Since the cost savings are so substantial, the care impact so positive, the reform so popular and moral imperative so strong for single payer guaranteed healthcare, advocates often wonder why the US and California have not adopted it.

The answer in large part is that we have yet to develop a political strategy that can overcome the deep pockets and political power of the healthcare industry.

The Healthy California Now campaign aims to do that.

The first step occurred this week with the introduction of SB 770 authored by California state Senator Scott Wiener.

Despite much progress and the passage of single payer legislation in one or both houses of the California legislature, support from Governor Newsom and at the federal level the majority of the Democratic caucus in the US House, improved Medicare for All, single payer reform remains the best unrealized reform in the country.

Our goal is to guarantee equitable healthcare to all California residents that provides better care at less cost, through public financing.

We believe it is possible to work out policy difference and establish a coordinated effort between the Governor, legislature, advocates, and funders to produce an “actionable” package of policy proposals in accordance with a waiver framework the Biden Administration will support by some point in 2024.

SB 770 is designed to achieve that result.

The bill will define the parameters of the federal waiver California seeks, which would be based on memorializing the Healthy California for All Commission’s recommendations and identifying the policy and financing issues to be addressed by a stakeholder process defined in the bill.

As Senator Wiener said in his introduction of the bill, “This approach retains flexibility for the Administration and Legislature to decide how the system will ultimately be structured and allows for engagement with stakeholder groups every step of the way. We must move the process along in order to avoid the hundreds of billions of dollars in healthcare costs projected by the Governor’s Commission if we fail to act.”

The tasks necessary to organize a credible program to achieve single payer in California start with getting on board key labor and advocacy organizations whose support is necessary to win. We are recruiting advocates who will join us to do the necessary legislative work and public education.

SB 770 establishes tangible steps on a concrete timeline toward creating this unified healthcare financing system by:

  • Directing the Secretary of the California Health and Human Services (HHS) Agency to pursue waiver discussions with the federal Center for Medicare and Medicaid Services (CMS) to facilitate the creation of a unified healthcare financing system;
  • Requiring the Secretary to establish a Waiver Development Workgroup of diverse healthcare system stakeholders appointed by the Governor, Speaker of the Assembly, and President Pro Tempore of the Senate;
  • Requiring 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 government and the progress of the workgroup;
  • Requiring 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

Naturally, developing a clear and sustainable financing approach the Biden Administration would approve is central to this process. Ultimately, we will need to incorporate the infrastructure being built through the Office of Healthcare Affordability and Cal AIM into a single payer program.

The HCN bill and CalCare are on complementary tracks, but the first legislative goal would be passing the collaborative engagement and advisory process in the HCN bill, to be followed by consideration of a comprehensive single-payer program, including the proposals in CalCare.

We have an historic opportunity to create a viable path to political success for single payer – let’s seize the moment!

See our SB 770 page for more