On Monday, California Assembly Bill AB 1400 was set to go up for a vote in the California legislature. AB 1400, also known as the Guaranteed Health Care for All Act, or “Cal Care,” was proposed to guarantee single-payer medical coverage to every California resident, including undocumented immigrants, and would be funded via business and payroll taxes.
The bill, however, was dead on arrival, as the author of the bill, Assemblyman Ash Kalra, (D-San Jose) declined to put the bill before a vote in the 11th hour, stating later that “It became clear we did not have the votes,” in the Democratic Party-controlled legislature.
Among some of the highlights of the bill were comprehensive benefits and freedom of choice, such as primary and preventative care, hospital and outpatient services, prescription drugs, maternity and newborn care, long-term services and supports, mental health and substance abuse treatment, ambulatory care, and so on. The bill promised no premiums, copays, or deductibles, with patients having the “freedom to choose doctors,” without having to worry if they are “in-network” or not. It also pledged the state to address health care disparities in rural and other underserved communities.
Naturally, the bill had wide support among the population, including among health care workers who work every day with patients for whom their course of treatment is dictated almost exclusively by cost and the quality of their insurance plan, if they have one. A poll conducted by Lake Research Partners last May found that 60 percent of voters in the state would support a single-payer health care initiative.
Millions still lack access to health care, and even for the insured, deductibles and out-of-pocket costs keep care out of reach. A report by the Labor Center at UC Berkeley found that 9.5 percent of Californians, close to 3.2 million people ages zero to 64, will not have any medical insurance in 2022. A majority of these residents are undocumented immigrants.
The bill that promised so much was in fact a sham from the beginning as the Democratic Party never had any intention of passing it. Although it certainly was not due to the claim that they “didn’t have the votes,” nor due to four vacancies in the Assembly.
In all, there are 120 seats in the California legislature and 91 are held by Democrats, just over 75 percent of all seats. Sixty of the 80 seats in the Assembly are Democratic, while in the Senate the split is 31 to Democrats to 9 Republicans.
The bill’s collapse is a devastating exposure of Governor Gavin Newsom and the Democratic Party, as well as their supporters in the pseudo-left who present the party of Wall Street and imperialist war as capable of carrying out significant social reforms.
Angry and disappointed comments, particularly from nurses and health care workers have flooded social media.
While Kalra deserves every last bit of contempt for not bringing his own two-years-in-the-making bill to a vote, the ignominious demise of AB 1400 makes clear that the Democratic Party is fundamentally loyal to the capitalist system, the health care giants, insurance companies, big business, and the major corporations.
Newsom himself campaigned four years ago on false promises of implementing single-payer health care, but as the darling of San Francisco’s wealthiest families, this was never actually going to be implemented. When it happened to be on the agenda Monday, the Democrats rejected it, without any members of the legislature having to cast a vote.
In 2018, Gavin Newsom told delegates at the California Democratic Party Convention that single-payer health care was part of the “battle for America’s soul,” and exclaimed “For me, this is more than a political campaign. It’s about Democrats acting like Democrats,” and “I’m tired of politicians saying they support single-payer, but that it’s too soon, too expensive, or somebody else’s problem.”
Numerous news outlets have turned apologist, with ABC7 stating that California Democrats succumbed to “intense pressure from business groups and the insurance industry in an election year.” The Los Angeles Times noted that “Instead of forcing a vote that could be politically damaging for some of his Democratic colleagues, Kalra opted to let the bill die”
The California Nurses Association (CNA) had focused its 100,000 California membership on supporting the bill. Last month, the union sponsored a “Day of Action” on January 8 in 15 cities to promote it and “demand that the state adopt the California Guaranteed Healthcare for All Act.”
This was so much cynical posturing by the state’s largest nurses union, which has taken no significant action to defend hospital workers as the entire health care system has teetered on the verge of collapse throughout the pandemic. On Monday, the CNA feigned anger at the Assembly’s decision not to vote on the legislation, stating “Nurses condemn this failure by elected representatives to put patients above profits, especially during the worst surge of COVID-19 yet, at a time when it’s more clear than ever before that health care must be a right, not just a privilege for those who can afford it.”
What the CNA does not say is that it is tied, hand and foot, to the Democratic Party which it politically and financially supports. In 2020, the union donated well over $8.3 million in contributions to the Democrats.
The CNA is an affiliate of the National Nurses United (NNU), the largest nursing union in the country, which represents some 175,000 nurses nationwide. The NNU has enforced the erosion of working conditions for nurses nationwide even prior to the pandemic. Like all the corporatist trade unions, the CNA and NNU assist the health care giants and financial elite in orchestrating the passage of sellout contracts as well as the suppression of strikes.
With the rapid spread of the highly infectious Omicron variant, California is in the midst of its deepest health care crisis since the start of the pandemic. Hospitals across the state have ICU capacities from 80-92 percent and medical staffing is down by 20 percent with nurses and other health care workers being infected with COVID-19.
Even as daily new infections have peaked, the seven-day average remains above 72,000 cases per day—higher than any previous wave—and the death toll now exceeds 80,000. Los Angeles County alone has recorded over two million COVID-19 cases since the start of the pandemic and nearly 29,000 deaths. Los Angeles is also the second-largest school district in the country, right behind New York City Public Schools. In K-12 schools, one in four children have been out due to contracting COVID-19.
The Biden administration and Democrats across the country from California to New York and Illinois have ensured COVID-19’s spread by forcing the reopening of schools to push parents back into unsafe work places.
In response to inundation of hospitals and trauma, many nurses and other health care workers have left the profession altogether. Health care workers’ demands for safe staffing levels and more resources have fallen on deaf ears as the world enters the third year of the pandemic. In late 2020, Governor Newsom gave the green light for California’s nursing ratios to be ignored, jeopardizing care and safety for staff.
The experience with AB 1400 is yet another confirmation of the hypocritical and cynical nature of the Democratic Party’s posturing about health care reform.