If Gavin Newsom survives the Republican-led attempt to oust him from office, the Democratic governor will face the prospect of paying back the supporters who have rallied behind him.
And the leaders of the California single-payer movement will want their due.
Publicly, union leaders say they stand by Newsom because he showed political courage during the covid-19 pandemic by taking action such as imposing the first stay-at-home order on statewide. But behind the scenes, they are aggressively pushing him to follow through on his 2018 campaign pledge to establish a government-run, single-payer health care system.
“I expect him to lead California by accomplishing a one-time payment and being an example to the rest of the country,” said Sal Rosselli, president of the National Union of Healthcare Workers, who urges Newsom to get federal authorization to fund such a system. .
Another union, the California Nurses Association, is pushing Newsom to back state legislation early next year to end private health insurance and create a single-payer system. But “first, everyone has to come out and vote no on this recall,” said Stephanie Roberson, the union’s lead lobbyist.
“It’s a matter of life and death for us. It’s not just a single payer. It’s about infection control. It’s about democratic and working class values,” she declared. “We lose if the Republicans take over.”
Together, the unions have made hundreds of thousands of dollars in political contributions, funded anti-recall ads and banked phones in defense of Newsom. The latest poll says Newsom will survive Tuesday’s recall election, which has become a battle between Democratic ideals and Republican angst over the government’s coronavirus mandates. The Democratic Party was quick to close ranks around the governor and push well-known Democratic candidates out of the ballot, leaving Liberal voters with little choice but Newsom.
“This is a pivotal moment for Newsom and for his supporters who line up behind him,” said Mark Peterson, UCLA professor of public policy, political science and law, specializing in health care policy. “They help him stay in office, but with that comes an expectation of action.”
But it’s not clear that Newsom – which will face competing demands to reimburse other supporters pushing for stronger action on homelessness, climate change and public safety – could bring change, too. massive.
Reorganizing the healthcare system according to a single-payer funding model would be extremely expensive – around $ 400 billion a year – and politically difficult to achieve, in large part because it would require tax increases.
The concept is already meeting stiff opposition from some of Newsom’s most ardent supporters, including insurer Blue Shield of California and the California Medical Association, which represents physicians.
No state has a single-payer system. Vermont tried to implement one, but its former governor, a Democrat, abandoned his plan in 2014, in part because of opposition to tax increases. California would not only need to raise taxes, but would also have to seek voter approval to change the state’s constitution and get permission from the federal government to use Medicare and Medicaid money to help. finance the new system.
The last big push for the single payer in California ended in 2017 because it did not adequately address funding and other challenges. Ahead of the 2018 gubernatorial election, Newsom campaigned on single-payer health care, telling his supporters “you have my firm and absolute commitment as your next governor that I will lead efforts to make it happen.” and “the only payer is the way forward.”
In power, however, Newsom has distanced itself from that promise by expanding the existing healthcare system, which relies on a mix of public and private insurance payers. For example, he and Democratic lawmakers have imposed a health insurance mandate on Californians and expanded public coverage for low-income people, making health insurers richer.
Newsom, however, convened a commission to study the single payer and wrote to President Joe Biden in late May, asking him to work with Congress to pass legislation giving states the freedom and funding to establish single-payer systems. âCalifornia’s innovative spirit is being stifled by federal limits,â Newsom wrote.
Newsom’s recall campaign, when asked about its position on the single payer, referred questions to its administration. The governor’s office said in prepared comments that Newsom remains committed to the idea.
“Governor Newsom has always said single-payer health care is where we need to be,” wrote spokesperson Alex Stack. “It’s just a matter of how we get there.”
Stack also highlighted a new initiative that will strengthen the state’s public health insurance program, Medi-Cal, saying it “paves the way for a principle single-payer system.”
Campaigners say Newsom let them down on one payer, but stands behind him as he represents their best chance of getting it. However, some say they are not ready to wait long. If Newsom doesn’t embrace the single payer soon, Liberal activists say, they will seek a Democratic alternative when he runs for reelection next year.
“Newsom is an establishment candidate, and we as Democrats have no hesitation in wresting the approval of someone who does not share our values,” said Brandon Harami, vice chairman of the Bay. Area of ââthe progressive caucus of the Democratic Party, which opposes it. the reminder. “Newsom has been completely silent on the Single Payer. A lot of us are really anxious to see some action from it.”
State Assembly Member Ash Kalra (D-San Jose), who also opposes the recall, will reintroduce his single-payer bill, AB 1400, in January after cutting it off earlier this year to work on a financing plan. Its main sponsor is the California Nurses Association.
Building on lessons learned from the failed 2017 attempt to pass single-payer legislation, the nurses union is deploying activists to pressure national and local lawmakers to support the bill. Resolutions have been approved or are pending in several cities.
“This is an opportunity for California to lead the way in healthcare,” Los Angeles City Council member Mike Bonin said ahead of an 11-0 vote supporting Kalra’s single-payer bill in late August. .
Kalra argued that Los Angeles support shows her bill is gaining momentum. He is also preparing a new strategy to confront doctors, hospitals, health insurers and other players in the health industry who oppose the single payment: highlighting their profits.
âThey are the No.1 obstacle to that overtaking,â Kalra said. “They are going to do whatever they can to discredit me and this movement, but I am going to turn the mirror over to them and ask them why we should keep paying for insane profits.”
An industry coalition called Californians Against the Costly Disruption of Our Health Care helped eliminate the single-payer bill from 2017 and is already pushing against Kalra’s measure. The group again argues that a single payer would keep people away from medicare plans and private employers and translate into less choice in medicare.
A single payer would “force those millions of Californians who love their health care into a new, unique, untested government program with no guarantees that they can keep their doctors,” coalition spokesman Ned Wigglesworth said. , in a press release.
Bob Ross, president and CEO of California Endowment, a nonprofit that works to expand access to healthcare, is on Newsom’s single-payer commission. He said it would work through “tensions” in the coming months before issuing a recommendation to the governor on the feasibility of a single payer.
âWe have a camp of single-payer fanatics who want the bold move to get to the single-payer tomorrow, and the other approach I call bold incrementalism,â Ross said. “I’m not ruling out any bold single-payer hits; I just want to know how we’re doing it.”
This story was produced by KHN, which publishes California Healthline, an independent editorial service of the California Health Care Foundation.
This article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorial independent news service, is a program of the Kaiser Family Foundation, a non-partisan health policy research organization not affiliated with Kaiser Permanente.