What is Going on with Single Payer in California?

Since Speaker of the Assembly Anthony Rendon shelved S.B. 562, the single payer bill, in California, hell has broken loose as figurative shots have been fired and there have even been alleged threats towards legislators in the Assembly. Talk of different ballot initiatives and process has obscured what is going on and how honest all the major players are being in the fight over this bill.

The Story So Far

Single payer was on a slow but steady path in the state legislature as it had passed through the necessary committees and then the Senate floor. There were headlines about the “400 billion” price tag, but after further analysis from policy experts like Matt Bruenig, this is entirely doable even when the press tries to throw scary numbers at less informed readers. The bill did not yet have a funding mechanism added, but presumably amendments were coming from the authors, Senators Toni Atkins and Ricardo Lara, and the sponsors, the California Nurses Association.

Three weeks after the bill passed the Senate floor, Speaker Anthony Rendon announced the bill would not be heard in the Assembly Rules Committee. He said the bill was incomplete, citing the lack of a funding mechanism and lacking other key provisions. Some of these critiques are important to consider, many of which have to do with important California ballot initiatives.

An Archaic Process

To understand some of the criticisms of the bill, one also needs to understand three important propositions passed by California during the 70s and 80s. These are the source of multiple headaches that have impacted how California deals with every policy issue. The first is Proposition 13, passed in 1978 and declared property taxes were to be assessed at their 1975 value and restricted annual increases of the tax to an inflation factor, not to exceed 2% per year. A reassessment of the property tax can only be made when the property ownership changes.

What does all of this mean exactly? Commercial properties like Disneyland or families that pass down houses are capped despite their value increasing massively. Another exploit for owners of commercial properties is that corporations often avoid reassessment by limiting portion of ownership by purchasing in groups where no single party owns more than 50%. This has created countless problems for California, the one being relevant here is that the handicapped revenue really hurt schools (which ties into a later proposition).

Prop 4 instituted the Gann Limit, that limited the growth of state spending, the max rate of growth being percentage increase in the cost of living and the percentage increase in the state or local government’s population. Any excess from state or local governments had to be returned to taxpayers. Instituting single payer in California would require a substantial growth in state spending as there would likely be a payroll tax on employers in place of them paying insurance companies.

Prop 13 and 4 then led to the passage of Prop 98, which required a minimum of 40% of California’s general fund spending to be spent on education and the actual percentage of the general fund spent on education be over 50%. Without another ballot, any single payer bill would have to double the amount of money raised to fund it while complying with prop 98.

This means that there are massive obstacles for simply passing a bill that would fund single payer, and that’s only one of many provisions the bill is missing. While the legislature can and in this case, should send a bill to the ballot in 2018 to fund this, it’s a convoluted process not many people understand. While there are many obstacles and a single payer bill in California would ultimately need a ballot initiative to enact, this isn’t an excuse to block the bill.

The Speaker Just Doesn’t Like Single Payer

Rendon claims to have been for single payer for a long time, which is becoming the standard line for those that say they support single payer while not advocating for it or making it a reality. As reported by David Sirota in the IB Times, Rendon has taken over 80,000 dollars from opponents to single payer in California since 2012. The California Democratic Party has received more than 2 million dollars from insurance and pharmaceutical companies in that same period of time. This is a pattern across the state. Even Rendon’s senior adviser and new chair of the California Democratic Party, Eric Bauman, lobbied against Prop 61 last cycle, an initiative that would allow Medical to negotiate drug prices.

The California Assembly is more conservative than the State Senate as well, with a substantial contingent winning their seats off the backs of big corporate donors across several industries. Rendon didn’t let this bill advance through the Assembly because even this shell bill wouldn’t pass a simple majority vote. Even looking at issues where one would think a Democratic super majority would find agreement. like bail reform and affordable housing funding. can’t get passed. also more conservative than the Senate, and wouldn’t even pass a simple majority vote when much less major but just as needed proposals like affordable housing funding or bail reform can’t get passed.

Rendon himself said he doesn’t think ‘single payer is the Holy Grail of progressivism’. This type of talk shows that he just has no real interest in passing single payer. Even if he does support it, he doesn’t see it as a priority because he won’t do anything that risks his position of power. His indication that this is all about signaling whether one is ‘progressive’, a word with little meaning nowadays, shows that he doesn’t even care about the material difference between universal affordable health care for all and not. Rendon is just covering for the Democrats in the Assembly, and due to some of the flaws in the bill, is able to hide behind that rather than just admit him and other Democrats, don’t want single payer.

