Health insurance is now California’s largest expenditure as a result of the expansion of Medicaid under the Affordable Care Act (Obamacare). Medi-Cal (the state’s version of Medicaid) now insures 13.5 million — 1 in 3 — Californians, making it the second largest single-payer system in the country. Spending now exceeds $100 billion per year, double spending in 2010.
Even though Medi-Cal affects so many Californians, is not particularly effective at improving health, is notorious for spotty service, and is crowding out spending on higher education, courts, parks and social services, there has been next to no discussion in the governor’s race about it.
Instead most of the health-related discussion in the governor’s race is about a proposal by the California Nurses Association (CNA) embodied in a bill (SB 562) that would quadruple the size of a state-run insurance system to $400 billion per year. As explained here, SB 562 is not a typical single payer system. It is better described as a single insurance company that would be controlled by recipients of payments from that insurance company.
According to press reports gubernatorial candidates Delaine Eastin and Gavin Newsom support the bill (though by one account Newsom’s support is “nuanced”), John Chiang urges caution, and Antonio Villaraigosa, John Cox and Travis Allen oppose the bill.
GFC believes elected officials should make the existing single-payer system (Medi-Cal) work well before it considers expansion of any sort.