Will California Make Single Payer Healthcare Happen?
Congress can’t even pass a voting rights bill. Build Back Better is dead. The same people who complain about religious persecution of Christians can’t bring themselves to vote for a Muslim appointee.
Half of the Senate would filibuster a bill including language about the sun rising in the East. The sedition caucus in the House would claim any mention of sunrise would be a sop to the Chinese Communists.
Since those pinheads in DC won’t give us a path to decent health care, the thinking is that maybe Californians should show them how it’s done. What used to be a pipe dream is becoming an urgent need.
The pandemic has made it evident that tying healthcare to employment isn't working for many families… or employers either.
It’s frankly embarrassing that Americans pay more and get less for health care compared to other industrial countries. The one thing that we’ve historically been good at –prevention measures like flu shots– has now become a centerpiece of the war on sanity being waged from the right.
Increased funding lowering monthly premiums for Affordable Care Act coverage will end on December 31, and there is zero chance congress can get its act together before then. Out-of-pocket healthcare costs for insured Californians will continue to sharply rise in 2022.
While ads touting cheap premiums may sound great, it’s those other costs that are making life difficult for many. So when you hear things like “most Californians are covered,” know that people are really just a couple of doctor’s visits and a procedure or two away from serious debt.
Here’s Ben Spielberg’s real life illustration:
Silver plans are typically considered the best value on the exchanges, in part because lower-income individuals who buy Silver plans can qualify for some cost-sharing reductions. The amount of those reductions vary, but let’s assume this individual buys a plan with a sizable reduction that takes their deductible down $2,000 from the $4,800 average. Co-pays and coinsurance also vary plan to plan, but one of the better Silver plans might cover 80% of costs above the deductible. So once the $2,800 deductible is exceeded, the insurance company in this case would pay $2,226 of the remaining $2,783 the individual owes.
Yet between the individual’s $1,020 annual premium payment to the insurance company, Medicare taxes, and $3,357 payment to their health care providers (due mainly to their still-large deductible), they would still be paying close to $5,000 towards health care – which someone making $30,000 a year obviously cannot afford. The government’s subsidy payment to the insurance company would be even larger than it was for the Bronze plan – $10,176 for the year – and the insurance company would pocket $8,718, which would once again be far more than the cost of care itself.
Currently there are 3.2 million people in California lacking health insurance. Another 12 million unable to afford to use their insurance because of costly copays or deductibles.
Legislators have been trying to get a single payer program on the books for more than a decade. It’s been a tough sell, even though the idea is supported by a supermajority of voters in the state, political and economic challenges have stopped it dead in its tracks.
Advocates think they’ve found a workable solution, and on Tuesday, the state assembly’s Health Care Committee will vote on advancing AB 1400, the California Guaranteed Health Care for All Act.
CalCare,as it’s called, would provide all medically necessary healthcare to every California resident, regardless of immigration status, with no copays, deductibles, or out-of-pocket costs.
A related bill, Assembly Constitutional Amendment (ACA) 11, introduced by Assembly Members Ash Kalra and Alex Lee —two of A.B. 1400's primary sponsors—would fund CalCare via a gross receipts tax, payroll tax, and a personal income tax on high earners.
The usual suspects are already poisoning the well in advance of public debate over the measure, with scary headlines in assorted media trumpeting a massive tax increase. Stories about health care rationing and not being able to choose your own doctor will come shortly.
Hoping to generate public awareness of the proposal, nurses organized a car caravan on Saturday in 14 cities across the state; the local version included 32 cars, starting at the San Diego Zoo, taking a couple of laps through downtown San Diego and returning to Balboa Park.
California’s proposal for single payer is not carved in stone. It’s complicated, and made more so the chatter coming from groups making obscene profits by handling paperwork for an overly complicated system. Any financial claims you see today will be largely irrelevant by the time the final language is agreed upon.
Three things can happen this year. One, some compromises will be included in the final law, likely creating an exit plan for the existing bureaucracy. Two, we’ll end up with Single Payer Lite, which will include enough backdoors to make it unaffordable in record time so naysayers can tout its failure. Three, nothing will pass because the medical establishment will scare people about what should be non-issues.
Done right, single payer for all will lower costs for the vast majority of Californians and employers. The biggest problem is getting people to see that, yeah they’re paying X number of dollars more in taxes, but saving more than X dollars in premiums and addons.
Combatting a blitzkrieg of distortions and fear mongering will prove the most difficult part of making single payer a reality. You can play an important role by taking what you hear from whomever with a grain of salt.
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Via National Nurses United, here is some more info:
Learn More About AB 1400
CalCare is the solution to our broken health care system.
Read the Fact Sheet
Read Our Guiding Principles
Learn About Financing
Learn About Waivers
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Email me at WritetoDougPorter@Gmail.com