Assembly Universal Health Care Hearing Wraps Up With Single-Payer Debate

Hearings about creating a single-payer health care system or universal coverage have wrapped up at the California state Capitol, for now.

The final meeting of an Assembly committee Wednesday was dominated by discussion of a single-payer bill passed by the state Senate last year and sponsored by the California Nurses Association, the union known for its hardline tactics, which sponsored SB 562.

Union members and supporters filled the committee hearing room and three overflow rooms. They were quick to cheer lawmakers and witnesses who advocated for single-payer, and boo those they thought critical of it.

Economist Robert Pollin of University of Massachusetts-Amherst told assemblymembers that a state-run single-payer system, without insurer profits, would save money.

“I believe there are large areas of potential cost-savings through Healthy California relative to our current system,” Pollin said.

The nurses union commissioned Pollin and the department’s liberal economists to perform its own analysis. It estimates single-payer would cost significantly less than the $400 billion projected by both Senate staff and the non-partisan state Legislative Analyst’s Office.

"Lots of details will need to be filled in to make the proposal fully workable,” Pollin said. “But in my view the basic approach is sound.”

The Senate bill doesn’t contain funding — potentially a 15 percent payroll tax increase on the high-end — nor does it discuss how the state would receive federal approval to leverage Medicaid and Medicare funds, nor whether it would seek voter approval to circumvent constitutional spending restrictions.

Democratic Assembly Speaker Anthony Rendon shelved the measure last year as “incomplete,” a position he doubled-down on last month. Instead, he convened this committee to come up with its own proposal for universal coverage, not necessarily single-payer.

Committee co-chair, Democratic Assemblyman Jim Wood, said whatever that proposal is, it’s unlikely to transform the state health care system immediately.

“Some of the logistics and the challenges we have going forward are multi-year challenges. We cannot ignore that," Wood said. "Waivers with the federal government—even with a friendly administration—still take two to three years."

The committee plans to publish its recommendations in a few months.