Gov. Gavin Newsom's commission on the feasibility of a single-payer healthcare system in California released its final report April 25, but it leaves more questions than answers, according to CalMatters.
The Healthy California for All Commission endorsed "unified financing" that would pay for a single-payer system in the nation's largest state, but it did not offer a specific proposal for legislation going forward.
While campaigning for governor, Mr. Newsom called for a state-sponsored single-payer system that would cover all 39 million Californians with little to no out-of-pocket expenses.
"I'm tired of politicians saying they support single-payer but that it's too soon, too expensive or someone else's problem," Mr. Newsom said in 2017.
The California Senate passed a single-payer bill the same year, but it lacked a financing system and stalled out. Mr. Newsom commissioned the report to study how to implement a single-payer system in the state. In 2022, similar legislation with a financing system also stalled out in the state's legislature.
The report said that if the state took all current federal, state and local government healthcare spending and then raised taxes, a single-payer system could slow the increase in costs, which total $517 billion annually, and still extend coverage to all state residents.
The report included a list of options to get to single payer rather than a single proposal, leaving questions such as how the state would gain approval from the federal government, which taxes would be raised and on whom, what services the system would cover, if the new system would include copays, and how care would be structured, according to CalMatters.
California would have to convince the federal government to continue giving it the tens of billions spent on Medicare, Medi-Cal, the ACA and other federally financed programs, and raise at least $200 billion in new taxes.
"A system of unified financing is uniquely positioned to transform care delivery and to shift the power that lies in health and healthcare to benefit those who have too often been overlooked," commission chair Mark Ghaly, MD, said.