Last month, 20 Democratic members of Congress jointly introduced AB1900 – California’s “Guaranteed Health Care for All” proposal, aimed at establishing a “single-payer” health care system that covers all residents of California. Republican lawmakers argue that this is tantamount to government takeover of healthcare and banning private operation.
In 2021, Democratic Assembly members from the 25th District, including Ash Kalra, proposed AB1400, also named CalCare. The proposal passed the Health Committee and Appropriations Committee but stalled in the State Assembly.
The bill includes the following key points:
1) Establishing a state-level health care plan covering all California residents, regardless of employment status, income, health, marital status, or immigration status;
2) CalCare will include services provided under the Affordable Care Act and additionally cover mental health, prescription drugs, dental care, audiology and vision care, as well as long-term care services;
3) CalCare will eliminate premiums, deductibles, copayments, and coinsurance, and also waive requirements like prior authorization for treatment, provider networks, and enrollment periods;
4) The CalCare plan will be funded by a public trust, including grants from the federal and state governments, as well as revenue determined by the California Legislature such as a “wealth tax.”
In 2023 and 2024, Kalra and others successively introduced related bills like AB1690 and AB2200, and now they have put forth AB1900, aligning with Governor Newsom’s push for universal healthcare coverage for all residents.
This government-operated universal healthcare system is expected to be financed through taxation, including:
1) A new 2.3% total income tax on businesses earning over $2 million annually;
2) A new 1.25% tax on businesses with over 50 employees;
3) An additional 1% tax on employees earning over $49,900 annually;
4) An additional 0.5% state income tax on individuals earning over $149,000 annually, graded progressively up to a maximum of 2.5% income tax.
AB1900 also calls for the establishment of a CalCare Board consisting of nine members to develop a comprehensive single-payer healthcare plan and cost-control system. Kalra stated in a press release on February 12, “With CalCare, healthcare will be considered a human right” and “access to healthcare should never depend on your occupation, residence, gender or sexual orientation, age, or medical history.”
He emphasized, “Given substantial federal budget cuts, we must rid the injustices within the deteriorating healthcare system and fight for a better future for all Californians. We can’t wait any longer.” According to data released this week, 86% of Democrats support universal healthcare.
The chairman of Reform California coalition and Assemblyman for the 75th District, Carl DeMaio, issued a warning in a video on February 23, stating, “California Democrats want to take over your healthcare, ban private insurance, all while levying $500 billion in taxes statewide (to fund universal healthcare).”
What is “single payer”? DeMaio explained that it is essentially a euphemism for a government-operated healthcare system, meaning government takeover. Democratic socialist Kalra promises free healthcare for everyone, but it is not truly free, costing nearly $500 billion (a legislative analysis from four years ago estimated nearly $400 billion).
DeMaio cautioned, “Remember, when the government says $500 million, it will actually cost far more. Have you heard about the ‘train to nowhere’ in California?”
“AB1900 prohibits private health insurance, and if passed, purchasing private insurance will be illegal,” DeMaio said. He reminded of the mandatory policies in 2020, mentioning various regulations where the government will decide who can receive what kind of medical services, including treatment directives concerning children regardless of parental wishes, possibly resulting in expensive yet low-quality healthcare services.
“California is the most heavily regulated state with the highest healthcare costs in the country. The average cost of an emergency room visit in California is $3,600, not including mandatory regulations; whereas in Maryland, it is $680. Moreover, calling an ambulance in California averages $2,400, compared to just $650 in North Carolina.”
Where will the funding for free California universal healthcare come from? It involves a series of large-scale tax measures. DeMaio noted that imposing a 2.3% tax on total income for all businesses would deter any businesses from creating job opportunities or conducting business activities in California. “Some businesses only make 5% to 7% in profit, imagine how much the government will be taking?”
“This is a catastrophic proposal,” DeMaio stated. “Employers will have to pay an additional 1.5% tax, increasing the cost of employment, potentially reducing job opportunities; if progressive taxation is implemented, households earning over $150,000 will have to pay additional taxes; levying a 2.5% super-rich tax, how many people will leave California?”
Why can’t California provide cost-effective healthcare like Maryland and North Carolina? In reality, AB1900 increases significant regulatory costs but does not enhance healthcare quality. The proposal will undergo subgroup discussions on the 15th.
With the 2026 California elections approaching, DeMaio urged, “Republicans need to win at least 26 seats in the State Assembly to break the Democrats’ two-thirds majority (Republicans currently hold 20 seats). This way, we can not only stop the government takeover of healthcare proposal but also halt a series of costly, unnecessary, and unfair tax proposals that will dismantle our job market and increase your financial burden.”