California Lawmaker Introduces Plan To Pay For State Universal Healthcare System


A California lawmaker introduced a bill Thursday that would fund single-payer healthcare in the nation’s largest state through new income, payroll and business taxes, part of a push by California politicians to roll out the country’s first single-payer system.

Key Facts

Assembly Constitutional Amendment 11, introduced by California Assembly Member Ash Kalra (D) on Thursday, contained a taxation plan to fund single-payer universal healthcare in California.

The concept, dubbed “CalCare,” was initially proposed by Kalra last February in California Assembly Bill 1400, but it failed to advance out of committee amid criticism that there was no detailed plan to fund the program.ACA 11 fills in those details, proposing to raise funding from a gross receipts tax on companies earning more than $2 million, a payroll tax for businesses with 50 or more employees and a personal income tax for those making more than $149,509.

CalCare would provide single-payer coverage for all residents of the state, allowing them to access any doctor regardless of network, and would aim to lower prescription drug costs.

The bill will need a two-thirds vote from both houses of the legislature, as well as approval by California voters.

A hearing for AB 1400 will be held in the Assembly health committee on January 11, with influential California lawmakers like the chair of the committee Jim Wood announcing Thursday he will be voting to move the bill forward along with at least 20 other Assembly Democrats.

Crucial Quote

“In 2022, we already have one guarantee, out-of-pocket healthcare costs for Californians will continue to sharply rise,” Stephanie Roberson, government relations director of the California Nurses Association, which is sponsoring the bill, said in a statement Thursday. “This time let’s guarantee Californians can get the care they need without going into medical debt, starting a GoFundMe campaign, or going homeless or not paying for food or heating bills instead.”

Chief Critic

The California Hospital Association and the California Medical Association have opposed AB 1400, stating it would “take away any choice for anyone who might want to select private coverage or opt out,” according to the Associated Press, while the California Taxpayers Association said CalCare would raise taxes by $163 billion per year.

Key Background

California Gov. Gavin Newsom (D.) was supportive of single-payer healthcare during his election in 2018, though some critics say he has intentionally shifted his phrasing in favor of expanding existing public options. California lawmakers introduced a universal healthcare bill in 2017, but it was shelved by Assembly Speaker Anthony Rendon (D-Lakewood) for being “woefully incomplete,” citing financing issues and potential pushback from the Trump administration.


The Biden administration’s Build Back Better plan aims to reduce prescription drug prices, reinforce the Affordable Care Act, reduce health care premiums, close the Medicaid coverage gap and expand Medicare to include coverage for hearing benefits. Some are deeming the bill dead following moderate Sen. Joe Manchin (D-W.V.)’s staunch denouncement of it in December, as he holds a key swing vote in the Senate. Biden stated in 2019 he does not support eliminating private health care, but rather a public option and building on the Affordable Care Act.  

Surprising Fact

Vermont came close to becoming the first state to establish a single-payer healthcare system in 2014, but the bill was scrapped at the last minute after lawmakers could not find a viable way to cover the cost of the plan.