California Post-ACA Considers Single-Payer Plan


The GOP-led American Health Care Act will not replace the Affordable Care Act (Obamacare). What now?

We turn to Congress. Vermont’s Independent Sen. Bernie Sanders announced plans to introduce a bill providing Medicare for all Americans.

Publicly funded, Medicare provides health care for Americans over the age of 65, and to younger people who are disabled and have certain medical conditions. Americans like Medicare.

As a Democratic presidential candidate, Sanders’ popularity soared in no small part due to his advocacy for making Medicare available to all Americans. By contrast, the ACA has expanded health-insurance coverage but still leaves millions of people without it.

Passage of the AHCA would have made the ACA’s shortcomings worse. The American public across political party lines overwhelmingly opposed worsening the flawed ACA.

Opposition to the AHCA also reveals fractures within both political parties over health care.

On one hand, the GOP’s House Freedom Caucus, unlike the party establishment, wanted deeper cuts to the ACA in the AHCA. That spelled in part the end of the AHCA.

On the Democratic side, a fissure between the progressive wing and the establishment block over improving the ACA is worth a look. A noteworthy example is underway in the Golden State.

In California, two Democratic lawmakers, state Senators Ricardo Lara (Los Angeles) and Toni Atkins (San Diego), introduced Senate Bill 562, the Healthy California Act, a Medicare for all-type bill, recently. Under this bill, the state government would be the only payer for patients’ health-care services.

SB 562 has sponsorship from the California Nurses Association/National Nurses United. This labor union has been at the forefront of progressive changes to the corporate-run health care system, with its backing of SB 562 the most recent case in point.

“With Republicans’ failure to repeal the Affordable Care Act, Californians really get what is at stake with their healthcare,” Sen. Lara said in a statement. “We have the chance to make universal healthcare a reality now. It’s time to talk about how we get to healthcare for all that covers more and costs less.”

Americans pay more and get less for their health care dollars than their counterparts in other developed nations. This fact is beyond dispute.

“The Affordable Care Act is still intact, and that is a good thing, but uncertainty remains, and we can’t afford to remain idle on healthcare,” said Sen. Atkins. “The framework outlined in the Healthy California Act is the option that we need on the table to take our state forward and provide healthcare for everyone.”

Consider two of 11 key provisions of the Healthy California Act:

First, the bill covers Californians for all medical care, including inpatient, outpatient, emergency care, dental, vision, mental health, and nursing home care. Last, SB 562 eliminates co-pays and insurance deductibles.

The ACA provides neither of these two provisions. The ACHA increased co-pays and insurance deductibles.

What are the prospects of SB 562 passing both houses of the California legislature and the Democratic governor, Jerry Brown, signing it into law? Significantly, he stated deep doubts about funding SB 562 on a visit to Washington, D.C., in late March.

Gov. Brown’s stance is music to the ears of private insurers. They are at-risk of losing market share and profit under a single-payer system of health-care services.

Gov. Brown couches doubt about funding SB 562 in the language of caution. Thus his stance is one of a sober adult, unwilling to tax and spend on new programs and services.

With the introduction of California’s SB 562, we see the progressive base of the state Democratic Party versus establishment interests. Further, the fight for a single-payer health-care system in California has far-reaching national consequences.

Imagine that single-payer health-care becomes the law in the Golden State. Americans would see that the sky doesn’t fall as a result of that.

To get to a single-payer system from the current corporate-run health-care model would require the active involvement of the populace in California, dare I say movement politics. It would necessarily heighten a major conflict over economics and politics among two groups of state Democrats.

Seth Sandronsky is a journalist and member of the Pacific Media Workers Guild. Email

From The Progressive Populist, May 1, 2017

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