Gov. Newsom’s new health care rhetoric stops short of single-payer promises

Twenty months ago, then-Lt. Gov. Gavin Newsom sealed the endorsement of the powerful California Nurses Association in the governor’s race with an impassioned promise to bring single-payer health care to the Golden State.

“There’s no reason to wait around on universal health care and single-payer in California. It’s time to move [Senate Bill] 562. It’s time to get it out of committee,” Newsom told a nurses union conference in September 2017. “If we can’t get it done next year, you have my firm and absolute commitment as your next governor that I will lead the effort to get it done. We will have universal health care in the state of California.”

But now, as Newsom undertakes a “California for All” tour of the state’s largest cities, that ambitious rhetoric has long since given way to more modest proposals – and to attempts to dampen expectations. Instead of the governor reviving Senate Bill 562 – a 2017 measure passed by the Senate that would have committed the state to creating a single-payer system – he now says that’s not feasible without the assistance of the federal government.

Newsom has asked the Trump administration to give California a waiver from federal laws allowing the state to set up its own unique health care system – and for a sum equivalent to the amount the federal government now spends on health care for state residents. Senate Bill 562 died in the Assembly over expectations it would cost about $400 billion a year – double the state’s budget.

Governor risks backlash from fellow Democrats

The May Revise of the 2019-20 state budget that Newsom unveiled last week includes several proposals to expand availability of health care partly subsidized by the state government, in particular raising the income threshold of eligibility up to $73,000 a year. Individuals who make $48,000 a year or more are not eligible for federal subsidies under the Affordable Care Act. But he stopped short of extending Medicaid coverage to unauthorized individuals in California, citing its $3.4 billion cost. And he made no concrete proposals on advancing single-payer beyond previously announced plans to use the newly created state Council on Health Care Delivery Systems to examine how the state could transition to such a system.

The potential for a backlash from Newsom’s own party is clear. Politico reported in March than Newsom believed strongly that leadership on single-payer should be led by “the horseshoe,” an insider’s term for the governor’s unusually shaped office. But having a commission look at the state’s possible courses of action isn’t the dramatic move that fans of Democratic presidential candidates like Sen. Bernie Sanders and Sen. Elizabeth Warren want. A Quinnipiac University poll released in February showed 61 percent of state Democrats back a government-run single-payer system in California.

The California Nurses Association has expressed disappointment with the lack of progress. In February, CNA lobbyist Stephanie Roberson told the Sacramento Bee that it was “baffling” that no state lawmaker had introduced a measure like Senate Bill 562 and said her union strongly believed that incremental improvements in health care access were not enough.

“We can’t, as leaders, just protect what we have because we fundamentally believe that health care is [a] human right,” Roberson said.