Single-payer healthcare proposal fizzles in California Assembly

Assemblyman Ash Kalra on the floor of the Legislature
Assembly Bill 1400 by Assemblyman Ash Kalra (D-San Jose), seen above in 2019, did not have the necessary votes to move forward ahead of a key deadline Monday.
(Robert Gourley / Los Angeles Times)
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Lawmakers declined to vote on a high-profile effort to overhaul California’s healthcare system on Monday, putting an end to a proposal that would have guaranteed medical coverage to every resident by levying billions in new taxes.

Assembly Bill 1400 by Assemblyman Ash Kalra (D-San Jose) did not have the necessary votes to move forward ahead of a key deadline Monday. Instead of forcing a vote that could be politically damaging for some of his Democratic colleagues, Kalra opted to let the bill die, angering the California Nurses Assn. that has championed single-payer for years.

“Despite heavy opposition and substantial misinformation from those that stand to profit from our current healthcare system, we were able to ignite a realistic and achievable path toward single-payer and bring AB 1400 to the floor of the Assembly,” Kalra said in a statement. “However, it became clear that we did not have the votes necessary for passage and I decided the best course of action is to not put AB 1400 for a vote today.”


AB 1400 would have created a publicly financed healthcare system called CalCare, which could cost between $314 billion and $391 billion in state and federal funds, according to a legislative analysis. But supporters said residents in the state would ultimately have saved money when compared with paying for insurance, co-pays and deductibles.

“Elected leaders in California had the opportunity to put patients first and set an example for the whole country by passing AB 1400,” the California Nurses Assn. said in a statement. “Instead, Assembly Member Ash Kalra, the main author of the bill, chose not to hold a vote on this bill at all, providing cover for those who would have been forced to go on the record about where they stand on guaranteed health care for all people in California.”

It’s the second time in the last five years that a single-payer bill has died in the Assembly. In 2017, a Senate bill to create a single-payer plan was shelved by Assembly Speaker Anthony Rendon (D-Lakewood), who called that proposal “woefully incomplete.” Rendon’s decision at the time angered the nurses’ union, which said failing to put it up for a vote was “a cowardly act.”

On Monday, Rendon said the shortage of votes for AB 1400 shows how difficult it is to implement single-payer healthcare in the state.

“Nevertheless, I’m deeply disappointed that the author did not bring this bill up for a vote today,” Rendon said in a statement. “I support single-payer and fully intended to vote yes on this bill. With time, we will have better and more successful legislation to bring us closer to this goal.”

Supporters of the bill said the COVID-19 pandemic made the importance of healthcare access critically clear. A recent poll by the California Health Care Foundation and NORC at the University of Chicago found 83% of Californians say it is “extremely” or “very” important for Newsom and lawmakers to focus on “making health care more affordable” this year.


Still, Kalra’s bill has faced immense odds since it was introduced last February. For nearly a year, AB 1400 failed to gain traction while it lacked details on how it would be financed. This year, Kalra introduced a second bill, Assembly Constitutional Amendment 11, which would have used $163 billion in proposed new taxes to pay for the single-payer plan under AB 1400.

That helped the bill win support this month in the Assembly’s health and appropriations committees. Lawmakers faced intense lobbying on both sides of the bill leading up to Monday’s critical vote. The Progressive Caucus of the California Democratic Party threatened to withhold endorsements from any Assembly member that did not vote for AB 1400.

Critics of the single-payer plan have been flooding Californians’ cellphones and social media with ads criticizing the bill, saying it would “cause massive disruption to Californians’ healthcare at the worst possible time” and urging people to call lawmakers to tell them to reject AB 1400.

Opponents say even with its massive price tag, the proposal would still come up short of paying for the healthcare system overhaul. Exactly how much the proposal would have cost if it ultimately became law is still unknown. The Assembly recently approved a Republican request for the nonpartisan Legislative Analyst’s Office to review the cost and effects of the legislation.

The California Chamber of Commerce added the proposal to its annual “job killer” list that highlights laws corporate interests say will hurt employment and the economy. A chamber spokesman said the legislation would “ruin quality healthcare delivery” and “create the largest tax increase in state history.”

“AB 1400 was a disaster in the making and an unnecessary distraction from the real work of creating a healthcare system that can provide affordable, high-quality care to all Californians,” said Jim Wunderman, president and chief executive of the Bay Area Council. “It was unworkable and would have cost California taxpayers and businesses hundreds of billions in new taxes, with little or no hope that it would ever produce any results.”


Assembly Republican leader Marie Waldron of Escondido praised Democrats who helped stop the “foolhardy plan.”

“Better late than never,” Waldron said. “The fact that a proposal for a government takeover of our state’s entire healthcare system even made it this far shows just how out of touch the Democratic Party is from the needs of everyday Californians.”

The single-payer proposal has largely overshadowed a budget proposal by Gov. Gavin Newsom to allow all income-eligible residents to qualify for the state’s healthcare program for low-income people regardless of immigration status.

California already allows children and young adults living in the country illegally to qualify for Medi-Cal, while Californians 50 and older will be eligible beginning May 1. Newsom’s plan would add the final age group, which includes an estimated 700,000 people who otherwise meet income requirements but can not receive Medi-Cal because of their immigration status.

Newsom, who campaigned four years ago on implementing single-payer healthcare, said he remains committed to the goal, but did not weigh in on Kalra’s bill as he pushed his Medi-Cal expansion.

The governor said he is awaiting a report by the state’s Healthy California for All Commission detailing a plan on how best to create a single-payer model in the state.


“The facts are on our side that a single-payer system will save money and lives — and the people are on our side that meaningful healthcare reform is urgently needed,” Kalra said. “Especially with four democratic vacancies in the Assembly, the votes were not there today, but we will not give up.”