After the California Assembly didn't vote on legislation that would've introduced the first government-funded universal health care system in the U.S., the bill's author says he is banking on changing attitudes and changing composition of the legislature for the measure's future.
Assemblymember Ash Kalra, a Democrat from San Jose, told KCBS Radio's Jeff Bell and Patti Reising in an interview on Monday night he is "committed to single-payer health care" but "will take some time to decide" if he will re-introduce Assembly Bill 1400. The bill simply needs "more legislators on board," whether or not they are currently serving in the legislature.
"That includes some of my current colleagues, who we're still engaging with and trying to get them on board with the bill," Kalra said on Monday, "as well as the impending prospect for new members. By next year, we're going to have several new members in the legislature, as many as 15 seats up for election."
Democrats currently control 56 of 80 seats in the Assembly, and they needed just 41 to vote yes on Kalra's bill on Monday. Kalra said "a new wave of legislators" could help ensure the bill's passage.
Critics of the bill, including Republicans, business groups, insurers and hospitals, cited its cost. A legislative analysis provided by the Assembly Appropriations Committee estimated the bill would result in $314 billion to $391 billion in health care spending. California's entire 2021-22 budget, by comparison, is nearly $263 billion.
A separate analysis from the UC Berkeley Labor Center estimated that, under the current system, California would pay $517 billion for health care expenditures. That included $222 billion in household and employer spending.
Kalra introduced a constitutional amendment to fund the state's single-payer system that would raise $160 billion through a 2.3% excise tax on businesses following their first $2 million in income, a 1.25% payroll tax on companies with 50 or more employees, a 1% payroll tax on wages above $49,900 and a progressive income tax on residents earning more than $149,500.
Two-thirds of the State Senate and Assembly would need to approve the amendment.
"So the reality is there is a cost savings to California families and businesses," Kalra said. "We do have to figure out what the best mechanism is. I believe we put forward a progressive taxation mechanism that works."
In a 2021 analysis of the U.S. and 10 other high-income countries, the Commonwealth Fund ranked the U.S. 11th in health care system performance. The U.S. was 11th in access to care, administrative efficiency, equity and health care outcomes, despite spending at least an additional 5.1% of its GDP – 16.8% in all – on health care in 2019.
Last March, a MorningConsult/Politico survey found 55% of U.S. voters supported a single-payer "Medicare for All" plan. Meanwhile, 68% of voters, including 56% of Republicans, supported a public option where people could choose between private insurance or a government-run program.
Kalra said a key hurdle to his bill's passage is to "beat down decades of misinformation" and "brain-washing" about the efficacy of health care in the state and across the country.
"For decades, the industry has done a masterful job of convincing us that somehow we have great health care," he said. "And the reality is that we may like our doctors, our clinics, our nurses, but to say that we like our insurance companies, or the way that they dictate what kind of care we're gonna get, is far from reality."
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