If these United States are 50 laboratories of democracy, then California is the mad scientist of far-left policies. That was evident last week as some of the session’s most controversial bills tried to clear the Assembly and continue through the legislative process.
From a bill to impose “sector-wide minimum standards” for wages, hours and working conditions at fast-food chains (that unfortunately passed the Assembly and now heads to the Senate) to forcing owners of rent-controlled apartment buildings to stay in that business for at least five years — even if they were losing money (that fortunately failed to garner enough support), the Legislature’s radicalism was on full display. But those measure were small potatoes compared to Assembly Bill 1400, which would have required the state to provide health care coverage for residents, after abolishing all private health insurance and Medicare.
Fortunately, AB 1400 also failed to get enough support in the Assembly to move on, but we’re likely to see it again. The state’s Democratic Party has added single-payer health care to its platform, and the Progressive Caucus of the California Democratic Party has vowed not to endorse any candidate that opposes single-payer health care.
That’s why it’s important to make clear why such a proposal should never be considered again. First, the taxes necessary to implement such a program would be astronomical. The author of AB 1400 proposed raising taxes by $163 billion dollars a year, but the actual cost could be upwards of $391 billion per year, according to the staff report from the Assembly Appropriations Committee.
For reference, the total amount of health care spending in California, from all sources, was an estimated $330.7 billion in 2021, and the governor’s 2022-23 proposed budget is only $286.4 billion and includes our existing state health care programs — along with everything else. But the truth is, even the Appropriations Committee’s estimate may be too low. A look at the outcomes of state Medicaid expansion suggests that the state’s “free” government-run health care program could cost Californians a whole heck of a lot more.
Under the Affordable Care Act, many states, California included, expanded their Medicaid coverage to able-bodied adults with incomes under 138% of the poverty level — a population previously not covered — and spending and enrollment are already up due in large part to the pandemic. In California, Medicaid is a whopping one-third of state spending.
Enrollment and spending estimates for these expanded programs have far exceeded projections in every state. Then-New York Gov. Andrew Cuomo said, “the cost of Medicaid is rising higher than anyone projected and started rising dramatically.” Now imagine the state taking on everyone.
But it isn’t just budgets that get hit when the state oversees health care. Studies show Medicaid patients have worse medical outcomes than those with private insurance. Due to the low reimbursement rates, many providers do not accept Medicaid patients and patients often face long wait times for appointments and procedures — a common problem in countries with government-run health care programs.
The recent debacles at the state’s Employment Development Department and our DMV system are enough to prove that the state government has no business trying to run everyone’s health care. If there are people in California who have fallen through the cracks of our current health care system, the solution is to find ways to help them, not put everyone on a poorly run state program with an astronomical price tag.
Single-payer health care is a bad idea our state would be absolutely mad to try.
Jon Coupal is president of the Howard Jarvis Taxpayers Association. Brooklyn Roberts is the senior director of the Health and Human Services Task Force at the American Legislative Exchange Council.