Silicon Valley lawmaker’s single-payer health care plan faces ‘uphill fight’

A bill proposing a state single-payer health care system, which would be the first in the nation if passed, has a swell of public support. But it’s unclear if that will be enough to make it over the finish line.

Assembly Bill 1400, also known as CalCare, would address issues such as the lack of transparency in medical billing and drug costs, advocates said. The legislation overcame its first major legislative hurdle last week when it passed the Assembly Health Committee on an 11-3 vote, with one abstention.

Salem Ajluni, a member of the Santa Clara County Single Payer Health Care Coalition, said it took a lot of public pressure to make that happen and the pressure hasn’t stopped. AB 1400 needs to get out of the Assembly before the end of the month to make it to the Senate floor for discussion. It’s set to be discussed by the Appropriations Committee on Thursday.

“It’s going to be an uphill fight,”  said Ajluni, an economist who lives in San Jose and joined the coalition four years ago.

His interest was piqued after he had been turned down for health insurance while working as an independent consultant.

“Trying to find health care coverage and being denied, that wasn’t an unusual occurrence before the Affordable Care Act,” Ajluni said.

Even with the Affordable Care Act’s passage, problems still lingered with the system. Navigation is still complicated and frustrating. Prescription costs are a mystery and medical procedures can run into the thousands of dollars, Ajluni said.

Ajluni and the single-payer coalition have been working with the California Nurses Association and a host of local groups to garner support for AB 1400, co-authored by local Assemblymember Ash Kalra.

The COVID-19 pandemic has highlighted the health care disparities in communities like East San Jose, which are among the hardest hit by the pandemic. In Western Santa Clara County, about 4,000 to 7,000 people out of every 100,000 are getting COVID-19, while in East San Jose it ranges from 14,000 to 18,000 infections per 100,000 people. A bill like this would ensure residents are better protected, Kalra said.

“Those workers that are suffering the most from COVID are also the ones that struggle the most with health care costs, whether they struggle with insurance or not,” Kalra told San José Spotlight. “Ultimately health care is a human right and we’ve been denying health care to millions of Californians for many many years.”

If approved, CalCare would replace and merge with other federal and state programs like the Children’s Health Insurance Program and Medi-Cal. It would get rid of copays, deductibles and premiums; expand coverage to all state residents regardless of citizenship status; and provide services above and beyond what’s generally available through insurance, such as dental and long-term care.

Funding for state and federal programs would be redirected to CalCare, though the funding plan is in a separate bill. Kalra said that allows legislators to parse the details at a later time.

The heads of local health organizations aren’t ready to speak in full support of the bill, though one is cautiously optimistic.

“Knowing who the authors are, they’re all really good legislators,” said Dolores Alvarado, CEO of Community Health Partnership, which serves about 225,000 low-income patients across 10 clinics. “So I can’t believe that there’s anything wrong with it. I just don’t know yet.”

Alvarado said she and others working in the health care space would like to see a town hall to address unanswered questions regarding AB 1400. On the same day the bill made it through the health committee, Gov. Gavin Newsom announced a plan to build on Medi-Cal to provide insurance to more low-income undocumented immigrants.

Alvarado said it isn’t clear if the two proposals are competing.

Contact Sonia Waraich at [email protected] or follow @soniawaraich on Twitter.