Single Payer Update: By Dorothy M. Cociu, RHU, REBC
As I write this in late August, we are now at the very end of the legislative session, and are in anticipation of what is to come in the general election on November 6th. I am reporting primarily on the legislative updates provided by Faith Borges at the CAHU Health Care Summit August 9th.
In the final month of the session, the legislature reconvened from Summer Recess on August 6th, and August 17th was the last day for fiscal committees to meet and report bills to the Floor. Final floor sessions for this year were held August 20-31, with August 24th being the last day to amend bills. August 31st is the last day for each house to pass bills and Final Recess begins. Another important date is September 30th, which is the last day for the Governor to sign or veto bills. By the time you read this, many of these dates will have passed.
The best way to update you on Single Payer is to discuss in part the political preview of what’s to come in the fall. Obviously, there is a general election on November 6th. The Governor’s race will heat up and all statewide offices are up for election.
In the Assembly, only one Assemblymember termed out in 2018, and 5 of 6 Assembly races are competitive between the two political parties. In the state Senate, 5 Senators termed out in 2018 and, there was one vacancy to replace Senator Mendoza that has been filled by Vanessa Delgado (D). The Orange-County based Josh Newman (D) was recalled and replaced by Ling Ling Chang (R), which I reported on in the last issue of the COIN. The importance of this is that with this recall, there is no longer a Democratic Supermajority in the state Senate.
Leadership in the Legislature is key to establishing and delivering legislative priorities, according to Faith Borges. In the Senate, President Pro Tempore is Toni Atkins (D– San Diego), who as you’ll recall, co-authored SB-562, and the Senate Minority Leader is Laguna Niguel’s Republican Patricia Bates. The Assembly Speaker is Anthony Rendon (D– Lakewood), and the Assembly Minority Leader is Brian Dahle (R-Bieber).
The Omnibus Health Trailer Bill (AB 1810) became law on June 27th. The health care portion of the budget compromise, according to Faith Borges, authorizes an all-payer claims data base and establishes several new health care councils, and declares the legislative intent to establish a health care system that “provides coverage and access through a unified financing system for all Californians.” This law should tell you where the Legislature would like to go relating to a single payer or a universal health care system. A committee has been created to look at universal health care financing by October, 2021.
Also notable, the Assembly formed a Select Committee on Health Care Delivery Systems and Universal Coverage as a way to explore the issues linked to SB 562, although no additional hearings are scheduled at this time
At the CAHU Health Care Summit, Faith Borges and the panel on The Future of Single Payer in California featuring political consultants Ned Wigglesworth & Rob Stutzman, observed that though there were many public health benefits that resulted from the creation of the ACA, it also put more pressure on the public with more out-of-pocket expenses. These costs have made the public more aware of health care financing, and there is a general consensus that there is a healthcare financing problem. However, no one has viable answers as to how to handle the cost of a single-payer system at the state level, so the panelists felt that it was not yet “ripe” in the legislature. They all felt, however, that this issue of single payer will resurface after the November elections, and primarily, after we see what likely Governor Newsome will signal to the legislature and stakeholders that he is willing to authorize and approve financing for. Newsome has been very quiet on the issue in the past few months, and he has noted to the press that single payer is NOT something he can do with just a signature. The “we’re working on it” line is often used. Additionally, the topic will likely be pursued at the federal level with ‘Medicare for All’ likely to be a big topic in 2020 during the presidential and house elections, according to Rob Stutzman.
Bottom line is, there are policy issues, cost issues and constitutional issues with implementing single payer at the state level. How do proponents repurpose existing funds into a new state pool? Employers currently provide a large percentage of the health care coverage in this country. How would they and could they get that money into such a pool?
According to Ned Wigglesworth, there are others besides the nurses that will likely pursue this topic. The Democratic Party platform, various unions and others are on record for supporting single payer. All, however, are concerned about where the money will come from. Will proponents look for other deep pockets, such as the super-rich as Bernie Sanders proposes? It is highly doubtful that President Trump would support a path to put Federal funds into a state system.
Another key race for all of us is the Insurance Commissioner race. SB 562 Joint Author, Senator Lara is running for Insurance Commissioner against Steve Poisner, a former Republican, running as an Independent. Poizner is the industry-backed choice, having served it well during his previous tenure as Insurance Commissioner from 2007-2011. The framing of single payer as a right versus a political liability is a strong theme in this close race.
On August 28th, the Sacramento Bee announced a coalition of influential, well financed, business and health care organizations, including CAHU “that have long helped shape the legislative agenda in California and have joined forces to oppose any future effort to craft a universal, single-payer health care system for the nation’s largest state. The main focus of the coalition, called ‘Californians against the costly disruption of our health care,’ is to kill any single-payer health care bill in the state Legislature, said Ned Wigglesworth, a political strategist for the coalition.”
The California Nurses Association responded to the introduction of this heavy-weight coalition by stating that the union plans to introduce another single-payer bill next year and that anything short of that is insufficient. So looking ahead, we’re seeing a lot of pressure in the legislature, and maybe some progress on single payer, but still there are BIG questions to address on cost and other important coverage issues.
Stay tuned for much more news in the next issue! ##
Author and Editor’s Note: Special thanks to Faith Borges, California Advocates, for her assistance with this article.
Originally published in the County of Orange Insurance News (The COIN), Published by the Orange County Association of Health Underwriters, Sept/Oct. 2018.
