Why Is Single-Payer Needed in California?

While the numbers of uninsured in the state have been reduced under the Affordable Care Act (ACA), many people are experiencing intolerable out-of- pocket costs for deductibles and co-pays, and rapidly rising premiums. Furthermore, they find the insurance rules under the Act to be confusing and often unfair. For employers and providers, administrative costs remain high.

Policies offered under the ACA, often provide very narrow health care networks. Patients can end up with very limited choice and substantial bills from the use of non-network providers. In 2017, the insurance exchange, Covered California, has only 11 competing insurance companies of all sizes. The average number per region in the state is two or three.

Insurance companies negotiate for the cheapest provider fees and tend to choose, as their “in-network providers”, those who offer the lowest cost. The result is that patients are left with not only limited choice of health insurance plans, but limited choice of health care providers.

When the ACA was fully implemented in 2014, the number of uninsured in the state was seven million people. In 2015 the number was down to 2.9 million. Of the newly insured, many became insured through MediCal, the government program for people with limited incomes. California now has 12.5 million people, or one in three, completely subsidized for their health care (California Healthcare Foundation, 2016).

Many in the state remain uninsured or under-insured. Not all working people are covered by employer-based insurance, nor do they qualify for MediCal. These individuals do have the option of purchasing insurance through Covered California (2017). In addition to the premium payment, many of these plans have high individual deductibles, up to $6,300 per person or more plus as much as a $500 deductible for prescription drugs. Based on income, some may qualify for a tax credit subsidy.

When people cannot pay the out-of- pocket costs when health care is needed, many put off seeing a health care professional and resort to home remedies. When individuals are uninsured or underinsured, their health is compromised and their quality of life is impaired. It is costly for everyone.

The Affordable Care Act has not prevented bankruptcies due to medical costs, nor does it provide universal or affordable coverage. Therefore, the ACA is under attack in Congress from both the right and the left.

A single-payer system can provide guaranteed, comprehensive health care for all individuals living in California. There will no longer be any threat of medical bankruptcies for patients and their families.


For more information see:

California Health Care Foundation. 2016; California Department of Health Care Services: http://www.latimes.com/local/california/la-me- medi-cal- growth-20151224- story.html.

Covered California (2017): http://www.coveredca.com/shop and compare/