The Authors are Awfully Quiet

Even some of the Democrats that are in support of single payer are not being honest about this fight. Senators Toni Atkins and Ricardo Lara are the main authors of the bill and since it passed the Senate did not put forth any amendments to complete the bill and neither referenced they had plans to put forward amendments in the future. Why are they so nonchalant about this important bill being stalled until next year? As David Dayen mentions in The Intercept, Ricardo Lara is running for Insurance Commissioner, and Toni Atkins is looking to replace current Senate Leader Kevin de Leon when he terms out, who is looking to run for something himself.

They could all be genuine in their support for single payer, but sending a bill to the Assembly with no intent of completing it should do more than raise a few eyebrows. Ultimately this is a wait and see moment, as Lara and Atkins could bring a complete bill forward in the next session, but they’ve made little comment so far, leaving the California Nurses Association and other organizers out in the cold and on their own.

We’re on Our Own

The California Nurses Association has come out with the fieriest response, holding multiple demonstrations and using strong language after Rendon shelved the bill. Importantly, they’ve yet to reveal their own amendment package that they referred to in their statement. While their statement was too charitable to the bill as Dayen reported in his piece, the Nurses Association is ultimately right in their outrage towards the Democrats. When the entire Assembly Democrats sign onto a letter saying that there are bullying tactics being used, it’s clear that the nurses are being targeted here.

David has been criticized by nurses and by some on the left for his critical piece in the Intercept which has been shared by many defenders of Democrats (which doesn’t work out for them too well when David says Rendon is being dishonest too). He does rightly say that if single payer is to happen in California, a lot of work must be done and each step must be handled in a way that leaves little ambiguity or confusion. That means the bill needs to be fleshed out and every organizer must be prepared for a long fight through the ballot and those fighting for single payer need to be clear about that. And unless it goes through the legislature first, the Democratic Party will almost definitely stay neutral in a ballot fight.

Activists on the ground like canvassers for the Democratic Socialists of America are aware this is more about a long-term movement and building a base starting with health care for all. They understand this is just one step in a long journey, one that will often involve going it alone and sometimes going against the Democratic Party.

The Long Con

None of the problems with the bill can excuse the California Democratic Party’s actions on single payer or the game they’re playing. When looking at how each actor in the party and its surrounding apparatus has acted, it pieces together an important picture. The most obvious factor is that many Democrats are against single payer, from the conservative Democrats in the Assembly, to the balanced budget obsessed Jerry Brown. There are Democrats in leadership who will put either no effort or a half assed effort towards enacting the bill like Rendon and De Leon. Others are just staying silent, like Gavin Newsome and both of California’s Senators. Newsome is a favorite for the Governor’s race in 2018 and Senator Harris is being floated for 2020, and both have said they support single payer. They are likely trying to let this leave the news and stay on the good side of all sides.

Democrats should be held accountable when they don’t fight for major policies that would benefit their base. In this case the opposite has happened, with SEIU, Planned Parenthood, UFCW, and more all lined up to back Rendon’s decision. This is simple transactional politics at play, with executives and leadership at these organizations getting some small-scale policy victories while Democrats get the endorsement and support of these organizations and their constituents. This would make any sort of challenge to any of these politicians difficult if not impossible.

While they shore up their flanks to prevent challenges from the left they will act like they did with Prop 61. They will stay neutral with any ballot fight for single payer, and some people in their party may actively be against it. There was a torrent of ads against prop 61 and tons of false or misleading attacks and this was just for allowing California to negotiate drug prices. A single payer initiative would face even more opposition from more than just insurance companies. Any ballot fight of this magnitude would require the full force of the Democratic Party and its allies in all but a few circumstances. Instead, they’ll stay out of the fight and stay in power eternally backed by the party machine and favored in the jungle primary system. They believe that they can weather the storm and the demand for single payer will die down with time, thinking a failed ballot fight or the potential repeal of ACA will silence the calls.

California is the eminent example that Democrats do not pass left wing goals when they get into power. Instead a neoliberal technocratic state persists, only progressing at the pace the donor and ruling class will allow. If you are somebody that is sympathetic to Democrats you must ask yourself, if they won’t pass single payer when they have a super majority in the legislature in one of the bluest states in the country, under what circumstance will they pass single payer?

For these forces to be defeated or pushed into passing left wing policies, a grassroots movement that has never been seen before will need to rise and shatter the pillars of California politics. Corporations, politicians and media will attempt to discredit and pick it apart whenever they get the chance, so it must have a simple, powerful, and effective message. It has to prepare itself for every procedural hurdle that will come its way and for many ‘supporters’ to turn their back when the going gets tough. It is a difficult path, but looking at all the signs, it’s the only path.