KPBS: Sen. Atkins Discusses Single-Payer Health Care For California

February 23, 2017

By Maureen Cavanaugh, Brooke Ruth

State Sen. Toni Atkins has co-sponsored a bill to explore the establishment of a single-payer health care system in California.

Under single-payer health care, the government, in this case California, would operate a health insurance plan for all residents that would be funded by tax dollars.

We spoke to Atkins on Wednesday's Midday Edition. Here's what she told us about the proposal:

Q. Do you envision a single-payer plan for California to be along the lines of the Medicare-for-all idea?

A. Well, I think that's one approach. Part of what we are doing and the bill that we put forward really is intent language for us to start the process to evaluate what program we could put into place. But, the key issue is universal health care. And there's going to be a lot of work. This is the start. When you put a piece of legislation forward, as you know, we will be working on that throughout the year as it goes from committee to committee.

Q. Have you explored this proposal enough to believe that it would be possible for California to do this?

A. Well, I think that we've shown that it's possible if we're willing to come to the table and really address where we've been successful under the Affordable Care Act. Clearly cost is going to be an issue. Are we going to have the resources to put into play? But, I think we have enough experience to have a real dialogue finally about this and I think it is the next possible step. It is a vision that is backed by the values of Californians. People want access to health care. And while we've worked very hard over the last several years on improving on the Affordable Care Act, I think single-payer and universal health care coverage would really take us to the next level. And it's going to take work. I don't want people to think this is going to be easy. But, I do think it is something worth striving for. I think health care and access to health care should be along the same lines as a right to education, a right to emergency responses, a right to public safety, which government provides. And I think that is what we strive. I think it is what people in California are ready for to make sure that we have that basic right. And so I think we're ripe for the discussion.

Q. Any ballpark estimate on how much a single-payer plan would cost the state?

A. The Legislative Analyst's Office says the overall cost could be upwards of well over $100 billion. But, here's the difference, since we had those discussions a decade ago, we have implemented the Affordable Care Act in which we've looked at the cost and how to take advantage of the numbers. I mean California is the largest state in the country. We have large numbers to put into the risk pool. We put into place the individual mandate and we talked about businesses participating. So this is the next step to put together a financial package of how we can pay for it. And if the federal system changes and the Republicans in Congress manage to replace the Affordable Care Act with some other form. They're talking about things like block grants. All of that would have to go into the package of how we make it affordable for us to do this in California. So that's why I say I think we're at the next level of discussion and I don't think we should avoid that conversation because if we get to the point where people now have the expectation of health coverage and we go back, we lose ground, we take that away from them, in terms of whatever new proposal, which we know nothing about either, coming out of Congress, then you know we've left Californians with this hope, this desire and a taste of something good that will now be taken away from them.

Q. Right now, it seems many Republicans in Congress are getting cold feet about dismantling Obamacare. Congressman Darrell Issa, R-Vista, just released a plan to allow all Americans to have access to the insurance plans offered to federal workers. I'm wondering, have you seen his proposal?

A. I haven't seen details of his proposal either. The thing that concerns me most is if we lose ground on trying to cover every Californian. And in California, remember we have been able to extend health coverage to undocumented children because these are individuals that show up in our emergency rooms already and receive care. We want to factor in every resident of California. And so I think that I'm willing to look at any proposal and any plan, but it cannot cause us in California to loose ground on what we've been able to accomplish so that Californians are able to get access to health care.

Q. Considering that there is so much unknown at this point, wouldn't it be a better use of our legislature's time to work with Washington on a new version of the Affordable Care Act?

A. I think our big concern is of the evidence we're seeing, there are two different philosophies. It isn't about universal coverage in D.C. From what I can tell it's about how to save money. Well, we haven't even seen the benefit of cost savings from actually ensuring people have preventative care and health care in general. The cost savings come when people have access to health care and they're not catching up from a decade of having no coverage. So the approach is how do we do cost savings, how do we reduce the cost and that's before we've even ensured that everyone has real access to coverage, so we're starting from two very different premises. And I just don't think Californians, I do think they care about cost so we have to have this discussion but we have it with a new set of facts and data and new possibilities that we didn't think were possible before. So that's why I say let's have a vision, let's be pragmatic, let's pull in the financial experts and figure out how we can do that. And that's why this piece of legislation is intent language to start a real discussion about is it possible today? It may have not been a decade ago but today is a new day with a lot more experience and I think that we owe it to Californians to have that dialogue.