By Ryan Skolnick, Healthcare Justice Warrior.
On September 27th, 2006, Governor Arnold Schwarzenegger signed Assembly Bill 32, or the Global Warming Solutions Act of 2006. The bill granted the California Air Resources Board (CARB) broad new powers to reduce the state’s carbon footprint. Under the authority granted by AB 32, CARB implemented the entirety of our current climate change program, including our cap and trade program, fuel efficiency standards for cars, and significant fees on polluters.
This, right here, is the crux of what is wrong with Speaker Anthony Rendon’s decision to shelve Senate Bill 562, or the Healthy California Act, in the Assembly rules committee. Like the false claim that delegating authority to a board makes a bill “woefully incomplete,” his arguments against the Healthy California Act are easily disprovable. His excuses have ranged from, “it’s only a framework bill” to “a 35 page bill isn’t serious legislation” to even accusing the California Nurses Association of a cynical plot to “co-opt Bernie Sanders supporters.” Not a single one of his criticisms are accurate, and he knows they aren’t accurate.
The Healthy California Act is NOT a framework bill. It is NOT a shell bill. And it is NOT “woefully incomplete.” In fact, the design of the bill, where an appointed board would craft and implement a single payer system, is not a unique design, and it was written this way for a reason.
The Healthy California Act was designed to maximize chances of passage through the more moderate State Assembly, by providing for the completion of the bill in the Assembly Health and Appropriation committees. In this effort, it is not the only bill of its kind. In fact, the structure of appointing a board and giving it broad powers to develop and administer a single payer healthcare system is the exact same framework the New York Health Act employs. Both bills establish a range of eligibility and coverage, delegate power to an entity to plan and administer the program, and establish a trust fund to pay for the program. The New York Health Act has passed the Assembly multiple times, only to be derailed by a Republican-controlled Senate.
Despite these facts, Speaker Rendon continues to spread mistruths about the bill. Again, all mistruths he, as the Speaker, knows full well aren’t actually the case.
He’s argued that it’s irresponsible for the State Senate to pass a bill without funding. He knows full well that it takes a 2/3 vote to pass tax increases, and that passing the bill through the Senate with a simple majority, and adding funding later, decreases the burden of passage. He also knows full well that the job of adding funding was intended to be done in the Assembly Appropriations Committee. In fact, according to Healthy California’s own Michael Lighty, Speaker Rendon’s own staff advised Healthy California to focus on completing the policy aspects of SB562, leaving funding for the Assembly. This was good advice, and Speaker Rendon knows that it is his Assembly’s job to finish the bill in committee.
He’s argued that the bill provides no way to compensate for Prop 98’s revenue re-routing provisions and the Gann Limit’s cap on spending increases. He knows full well that anything the legislature could do to avoid infringing on those parts of the California constitution, including reworking the structure of the program into a public utility or devising a premium structure to fund the program, would need to be done in the Health and Appropriations committees. Those provisions were intentionally withheld from the Senate version to give the bill an easier chance of passage in the Assembly. By allowing the bill to take its final form in Assembly committees, the chances of approval increase over if the bill was completed entirely in the Senate. Furthermore, if the Assembly decided to move forward by using tax increases to fund the program, there’s nothing that can be done by the legislature: the voters would need to approve such a course via ballot initiative. This was never a legitimate reason to shelve the bill.
Speaker Rendon has argued that the program depends on federal waivers that we aren’t guaranteed to receive. In fact, he’s even shared an article with the bald-faced lie that Congress needs to approve waivers. While this would definitely make it much harder, it’s not true at all: he knows full well that Congress has nothing to do with the waiver process. In addition, the Social Security Act allows for states to administer Medicare. By enabling California to become a Part B provider, as well as allowing the state to provide subsidies under Medicare Part D, we will have full access to Medicare funds to use in the program. Finally, the innovation waivers provided by the Affordable Care Act are designed to allow states to set up their own healthcare systems, including single payer systems if they so choose. The only reason these waivers, which include Medicaid waivers, would be denied is if they aren’t revenue-neutral for the federal government, they reduce access to care, or they decrease affordability. Since the Healthy California Act does none of these things, we will be able to obtain those innovation waivers to set up our own single payer program.
Virtually all of Speaker Rendon’s other arguments can be answered with the same response, “the Assembly was always intended to be the place where the bill was completed.” Rates of doctor compensation? Regional zoning? Cost controls? All were intended to be either completed in the Assembly, or be implemented by the Healthy California board. In fact, the California Nurses Association, literally hours before Rendon shelved the bill, submitted 17 amendments that would have clarified many of these questions, again, showing the Speaker to be a dishonest actor that never had any intention of genuinely fighting for single payer.
Some supporters of the Speaker argue that this just isn’t the time to take up this fight. In reality, this is the perfect time. The majority of Americans support single payer healthcare. An even larger percentage of Californians support SB562, even after hearing about potential tax increases.
Furthermore, sweeping legislation like this has gone through in tough times before despite questionable support from the Governor. AB 32 was passed in an election year and signed by a Republican Governor. With the failure of the Republicans in their attempts to repeal the Affordable Care Act, now is the perfect time to make a genuine effort to make California the first state in the country to truly guarantee healthcare as a right to all its people. The aforementioned arguments aren’t the real obstacles to single payer. The real obstacle is an Assembly Speaker that is not an honest actor, and has no genuine interest in truly fighting for single payer.
We, as advocates for the Healthy California Act, need to make these points the center of our counterarguments. Everybody needs to know that the entirety of our climate change program stems from a 12-page bill, passed in an election year by a Republican Governor. Everybody needs to know that the job of completing the bill, as even Rendon’s staff has acknowledged, falls to the committees that the Speaker refuses to allow to hear the bill. Everybody needs to know that the real obstacle is not the nurses or 562 activists, it is Speaker Rendon.
With all this being said, it’s important that we continue to keep the pressure on. Make sure to continue calling your Assembly members on the regular. They need to hear from us consistently, that 5 people dying every day in this state due to lack of healthcare is absolutely unacceptable. They need to hear that we demand that Speaker Rendon release the bill. Finally, we need to be ready to continue pressuring for the long haul. To change the narrative from “single payer is a good idea in theory” to “we need single payer NOW” it will take nothing less.