Everything You Need to Know About the Single-Payer Fight in California – Patrick Caldwell Jun. 7, 2017 6:00 AM

The $400 billion plan to rebuild the state’s health care system.

Marchers at a Medicare-for-all rally in Los Angeles, California on February 4, 2017Ronen Tivony/ZUMA

As Donald Trump and congressional Republicans struggle to repeal Obamacare, Democrats in the nation’s most populous state are pushing a very different reform proposal that would radically change the way health care is paid for. Last week, the California Senate overwhelmingly passed a bill that would demolish the state’s current insurance plans and replace them with a single-payer system that would provide comprehensive treatment to all residents free of charge. The measure is still a long way from becoming law, but progressives already see it as a model for how states can expand access to care even as Republicans at the national level try to roll back coverage.

In many ways, the single-payer bill is quite simple; for consumers, it would mean no more copays, no more figuring out which doctors are in-network or out-of-network, and no more searching the health care marketplace for the plan that’s right for you. At the same time, it’s an immensely complicated scheme that would fundamentally alter the state’s health care system and its relationship with the federal government. Here’s what you need to know:

What’s going on?

On June 1, the California state Senate passed SB 562 by a vote of 23-14. One Democrat and every Republican voted against it (with three other Democrats not voting). The bill would essentially end private health insurance and most current forms of government insurance in the state, replacing those with a single, government-run insurance program that would pay health care providers (doctors, hospitals, pharmacies, etc.) for treating patients. Californians would no longer get insurance from work or through Medicaid. Instead, all state residents would be eligible to enroll in a program that supporters have dubbed Healthy California. That program would come with zero out-of-pocket costs for patients. The bill now heads to the state Assembly, which will have to figure out a way to pay for it.

Who’d be covered under the single-payer system?

Everyone who lives in California (including college students, if their university decides to pay for the coverage). The rate of people without health insurance in the state has improved since Obamacare care went into effect, dropping from 17 percent in 2013 to 7 percent today. But that still leaves 3 million Californians without coverage, along with many residents who are paying more in premiums, co-pays, and deductibles than they’d like. Everyone would be eligible to enroll in Healthy California. That includes undocumented immigrants, who are currently shut out from Obamacare.

What would be covered?

Pretty much everything you can imagine. Healthy California would cover almost any sort of medical care, including things like dental, vision, and long-term care that are typically excluded from other government-funded insurance programs in the United States. There’d be no more restrictive HMO plans or out-of-network providers; instead, you’d be able to see any licensed doctor, and they’d be free to prescribe treatments they deem necessary.

How much would health care cost me under the plan?

Nothing. There state wouldn’t charge any premiums. There’d be no co-pay charge during a visit, no co-insurance, no deductibles. Prescriptions would be also be free. Out-of-pocket expenses would completely disappear.

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