Five years ago, when he was running for governor, Gavin Newsom promised to move California’s medical care into a single-payer system similar to that of Canada and Western Europe.
Newsom supported the single-payer bill that passed the state Senate, saying, “There’s no reason to wait around.”
“I’m tired of politicians saying they support single payer but say it’s too soon, too expensive or someone else’s problem,” Newsom said.
His stance helped solidify Newsom’s support among progressive advocates of the proposal as he debated fellow Democrat Antonio Villaraigosa.
The bill stalled in Congress, and after winning the election, Newsom began to move away from the single-payer concept, citing serious obstacles. One is to convince the federal government to give California more than $200-billion in health care spending for Californians — about half of the state’s total medical expenses.
Newsom said that means about 40 million Californians will have some form of coverage, and that’s up from last year.
At the time, “Nearly 3 million Californians reported being uninsured by spring 2022. “Nearly seven in 10 (68%) are Latino, 38% are stateless, and 80% are low- or moderate-income (below 400% of the federal poverty line).”
It was closed in the 2022-23 budget by expanding Medi-Cal coverage to undocumented immigrants, creating a budget surplus of nearly $100 billion.
The final 2022-23 budget states that “Beginning January 1, 2024, Medi-Cal will be available to all income-eligible Californians.”
The expansion of Medi-Cal — California’s federal Medicaid program — was eased when federal officials eased eligibility requirements during the Covid-19 pandemic. This year, enrollment is over 15 million, or nearly 40% of the state’s population.
Under his “California Blueprint,” universal health care remains Newsom’s goal. However, at the moment, coverage appears to be dwindling, and with the state facing a chronic budget deficit, it will be difficult if not impossible to reach before the end of Newsom’s tenure.
The federal government’s “Continuous Enrollment” pandemic policy has expired, and hundreds of thousands of Californians will have to reconfirm their eligibility.
Newsom’s revised 2023-24 budget, unveiled last month, projects that Medic-Cal enrollment will be reduced by more than a million people, still more than a third of the state’s population, but Newsom wants to drop universal coverage as a single-payer. substitute.
Single-payer advocates are understandably frustrated by Newsom’s failure to deliver on his 2018 promises. They took some heat for him when he attended the Democratic Party convention last month.
Covering all Californians would be expensive. Medi-Cal coverage costs the federal and state governments $10,000 per enrollee. No one knows yet how many Californians are without coverage, but 2 million is as good a number as any, and many in Medi-Cal could spend another $20 billion a year.
Meanwhile, single-payer advocates haven’t given up. Last week, California Sen. Newsom In 2019, he approved Senate Bill 770 to implement a single-payer coverage plan developed by the Healthy California Commission for All.
The bill directs state agencies to begin discussions with federal officials about participating in California’s single-payer system.
State Sen. Scott Wiener, D-San Francisco, said, “It’s time to make real progress to end the inequity and inequity of our broken health care system.”
As Newsom eventually found out, that’s a lot easier said than done.
Dan Walters has been a journalist for nearly 60 years, all but a few years for California newspapers. His comments come via CalMatters.org, a public interest journalism organization dedicated to explaining how California’s state capitol works and why it matters. For more, go to calmmatters.org/commentary.