Friendly Fire, Allies tangle over single-payer strategy

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Bill Haskell
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California Democrat State Senator Scott Wiener’s (SB770) wants to talk more about single payer which some dispute as even being single payer. Health Care 4 Us (Democrats) join with union nurses in California who champion AB 1690. SB 770, establishes a “working group” to advise the Governor in informal conversations with the federal government about waivers to capture federal funds for a unified financing health care system. The fear being the talking stage could carry as far out as 2028. AB1690 says we have talked enough, lets get this signed off. The Feds will not act till the state passes a bill.

Allies tangle over single-payer strategy, POLITICO, Rachel Bluth, August 2023

FRIENDLY FIRE: Sometimes the loudest opponents can come from your own side.

That’s certainly true with the quest for a single-payer health care system in California, where the greatest debate of the day is playing out between groups that are seemingly working toward the same goal.

Divisions among single-payer proponents are only widening in the uphill battle to overhaul California’s entire health care system — an undertaking that would require permission from the federal government..

A bill winding through the legislative process — SB 770, from state Sen. Scott Wiener, a San Francisco Democrat — would create an advisory group and a timeline for starting informal discussions with the federal government on the necessary paperwork to get a new system going.

But strategic and ideological fissures have formed around when to start engaging the feds and how incrementally to proceed. The California Nurses’ Association, a fervent and outspoken single-payer advocate, argues the state has done more than enough studying of the issue. The federal government, CNA says, has been clear that a state would need to pass single-payer legislation before it can ask for permission to carry it out.

The group’s proposal to set up a single-payer system known as CalCare. Coming from San Jose Assembly member Ash Kalra, it still contains few details and won’t be introduced in earnest until early next year. It will closely hew to a bill from last year that never made it to the floor, but that advanced further than previous attempts in the Democratic-supermajority Legislature.

Wiener and proponents of his bill think the two proposals can go hand-in-hand, but the CNA disagrees. Its leaders argue the two approaches are mutually exclusive — and SB 770 isn’t even a single-payer bill.

Jasmine Ruddy, an assistant director on CNA’s CalCare campaign.

“There is a growing coalition that is preparing and getting ready to be behind a single-payer bill in early 2024. I think that there is a faction of that movement that is interested in a different direction that is not single-payer health care, and we will always be opposed to that.”

The nurses’ union is spending the year doing outreach and organizing for CalCare, including monthly trainings and canvassing, as well as series of local town halls attended by supportive elected officials like Wendy Carillo (D-Los Angeles), Dave Cortese (D-San Jose), Damon Connolly (D-San Rafael) and, of course, Kalra. They’re also pushing out materials to supporters, directing them how to bring down SB 770.

But Healthy California Now, the coalition of groups behind Wiener’s bill, isn’t interested in tangling with CNA, which could antagonize key allies.

“I guess it takes two to tango, and we’re kind of not up for that dance,” said Michael Lighty, president of Healthy California Now.

Getting this bill through the Appropriations Committee and then through the Assembly isn’t a slam dunk; neither is the governor’s signature.

And if everything goes according to plan, the voters will eventually get a say. That’s where the real fight begins.

Voting Yes on CalCare Means No on SB770, Angry Bear