What Is the Single-Payer Movement in California?

A grassroots movement for the establishment of a single-payer health care financing system in California (CA) has been building since the 1990s. In 1992, state Senator Nick Petris introduced a single-payer bill in the state legislature. Insurance Commissioner John Garamendi created a plan for universal coverage with a modified single-payer approach that passed the legislature, but was vetoed by Governor Pete Wilson. In 1994, a single-payer ballot initiative, Proposition 186, was defeated in the face of strong opposition by industry stakeholders. The initiative increased public awareness of single payer and was followed up in 1998 by introduction of Senate Bill (SB) 2123, calling for establishment of a universal single-payer system in the state. This bill led to a resolution calling for a study to compare different models of financing universal health care, including single payer.

In 2002, after completing the study of the impacts of various models for health care financing, the Lewin Group and AZA Consulting reported that more people could be covered for more services for less money with a carefully designed single-payer system. In the 2003-2004 legislative session, a single-payer bill, SB 921, introduced by state Senator Sheila Kuehl, passed the full Senate and the Assembly Health Committee. In 2005 the financial analysis of SB 921, by the then-independent Lewin Group, reported that if a single-payer system were implemented in 2006, California would save $8 billion in the first fiscal year and $344 billion in 10 years, while covering all California residents with comprehensive health care.

In the 2005-2006 legislative session, Senator Kuehl introduced SB 840. The bill won approval by both houses, with California becoming the first state in U.S. history to pass single-payer legislation. The bill was vetoed by Governor Arnold Schwarzenegger. Senator Kuehl reintroduced SB 840 in the 2007-2008 legislative session. The bill passed in 2008. Governor Schwarzenegger again vetoed the bill.

Senator Mark Leno reintroduced the bill as SB 810 in the 2009-2010 legislative session. The bill passed the full Senate and Assembly committees but was not put to a vote by the full Assembly. Senator Leno reintroduced SB 810 in the 2011-2012 legislative session, It passed all the Senate committees. However, the complete Senate, focusing on the Affordable Care Act (ACA) implementation and the upcoming election, decided not to pass SB810 when it came up for a vote in June 2012.

In January 2017, while the Congress was trying to repeal the ACA, Californians were lobbying legislators to introduce a new single payer bill to replace the ACA. On February 17, 2017 Senators Ricardo Lara and Toni Atkins introduced SB 562, The Healthy California Act. Advocacy for the bill is led by the "Healthy California Campaign”, composed of the AllCare Alliance, the Campaign for a Healthy California (CHC) and Labor United for Universal Healthcare. Healthy California is a campaign of more than four million Californians building a statewide movement to win guaranteed health care for ALL California residents.