The campaign for universal single-payer healthcare in California: SB 562

The campaign for single-payer universal healthcare in the US took a big leap forward in February 2017 with the introduction in the California State Senate of the bill SB 562 by State Senators Ricardo Lara and Toni Atkins. The full content of the bill is here. I’m going to explain what the bill is, what the campaign to get it passed looks like, and how you can help. I’m an activist with the single-payer activist organization Health Care for All — California, as well as being on the communications committee for the “Healthy California” coalition working to get the bill passed. I’ve been working on single-payer healthcare in California since last June, almost immediately after the People’s Summit in Chicago last year.

What is this bill? SB 562 aims to create an independent public entity that would provide guaranteed comprehensive healthcare to all California residents with no premiums, no deductibles, and no co-pays. The financing details of the bill are not yet available, and won’t be written until the financial study is completed. That is under way now by economist Robert Pollin at the University of Massachusetts at Amherst and is expected to be completed sometime in late May. He is known to Governor Jerry Brown and the hope is that a financial analysis of the bill from him will carry more weight with Gov Brown. The general idea is that the state would create an agency that would collect all the money currently being spent on health care into one pool: all the Medicare money that comes to state residents, all the Medicaid money (those two sources would comprise around 50% of the funding), all the money for insurance premiums people are currently paying, all the money employers are currently paying for their employees’ insurance premiums, plus a small progressive tax probably payroll but could be sales or any other kind of tax. This combined pool of money would be the fund for every resident’s healthcare. Those who currently qualify for Medicaid would not pay anything for their healthcare. Previous studies have shown that such a system would be able to provide comprehensive coverage to everyone, including mental health care and dental and vision care, with no premiums, deductibles, or co-pays.

The way the system would work for patients is expected to be much like how Medi-Cal works now, but with no income requirement, and it would pay doctors more and you’d have way more choices of providers. You prove you’re a resident and you are given a card. When you go to your doctor, you show the card, and that’s it, with no co-pays and no deductibles. The expectation is that the vast majority of providers will accept the program because so many people will be on it. The system would be available to everyone whether they’re a citizen or not, because healthcare needs to be treated as a public good. Much like how fire protection services used to be private, until everyone collectively realized that fire spreads, so letting one building burn because they hadn’t paid their fire protection premium would put other buildings in danger. Somebody with tuberculosis is going to spread it if they’re not treated and disease doesn’t care if you’re insured or not.

California is uniquely suited to be the major fight for guaranteed healthcare. California has the benefit of over twenty years of single-payer guaranteed healthcare activism as well as multiple campaigns for ballot measures and legislative bills, including two previous single-payer bills that passed both houses of the state legislature, in 2006 and 2008. This history has created a landscape with dozens of organizations supporting the guaranteed healthcare cause before the bill was even announced.

A week after Donald Trump was elected, nearly every major healthcare and progressive organization that’s every supported single-payer healthcare in California come together for a new working not-yet-named coalition. That coalition created the legislation that was introduced in the state senate. Now that the bill has been announced, the coalition is calling itself “Healthy California” and has launched a new branding and website. The Healthy California coalition includes three large groups that had already existed for years: the Campaign for a Healthy California, the AllCare Alliance, and Labor for Single Payer. The major organizations that are part of these groups are the California Nurses Assn (CNA), Health Care for All-California (HCA), Physicians for a National Health Program (PNHP), Democracy for America (DFA), the League of Women Voters (LWV), Courage Campaign, San Francisco Berniecrats, and dozens of other labor and progressive organizations. The coalition has several working committees as well as a regional structure with regional leaders, many of whom are the leaders of the Health Care for All-California chapter in that region. The name of the campaign to get SB 562 passed is also being called “Healthy California”.

What’s the process?

• The bill has been introduced in the state senate and will first go through the Senate Healthcare committee, then to the Senate Appropriations committee. After that it will likely be on hold while a financial viability study is being done. That study has already been commissioned to be done by economist Robert Pollin at the University of Massachusetts at Amherst.
• After the study is done, hopefully by the end of summer, we expect the bill to be brought to the full senate, and people in the campaign generally think it’s likely to be successful there.
• Then we expect the bill to be brought to the state Assembly for next year and it’s likely to be much tougher there. Many Assembly Democrats are amusingly referred to as “business-friendly” Democrats, which means they would be Republicans in any other state but ever since Gov Pete Wilson destroyed the Republican brand in California with Prop 187, running as a Republican isn’t feasible in many districts. This means the Democratic party dominance in California does not indicate as much liberal representation as it might appear to. The assembly will be a huge battle, and we suspect this is when the big guns from the insurance companies and pharmaceutical companies and hospitals and medical device companies will come out and try to turn people against this plan.
• The campaign to get the bill passed will focus on creating a popular movement, and on garnering thousands of endorsements from organizations all over the state. Legislators are most moved to vote for legislation by the endorsements of organizations in their districts, so local HCA chapters and other regional groups will be focused on gathering the names of organizations and the people to contact in each one, and then tracking the process of contacting them, speaking at a membership meeting or presenting them with some information, asking for their endorsement, and finally getting their endorsement.
• The campaign will also be setting up lobby days to lobby state legislators, and speaker training sessions so people can get grounded in the policy and learn how to speak to organizations to get their endorsements.

