It is with great sadness that we must tell you that the course of single payer health care -- "Medicare style care for all" -- appears to be dead. This is not just the bill, SB 810, but the issue. Events unfolded at the end of January that changed, perhaps permanently, the ability of legislators to work with single payer supporters. It is not a pretty story.
This is a long discussion. We believe it is essential to tell it.
Many of you know single payer began as a legislative strategy in about 2003 then was introduced by Senator Sheila Kuehl. It was passed through the Legislature several times only to be vetoed by then-Governor Schwarzenegger. He grew up in Austria with single payer but continued to insist it was "socialist" and thus unacceptable to him.
After Sen. Kuehl was termed out, the bill was eagerly adopted by newly-elected Senator Mark Leno. However, he arrived in the Senate along with a new group of Senate and Assembly leaders who had no history with single payer. By 2010 the financial data from the Lewin Report -- crucial to passage -- was over 12 years old and highly out of date, and educating the new members was therefore increasingly difficult.
Over a year ago the single payer grassroots steering committee, the State Strategy Group, agreed to create a panel of experts who would do a new fiscal analysis to update the information from the Lewin Report. IMPACT helped find experts on health care financing for the panel, and the SSG knew that it would cost about $250,000 to get this done well.
For both the incoming governor, Jerry Brown and all the new legislators, this evidence of cost savings for individuals, families, small business, and the state was crucial. Single payer had to show it would be at least as if not more effective than federal health care reform in cost savings for all parties. It would be impossible to convince legislators unfamiliar with single payer that it was a very responsible measure = without those data.
Consequently, in its first foray under Senator Leno's authorship, the bill did not pass on the Assembly floor. There were simply too many grave doubts, and the newer members had no interaction with single payer supporters who might have eased their concerns.
In response to that loss, the SSG decided suddenly to abandon SB 810 and the fiscal report and go the initiative route thinking it would be simple and that the governor could put it on the ballot. That is not possible since it would have to be done legislatively and requires a supermajority vote. To do an independent initiative with signature gathering is extremely expensive. SSG fund raising therefore turned to obtaining the $2-3 million needed just to do a signature drive, but the money never materialized for the ballot measure, much less the financial analysis.
No initiative. No fiscal study.
Senator Leno continued to shepherd SB 810 until, as is customary, it went into "suspense" the last week of January in Senate Appropriations. Suspense occurs when there are large questions about costs and means to cover them. Despite the pressure to hold the bill for lack of financial analysis, President pro Tem of the Senate Darrell Steinberg used his leadership strength to send it to the floor. At the first floor vote, five Senators abstained, all of whom had the same fiscal reservations expressed by Senators in Appropriations. Steinberg, as a strong single payer supporter, kept the bill "on call" until the absolutely last moment, January 31 by which time legally it had to pass or die.
Over the weekend senators Leno and Steinberg asked the abstaining members for a "courtesy vote." This is a vote that occurs when a member with reservations still moves a bill to keep it going.
Those votes were getting pinned down when on January 30th the grassroots advocates started a massive phone campaign to senators. The results were shocking. Office after office including Leno's and Steinberg's were flooded with calls -- angry, berating, nasty, threatening, and bullying calls. These were not from opponents of single payer. These were from supporters.
When callers could not access senators or their top staff, they lambasted lower-level staff right down to the receptionists. One young woman, new to the Capitol, was shattered by the vicious attacks on her and her senator. She was absolutely devastated by the personal assaults on her character and politics. Other, older staff were tougher, but every one of them was shaken to their foundations by how incredibly violent and abusive the calls were from supporters.
What the enraged supporters did not realize -- because they never asked -- is that yes, the requisite number of courtesy votes were being gathered. But after the barrage of abuse, these senators, all with reservations due to the absence of information on financial impacts, withdrew those votes in disgust. Senator Leno then pulled the bill rather than having it die on the floor.
We are aware that these calls did not involve the faith community. Insofar as people identified themselves, those from faith groups were not the source of the harassment. It did not matter enough, however, to prevent the massive meltdown from other less responsible groups and individuals.
At this moment so much damage has been done from the barrage of nasty calls that it is seriously doubtful any legislator will ever work with any of the single payer supporters again, not even in the faith community.
This means single payer likely is dead in California. The most important point is that SB 810 died NOT due to the insurance industry or even from Senate opposition -- the votes were ready for passage - but due to the obnoxious and outrageous actions of its supporters.
We have no idea what will now transpire. What we do know is thatbefore we go any further as a body of people, faith and secular, we need to have some resolution about how we proceed. We encourage opening these discussions in your area. That will not be easy. No one likes to think that his or her actions could have caused so much damage. No one likes to think that they are in the wrong. It is easy to dismiss the lack of votes as the fault of the Senators.
But if we are going to be effective, we need to have not just progressive politics but progressive humanity and good sense as well. That is a community conversation we all must have.
We will keep you apprised of what happens next.
Director of Public Policy