California Assembly Report Rejects Single-Payer Approach to Achieving Universal Coverage in the State

March 19, 2018
By Brett Johnson

On March 12, the California State Assembly released its report summarizing findings and recommendations from six hearings held by the Assembly’s Select Committee on Health Care Delivery Systems and Universal Coverage over the past few months. These hearings were in response to a push from progressive activists to advance Senate Bill 562 (Lara), which would have California adopt a single payer healthcare system with no clear source of funding.

The report rejects the publicly financed single-payer approach of SB 562, citing numerous substantial obstacles beyond just costs. These obstacles included integrating multiple payers, some of which are governed and protected under federal law, and the state’s inability, even with sufficient funding, to guarantee a dedicated and reliable revenue stream under the California Constitution.

Instead, the report suggests short term steps  to cover the remaining 3 million uninsured in California, as well as a longer term roadmap to addressing the preconditions necessary to entertain an approach like that of SB 562.  Chief among these short term steps are: the creation a publicly run option for low-income patients on Medi-Cal, the extension of Medi-Cal to undocumented immigrants, sufficient fines for people refusing insurance coverage, and the creation of a database for all healthcare claims in an effort to improve transparency and coordination.

To address these recommendations and the critiques about not advancing SB 562, Democrats in the legislature are developing a legislative healthcare package of up to twenty bills. Proposals to create a version of Medi-Cal coverage available to a broader segment of Californians, including undocumented immigrants, through the state’s health benefit exchange, Covered California, are among those anticipated.

CLSA has yet to take an official position on any of the proposed significant coverage reforms but will continue to closely monitor all legislation as the proposals are developed. As we continue to analyze the potential impacts of related legislation on our industry, any members who would like further information on this or any other California legislation are encouraged to reach out to Oliver Rocroi ( or Brett Johnson (