Frustrated with partisan stalemates in Washington, California's overwhelmingly Democratic Legislature on Tuesday will begin debating whether to create their own universal health care system — a move that will test how far the state's progressive politicians are willing to go to fulfill their campaign promises.
Government-funded health care for everyone has been a staple of California political rhetoric for decades. Gov. Gavin Newsom promised to do it when he ran for governor in 2018, and voters elected him in a landslide.
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But it's not been easy to accomplish in the nation's most populous state, where nearly half of people pay for private health insurance through their jobs. In 1994, voters overwhelmingly rejected a ballot initiative that would have created a universal health care system. Another attempt passed the state Senate in 2017, but it never got a vote in the state Assembly.
This year, Democrats in the state Assembly are trying again with a new strategy. First, they want to pass a bill that creates a universal health care system and sets its rules. Then, they want to ask voters to approve a major tax increase to pay for all of it.
The plan, which would require voter approval, would raise taxes on businesses and individuals who earn at least $149,509 per year. The California Taxpayers Association, which opposes the plan, estimates it would raise taxes by about $163 billion per year.
“If we can agree on a policy and get that policy passed, then it becomes more real. Then you are actually telling the voters what they are voting for. That’s really important," said Assembly member Ash Kalra, a Democrat from San Jose who is the author of the proposal.
Questions about how to pay for a universal health care system have doomed previous plans. In 2011, Vermont enacted the nation's first universal health care system in the country. But state officials abandoned it three years later because they said they couldn't afford to pay for it.
California's 1994 proposal also relied on a tax on employers and individuals, and it failed after strong opposition from the insurance industry. Insurers, doctors and business groups are again lining up to oppose this latest proposal, arguing it would cost too much and limit people's choices.
In his first three years in office, Newsom has focused more on making sure everyone in California has health insurance. He has expanded the state's Medicaid program to cover low-income 26 and younger and 50 and older regardless of their immigration status. Monday, he proposed covering everyone else at a potential cost of $2.7 billion per year.
Monday, Newsom reiterated his support for a universal health care system, but declined to say if he supported the plan in the Legislature because he said he had not read it. Asked if he had “given up” on a universal health care system in California, Newsom pointed to a commission he founded that is examining such a system and how much it would cost.
He also said he's working with President Joe Biden's administration on the “flexibility” required for California to implement such a system.
“The difference here is when you are in a position of responsibility, you’ve got to apply, you’ve got to manifest the ideal. This is hard work,” he said. “It's one thing to say. It's another thing to do. And, with respect, there are many different pathways to achieve the goal."
Tuesday, the Assembly Health Committee is scheduled to debate the bill that would create the universal health care system. They are not scheduled to debate the bill that would pay for it. But opponents of the plan will likely still highlight the cost.
“In the Health Committee, I look forward to a robust discussion on the impacts of socialized medicine in California, including: how much taxes will increase on the middle class,” Assembly Republican Leader Marie Waldron said.
