New Bill Seeks to Implement Universal Healthcare Coverage in California

With many Americans losing healthcare insurance during the pandemic, a recently proposed state assembly bill would create a Medicare for All-like system in California.


Ash Kalra

Assembly member Ash Kalra, one of the bill’s main writers.

Luca Dhagat

The United States, despite being the richest country in the world, is one of the few industrialized nations to not provide universal healthcare coverage. This reality, combined with notoriously high costs has led to Americans spending over twice the amount of money on healthcare compared to a mere 40 years ago.

The COVID-19 pandemic has exacerbated this health crisis to new heights, with millions of Americans having lost their jobs over the course of the last year and a half. Private healthcare insurance, already inadequate before, has now disappeared completely for many. This has helped strengthen an already growing movement to implement universal healthcare coverage. A Hill-HarrisX poll released last year revealed that 69% of registered voters would support Medicare for All, with a large amount of support from voters of both parties.

California, in tandem with the rest of the country, was hit hard by the economic fallout caused by the pandemic, with a record 15% of Californians being unemployed in April of last year. Unemployment still remains a problem, with 145,000 Californians applying for unemployment assistance this week, an increase of 39,000 compared to last week.

This crisis prompted State Assemblymember Ash Kalra (D-San Jose) to introduce the California Guaranteed Healthcare for All Act, also known as CalCare, on February 19th. Written in collaboration with other prominent politicians like recently elected Assemblymember Alex Lee (D-San Jose) and the California Nurses Association, and co-sponsored by nearly 20 other assembly members, Calcare, according to a press release from Kalra’s office, would “guarantee comprehensive, high-quality health care to all Californians as a human right.”

“People are dying and suffering. They’re going bankrupt and starting GoFundMe pages just in order to survive in the wealthiest state in the wealthiest nation on earth,” Kalra said. He also emphasized how, with Democrat President Joe Biden in office, and Xavier Becerra, a supporter of Medicare for All and Biden’s Secretary of Health and Human Services, a single-payer healthcare system on the national level would be more politically feasible.

CalCare has also received the support of many activist organizations, as well as labor unions. “From our experiences caring for patients, we nurses have known the need for and fought for decades for everyone to have guaranteed health care through a system like CalCare,” said Bonnie Castillo, Executive Director of the California Nurses Association. The CNA is affiliated with the National Nurses United, a nationwide nurses union that has gained attention for its active fight for healthcare reform. Recently, they’ve begun reaching out to California residents through phone and text in order to create pressure on certain Assembly members. 

CalCare, much like similar Medicare for All legislation that has been proposed on the national level, is distinct from socialized healthcare systems where healthcare providers are publicly owned. Instead, it seeks to create a single-payer healthcare system where the State would cover healthcare expenses. Healthcare providers, like Kaiser Permanente and Sutter Health, would still operate privately and in a competitive market. However, a board of state officials with healthcare experience would have the ability to bargain with healthcare providers and come to agreements over expenses. These agreed-upon expenses would then be covered with revenue allocated in California’s state budget. 

One of the main concerns over CalCare is financing. However, it is currently still hard to calculate exactly how much a single-payer healthcare system in California would cost. Although this isn’t the only time an assembly bill to implement universal healthcare in California has been proposed, CalCare is distinct in the sense that it eliminates certain loopholes insurance companies could use, thus making it easier for a future Calcare system to get the funding it needs. Along with this, a single-payer system would allow the state to consolidate waivers and financial support provided by the federal government. On April 21st, the California Health Benefits Review Program, established by the State to analyze the impacts of legislation impacting health services, will determine the financial viability of CalCare. 

The main obstacle proponents of CalCare will face is the overwhelming influence special interests like Big Pharma have in local government. Many state politicians rely on money from corporate special interests through lobbying to conduct their re-election campaigns. Voting against the interests of their benefactors could mean that this money is given to their opponent when they’re up for re-election. Lobbying firms also have the financial ability to run extensive PR campaigns to push public opinion against the bill. 

However, many of the politicians who have already cosponsored CalCare are part of a new generation of elected officials that are actively rejecting the influence of special interests in government. Assembly members Ash Kalra and Alex Lee, the two principal writers of the bill, both ran their election campaigns on the promise of not taking money from corporate lobbyists. Assembly member Alex Lee also recently introduced the Clean Money Act, which would ban financial contributions to politicians from corporate entities. Utilizing grassroots movements and the support of organizations like National Nurses United may allow them to ensure that there’s enough public pressure on politicians to ensure that the bill passes.