Photo: Coolcaesar / Wikimedia Commons (CC BY-SA 3.0)
California has debated replacing private insurance with a single state-run health plan for years. Each attempt has run into the same questions: how to pay for it and how to get federal approval to redirect Medicare and Medicaid funds.
SB 562 (2017)
In 2017, the state Senate passed SB 562, the Healthy California Act, which would have created a single-payer system covering all Californians. It did not include a detailed financing plan. In June 2017, Assembly Speaker Anthony Rendon shelved the bill, calling it “woefully incomplete.”
AB 1400 (2022)
In 2022, Assemblymember Ash Kalra’s AB 1400, known as CalCare, sought to create a single-payer system, paired with a proposed constitutional amendment to raise taxes to fund it. The bill was pulled before a floor vote in January 2022 when it lacked enough support.
A different path: the Healthy California for All Commission
A state commission created in 2019 studied options for a unified financing system and issued a report in 2022, but no plan has been adopted.
How San Diegans get coverage now
- Employer plans cover the largest share of residents.
- Covered California, the state marketplace, offers subsidized plans, with open enrollment each fall.
- Medi-Cal, California’s Medicaid program, covers low-income residents; the County of San Diego processes applications.
- Medicare covers people 65 and older and some people with disabilities.