SACRAMENTO — In a surprise move that further complicates President Donald Trump’s push to repeal and replace the Affordable Care Act, two California lawmakers Friday introduced legislation that would create a single-payer health care system covering all 38 million Californians, including its undocumented residents.
“We’ve reached this pivotal moment,” Sen. Ricardo Lara, D-Bell Gardens, said in an interview Friday, “and I thought to myself: `Look, now more than ever is the time to talk about universal health care.’”
The universal health care proposal — the Healthy California Act, introduced by Lara and Sen. Toni Atkins, D-San Diego — was submitted just before the deadline for new legislation and doesn’t yet offer many specifics. But it seeks to create a single-payer system, which would replace private insurance with a government plan that pays for coverage for everyone. Proponents argue that single-payer systems make health care more affordable and efficient, but opponents say they raise taxpayer costs and give government too much power.
Medicare, the federally-funded health coverage for the elderly, is often held up as a model of what a single-payer system might look like.
The idea has periodically gained traction in the Golden State. Vermont Sen. Bernie Sanders has helped to widen its popular appeal on the left, though such a system has yet to get off the ground in the U.S. Colorado voters rejected a similar plan last fall amid widespread concerns about the cost. Perhaps the best-known effort to create one was in Vermont, but it failed in 2014 after the state couldn’t figure out how to finance it.
Proponents say taxes would replace insurance premiums, and that savings would come from eliminating the huge administrative costs — and profits — of insurance companies.
“Quite frankly, we have to cut out the insurance company waste and duplication,” Lara said.
But one longtime critic of single-payer plans, who moved to California from Canada in the early 1990s, said the national health care system in her country has led to increasingly long waits to see a doctor — and has driven many Canadians to come to the U.S. for treatment.
“It’s been a disaster in countries like Canada,” said Sally Pipes, president and CEO of the conservative Pacific Research Institute based in San Francisco.
Data this week related to the stunning impact of the 2010 health care law, better known as Obamacare, may help single-payer advocates like Atkins and Lara.
The U.S. Centers for Disease Control and Prevention reported that California’s uninsured rate has dropped from 17 percent in 2013 to 7.1 percent in 2016, a record low for the state. The national uninsured rate is at an all-time low of 8.8 percent, down from 14.4 percent in 2013.
“In light of threats to the Affordable Care Act,” Atkins said in a prepared statement, “it’s important that we are looking at all options to continue to expand and maintain access to health care. The Healthy California Act is an essential part of that conversation.”
The senators said in a statement that their vision of the bill will be outlined “in the weeks ahead with the people of California.”
As a starting point, they cite Trump’s Jan. 20 executive order aimed at beginning the process of repealing the Affordable Care Act. The order states that the federal government should “provide greater flexibility to states and cooperate with them in implementing health care programs.”
