What Is the Single-Payer Movement in California?

A grassroots movement for the establishment of a single-payer health care financing system in California (CA) has been building since the 1990s. As early as 1992, state Senator Nick Petris introduced a single-payer bill in the state legislature. Insurance Commissioner John Garamendi created a plan for universal coverage with a modified single-payer approach that passed the legislature, but was vetoed by Governor Pete Wilson. In 1994, a single-payer ballot initiative, Proposition 186, was defeated in the face of strong opposition by industry stakeholders. The initiative increased public awareness of single-payer and was followed up in 1998 by introduction of Senate Bill (SB) 2123, calling for establishment of a universal single-payer system in the state. This bill led to a resolution calling for a study to compare different models of financing universal health care, including single payer.

In 2002, after completing the study of the impacts of various models for health care financing, the Lewin Group and AZA Consulting reported that more people could be covered for more services for less money with a carefully designed single-payer system. In the 2003-2004 legislative session, a single-payer bill, SB 921, introduced by state Senator Sheila Kuehl, passed the full Senate and the Assembly Health Committee. An analysis of the financial impact of SB 921 by the then-independent Lewin Group reported in 2005 that if a single-payer system were to be implemented in 2006, California would see a savings of $8 billion in the first fiscal year and $344 billion between 2006 and 2015, while covering all California residents with high quality health care.

In the 2005-2006 legislative session, Senator Kuehl introduced SB 840. The bill won approval by both houses, with California becoming the first state in U.S. history to pass single-payer legislation. The bill was vetoed by Governor Arnold Schwarzenegger. Senator Kuehl reintroduced  SB 840 (the California Universal Healthcare Act) in the 2007-2008 legislative session.  The bill passed the legislature in 2008. Governor Schwarzenegger again vetoed the bill.

Senator Mark Leno reintroduced the California Universal Health Care Act as SB 810 in the 2009-2010 legislative session. In August 2010, SB 810 passed the full Senate and Assembly committees but was not put to a vote by the full Assembly. Senator Leno reintroduced SB 810 in the 2011-2012 legislative session. It passed all the Senate committees but failed by two votes on the Senate floor.

The single-payer movement in California continues to grow, with more support today than ever before.