California Legislative History

Following the 1994 defeat of Prop.186, a single-payer ballot initiative, activists met and agreed to create a “dedicated single-payer organization.” In 1996 Health Care for All -California (HCA) was established and chapters were formed across the State. In 1999, SB 480, a state-sponsored study of ways to achieve universal health care, passed the legislature and was signed by Gov. Gray Davis. Also, HCA launched its website.

In 2000, California received federal funding ($1.2 million) for a Health Care Options Project (HCOP). Three single-payer and six incremental multiple payer proposals were analyzed. In 2002, the analysts concluded that the single-payer plans were the most cost-efficient, while providing universal coverage with the best benefits and the highest quality health outcomes. ( the report on the nine HCOP proposals, the Lewin Group analysis, and the AZA Consulting analysis.) The HCOP provided support for the introduction of a single-payer bill in 2003 (SB 921 – Sen. Sheila Kuehl), which failed to pass. Moving forward, a new single payer bill, SB 840, also carried by Sen. Kuehl, passed the legislature in 2006 and 2008, only to be vetoed both times by Gov. Arnold Schwarzenegger. After the introduction of the federal Affordable Care Act in 2010, subsequent bills, SB 810 (2009, 2011), SB 562 (2017), and AB 1400 (2022), failed to advance through the legislative process.

For information about the grassroots campaigns to enact single payer, read “History of California Single Payer Legislation & Movement: 1997 – 2024.” Prepared by long-time HCA leader, Dan Hodges, the document is both comprehensive and illustrated.

Single-Payer Coalitions

A statewide coalition of organizations, who support a single-payer financing system, has been evolving and growing. In 2006 the State Strategy Group (SSG) formalized its leadership of the movement. With the strong support of the California Nurses Association, the SSG evolved into the Campaign for a Healthy California (CHC) in 2011. During 2013, because of disagreements over strategies, a subgroup of single-payer focused organizations (HCA, PNHP, CA One Care, Single Payer Now and others), split away from the CHC to form the All Care Alliance. In the Fall of 2018, the two group again joined forces and, in the spring of 2019, Healthy California Now (HCN) was formed with a representative leadership structure.