California: Single Payer advocates walk back their efforts...significantly.
via Melanie Mason of the L.A. Times:
A new bill introduced in the California state Senate aims to lay the groundwork for a state universal healthcare system, proposing an incremental approach that departs from recent sweeping, and unsuccessful, efforts to reshape how Californians receive care.
Under the measure by state Sen. Scott Wiener (D-San Francisco), California would begin the process of seeking a waiver from the federal government to allow Medicaid and Medicare funds to be used for a first-in-the-nation single-payer healthcare system.
“In the wake of COVID-19’s devastation, and as costs for working people have skyrocketed, the need to provide affordable healthcare to all Californians has never been greater,” Wiener said in a statement. He touted his measure as making “tangible steps on a concrete timeline toward achieving universal and more affordable healthcare in California.”
On the surface, this still sounds like a significant step...but the "begin the process" clarifier seems to dampen that. In addition, redirecting Medicaid and Medicare funds would still require a huge chunk of funding from the state itself to cover the cost of single payer healthcare coverage for all ~40 million Californians.
The next sentence underscores how much the California single payer movement has had to regroup over just the past few years:
The legislation would require California’s health secretary to offer recommendations on crafting the federal waiver by June 1, 2024.
"Offer recommendations" for wording the waiver application by June 1st of next year.
To be clear, I"m not criticizing Wiener for introducing this bill; in fact I praise him for taking a step back and approaching such a sweeping, massive overhaul of the state's healthcare system in a more rational manner. I'm just curious how it's going to go over with the single payer die-hard folks, who are quite vocal, to put it mildly.
I'm pretty sure the bill in question is SB 770, which has six other sponsors at the moment:
SB 770, as amended, Wiener. State boards and commissions. Health care: unified health care financing.
Prior state law established the Healthy California for All Commission for purposes of developing a plan that included options for advancing progress toward achieving a health care delivery system in California that provides coverage and access through a unified health care financing system, including, but not limited to, a single-payer financing system, for all Californians.
This bill would direct the Secretary of the California Health and Human Services Agency to pursue waiver discussions with the federal government with the objective of a unified health care financing system that incorporates specified features and objectives, including, among others, a comprehensive package of medical, behavioral health, pharmaceutical, dental, and vision benefits, and the absence of cost sharing for essential services and treatments.
The bill would further require the secretary to establish a Waiver Development Workgroup comprised of members appointed by the Governor, Speaker of the Assembly, and President Pro Tempore of the Senate, as specified. The bill would require the workgroup to include stakeholders representing various specified interests, including consumers, patients, health care professionals, labor unions, government agencies, and philanthropic organizations.
The bill would require the secretary to provide quarterly reports to the chairs of the Assembly and Senate Health Committees on the status and outcomes of waiver discussions with the federal governments and the progress of the workgroup. The bill would also require the secretary to submit a complete set of recommendations regarding the elements to be included in a formal waiver application, as specified, by no later than June 1, 2024.
The bill would include legislative findings related to the findings of the commission and declare the intent of the Legislature in implementing a unified health care financing system in California. Existing law states that it is the policy of the State of California that the composition of state boards and commissions shall be broadly reflective of the general public including ethnic minorities and women. This bill would make a nonsubstantive change to those provisions.