Single-payer health care for California takes the next step

California’s latest attempt at creating a state-run health care system faces a critical juncture Monday. Senate Bill 562, titled the Healthy California Act, goes before the state Senate appropriations committee in Sacramento.

The bill, which lays out a plan to provide universal single-payer health coverage for California, passed the California Senate health committee in April. Under single-payer health care, residents would pay the government for their health care costs, rather than buying insurance from private insurers.

The next step could be make or break for the bill.

"It’s essential. If it doesn’t go through appropriations, it dies," said Shana Alex Charles, faculty associate at the UCLA Center for Health Policy Research and an assistant professor at California State University, Fullerton.

SB 562 would establish a nine-member board to oversee health care in the state. It would create a trust fund where federal health care dollars would go to help pay for the program. What it doesn’t include is a detailed plan to show where the rest of the funds would come from.

Charles explained that’s not uncommon for bills coming into the Legislature without a detailed price tag. Some of that accounting will come out in the appropriations committee meeting on Monday and in subsequent reviews.

Advocates of single-payer say any increase in taxes to pay for the program will be similar to what Californians already pay in premiums and deductibles.

"At this point it is a goal, not a certainty," said Charles. 

Any uncertainty in the ultimate costs to the state gives single-payer detractors pause.

Californians spent more than $350 billion on health care in 2016. Public funds paid for 71 percent of those costs.