California lawmakers are preparing to hold a second hearing on AB 1400 — the state's Guaranteed Health Care for All bill — this week.
The single-payer health care bill, or "Medicare for All" bill, appears to have broad support from California state and local officials, but hospital and physician groups have united with insurers and employers in opposition.
The head of a major California health consumer advocacy group, Health Access California, has written to state lawmakers in support of the concept of creating a single-payer health finance system, but he also expressed concerns about the original version of AB 1400.
AB 1400 supporters face a tight deadline and may have trouble getting the bill enacted as a stand-alone piece of legislation during the current session. But the Health Access California comment letter could shape how lawmakers draft single-payer health care bills in California, and elsewhere in the United States, in the future.
AB 1400 Basics
Assembly member Ash Kalra, a Democrat who represents the San Jose, California, area, introduced AB 1400 with two other assembly members in 2021.
The bill would eliminate commercial health insurance and Medicaid coverage in California and replace those forms of coverage with CalCare, a government-run health plan.
In addition to paying for medical care, CalCare would pay for oral health care, audiology services, vision services, transportation for people with disabilities, and long-term care services. CalCare could also replace or crowd out the traditional Medicare program, Medicare Advantage plans and Medicare supplement insurance policies.
Commercial insurers could continue to sell some kinds of supplemental coverage, but they could not sell policies that covered any services that the California single-payer plan covered.
Members of the California Assembly Health Committee approved the bill by an 11-3 vote Jan. 11.
Members of the Assembly Appropriations Committee are preparing to consider the bill Thursday.
Under California rules, lawmakers have until Jan. 31 to approve the bill. If they approve the bill by that deadline, with a two-thirds majority in both the Assembly and the Senate, then the bill will appear on the ballot in the fall.
The Health Access California Letter
Anthony Wright, the executive director of Health Access California, emphasized in a comment letter on the bill that his group likes the thinking behind AB 1400.
"We are encouraged about the main intent of this bill, to advance our primary goal of quality, affordable health care for all," Wright writes in the letter. "We support this bill and the goal of reaching a universal health system in California."
But Wright also talks about what he and others at his organization believe were gaps in the original version of AB 1400.
Wright writes that the original version of the bill lacked a funding mechanism, other than a provision stating that it's the intent of the California Legislature to develop a revenue plan.
