-City Campaign is a project of OneCareNow, which is initiated by HCA, in partnership with other organizations. Soon afterwards, HCA and the other organizations form the State Strategy Group. In the following years more organizations join the State Strategy Group. (The current members are listed below on this page.)
2007	Sen. Kuehl reintroduces SB 840, renamed the California Universal Healthcare Act. At a special Assembly Health Committee educational hearing, Sen. Kuehl shows the HCA video, “The Healthcare Solution: California OneCare,” which is posted on YouTube at http://www.youtube.com/watch?v=gAWZrfYXs-c. Hearings on SB 840 are packed with supporters. The California Nurses Association hosts two large rallies at the capitol. The second features Michael Moore, who testifies at a hearing chaired by Sen. Kuehl. At a nearby movie theater, Moore hosts two screenings of SiCKO, one for advocates and one for legislators and staff. The Senate passes SB 840. Throughout California where SiCKO is shown at movie theaters, flyers explaining SB 840 are distributed. Each flyer has a postcard with prepaid postage. Over 50,000 postcards in support of SB 840 are collected in a few weeks. On Aug. 11, the 365-City Campaign ends with a rally of 3,000 in front of L.A. City Hall. Speakers include Sen. Sheila Kuehl, Lily Tomlin, Lt. Gov. John Garamendi, U.S. Congressman Dennis Kucinich, Secretary-Treasurer Emeritus of the United Farm Workers Dolores Huerta, Executive Treasurer of the L.A. County Federation of Labor Maria Elena Durazo, and spokespersons from the State Strategy Group. (Rally video is posted on YouTube at http://youtube.com/watch?v=5VuKMk0ZxHI.)
2008	On Feb. 23, the State Strategy Group holds a State Strategic Summit in L.A, which is attended by over 300 single payer activists from all over California. Among the results of the Summit, a Healthy Majority Campaign is launched to elect two-thirds majorities in the Assembly and Senate. (It will take a two-thirds majority in each house to override a governor’s veto of a single payer bill and to pass legislation to finance a single payer plan.) On June 19, thousands rally for single payer bills, SB 840 and HR 676, outside San Francisco’s Moscone Center West, the site of a national convention for America's Health Insurance Plans, the trade association for insurers. The rally’s theme is: Healthcare YES – Insurance Companies NO. Sen. Kuehl is among the speakers. Smaller support rallies are held in 18 other cities. A report from the Legislative Analyst’s Office finds that the model used to fund SB 840 in 2006 would not be enough to fund it 2011. The deficit projected by the LAO can largely be looked at as the cost to the state created by the governor’s veto of SB 840 in 2006. The Legislature sends SB 840 to Gov. Schwarzenegger for his signature. It has 48 co-authors (15 Senators and 33 Assembly Members). On Sept. 8, HCA publishes a half-page ad in the Sacramento Bee and a few other local papers calling on the governor to sign SB 840. The same day the State Strategy Group organizes a large rally with Sen. Kuehl on the north steps of the capitol. A delegation delivers the 50,000 “SiCKO” postcards to the governor’s office. (Rally video is posted on YouTube at http://www.youtube.com/user/humantoo.) Gov. Schwarzenegger vetoes SB 840. Mark Leno, who is elected to the senate in November, announces he will introduce single payer legislation in 2009. In a statement, he says, “I applaud Sen. Kuehl, the OneCareNow Campaign and all of the statewide organizations and advocates for their tireless fight for affordable, accessible health care for all Californians. We will bring this issue back again and again until everyone in California has access to high quality health care that puts people before insurance company profits.” In the November election, the Healthy Majority Campaign helps turn three Assembly districts to Democratic from Republican. (To achieve two-thirds majorities in the future, two Senate districts and three Assembly seats must also be turned Democratic.)
2009	Sen. Mark Leno introduces SB 810, which retains the language in Sen. Kuehl’s SB 840. There are 45 coauthors (13 Senators and 32 Assembly Members).
Member Organizations of the State Strategy Group: Member Organizations of the State Strategy Group: American Medical Student Association, California Alliance for Legislative Action, California Alliance of Retired Americans, California Church IMPACT, California Faculty Association, California Federation of Teachers, California Gray Panthers, California Nurses Association, California Physicians Alliance, California Retired Teachers Association, California School Employees Association, California Teachers Association, Consumer Federation of California, Dolores Huerta Foundation, Health Care for All-California, Labor Task Force for Universal Healthcare, League of Women Voters-California, Progressive Democrats of America, Single Payer Now, Wellstone Democratic Renewal Club

Prepared by Dan Hodges, Chair, Health Care for All-California (www.healthcareforall.org), May 1, 2009