How can you get involved?

• Sign up for email updates with Healthy California at http://www.healthycaliforniaact.org/home, and follow them on their Facebook page at https://www.facebook.com/CampaignForAHealthyCalifornia/, where they’ll posting campaign updates and events including speaker training sessions and lobby-your-legislator days.
• Join or donate to Health Care for All — California (HCA), http://healthcareforall.org. HCA is one of the core groups in the Healthy Calfornia coalition and has been working at the grassroots for single-payer healthcare in California for over twenty years. HCA collectively has the most expertise in the state of getting single-payer legislation passed, as they still have many of the same people who helped get single-payer bills passed in the California legislature in 2006 and 2008. Most other single-payer organizations in California are specifically labor-based or only work with other organizations, or have multiple issues they’re working on, but HCA is the only organization working at the grassroots who’s solely devoted to getting single-payer healthcare in California. HCA is regional-chapter-based with chapters all over the state, and new ones are forming soon: http://healthcareforall.org/chapter-directory. HCA’s Facebook page will have updates to the campaign and news on movie showings and chapter meetings and training sessions: https://www.facebook.com/HealthCareForAllCA/.
• Join Democratic Socialist of America (DSA). DSA is also strongly in support of single-payer and they also have chapters all over the state. I know that East Bay DSA is heavily involved with the campaign already and their Facebook page will have updates about what they’re doing: https://www.facebook.com/eastbaydsa/. Probably other DSA chapters in California will be helping with this campaign but I’m not sure what they’re doing yet.
• Join or donate to Courage Campaign. Courage Campaign is a California netroots advocacy organization for an array of progressive causes. They cut their teeth with the anti-Prop 8 campaign and are now a strong supporter of the California single-payer cause. You can sign up for their emails on their website: http://couragecampaign.org/. Courage Campaign has traditionally been an online-only organization but they are just starting to organize real-life events, especially in support of the ACA.
• Join your local Democratic club. Democratic clubs in California are sponsored by the state party and are the entry point for everyday Democrats to get more involved with the party. Many Democratic clubs in California will be strongly in favor of this bill right away, but many of the more “centrist” clubs will be hesitant or indifferent. Moving the Democratic party is part of the process so get involved with your local club and make this bill an issue for the club to endorse. Remind them if you need to that the California Democratic Party platform includes a plan calling for singly-payer guaranteed healthcare in the state.
• Other groups may be mobilizing their members, the campaign is still evolving. Keep your eyes and ears open!

Things you can do all the time and get other people to do:

• Get grounded in the basics of what single-payer healthcare is and how it works. Look over all the pages on the HCA and Healthy California websites. Also the PNHP website has an excellent FAQ page: http://www.pnhp.org/facts/single-payer-faq.
• Wear a pin or button or t-shirt for SB 562 or single-payer healthcare in general when you’re out and about and be open to talking to strangers about it in stores, banks, parks, etc .
• Talk to your family, friends, co-workers, neighbors using the information you’ve read. See what resonates. Listen to them. Report back with the objections or questions you hear that you don’t know the answers to.
• Find a way to see the “Now is the Time” movie, tell other people about it, bring them to a movie showing, maybe have a house party where you show the movie and talk about it.
• Follow the Healthy California campaign and Health Care for All — California on Facebook and on Twitter, and like and reply to and share their social media items with your networks, especially on Facebook. Every engagement you make with Facebook items tells the Facebook algorithm that that item is a popular post and should be displayed in more people’s timelines.
• use the hashtags #HealthyCA and #SB562 in your social media posts about the new bill
• If you want a high-volume Twitter stream about single-payer healthcare and many other progressive causes, follow me on Twitter at @RedwoodGirl.

Thank you for getting involved! There’s never been a better time for this so let’s make it happen.