Twenty minutes earlier than the one scheduled 2018 California’s gubernatorial debate, Lt. Gov. Gavin Newsom rolled into the San Francisco parking storage in a black SUV. Through the tinted home windows, a gentle overhead mild barely illuminated the front-runner’s chiseled options and slicked-back hair.
In a well-tailored blue go well with and matching tie, Newsom strode to the elevator and casually leaned his tall body in opposition to the nook, rising on KQED radio’s third ground to banter with ready reporters — the image of a sophisticated and assured front-runner.
Then, in gravelly tones, Newsom squared off together with his Republican opponent John Cox, letting free his internal wonk, delving into the weeds on all method of points within the Golden State. “If you’re looking for timidity, I’m not your person,” he stated when requested about his temperament.
But not as soon as did the Democratic candidate point out one of the crucial controversial pillars of his marketing campaign: single-payer medical health insurance.
Nationally, Newsom’s help for single-payer is probably how he’s finest identified — except for his daring transfer as San Francisco mayor in 2004 to signal marriage licenses for same-sex couples, a prescient choice that then ran opposite to regulation.
Newsom’s backing for government-run, common protection has typically been equally daring, however different instances it has been extra muted, prompting conservatives to name him too liberal and liberals to label him too skittish. That dichotomy is probably going a mirrored image of the political challenges he’ll face, if elected, even in one of many nation’s bluest states.
His notable omission of single-payer within the debate earlier this month may have stemmed from a tightly choreographed format and time limitations — however his opponent’s campaign instantly jumped on him for it, calling his previous effort to create common well being care in San Francisco a failure of which he ought to be “ashamed.”
Newsom, 51, who declined requests for an interview, has at instances tried to dampen expectations, suggesting in July to the San Francisco Chronicle that the single-payer effort may take years. In half, he was acknowledging a sensible hurdle: The federal authorities must approve the transfer if federal are for use, and the Trump administration is flatly opposed.
On his marketing campaign web site, nonetheless, Newsom has publicly called for single-payer protection in California. Last yr, he endorsed the amended Healthy California Act, SB 562, which known as for protecting each Californian, together with undocumented immigrants, underneath one public program.
The invoice stalled, partly as a result of it was projected to value $400 billion a yr, almost thrice the general fund expenditures for 2018-19. But the California Nurses Association, which has endorsed Newsom, plans to sponsor a brand new invoice within the coming legislative session.
Newsom’s supporters say he’s dedicated to the hassle — just because he believes it’s the proper factor to do.
“There are some people who have health care coverage and others who don’t,” stated Mitch Katz, director of public well being in San Francisco when Newsom was mayor and an unpaid adviser to his marketing campaign. “Everyone should be covered — for Gavin, it’s a fairness issue.”
(His opponent, Cox, dismisses the very concept. Asked earlier this yr whether or not he helps single-payer, his reply was easy: “God, no.”)
Even some who respect Newsom’s motives see his purpose as quixotic.
“I’ve followed his career and believe he is an individual of integrity who wants to advance meaningful legislation that helps people,” wrote Stanford professor and writer Dr. Robert Pearl in Forbes magazine. “That said, in a state that’s currently struggling to fund its schools and rebuild its infrastructure, Newsom will likely soon realize that turning California into a single-payer state is too expensive a promise to carry out.”
Newsom generally pulls out his well being care bona fides, particularly his expertise as mayor of San Francisco, when town spearheaded a novel, all-embracing well being care system for metropolis residents.
“I did universal health care in San Francisco,” stated Newsom on a progressive podcast not too long ago. “We proved it could be done without bankrupting the city. I’d like to see that we can extend that to the rest of the state.”
Healthy San Francisco shouldn’t be a single-payer system — not a wholly publicly funded insurance coverage plan. It goals for common care by protecting lower-income residents by means of a mixture of metropolis funds, charity care, copayments and contributions from employers. It’s not true insurance coverage as a result of it will possibly’t be used exterior town.
Enrollees have entry to a citywide community of preexisting safety-net hospitals and clinics. At its peak, it enrolled 60,000 metropolis residents, although enrollment plunged to 14,000 after the Affordable Care Act took impact. Today, undocumented residents make up the most important share of these on Healthy San Francisco.
Some critics on the left say Newsom took credit score for Healthy San Francisco solely after it was deemed a hit.
“Newsom is claiming credit for something he didn’t really do and didn’t support,” stated Tom Ammiano, the previous San Francisco supervisor and state meeting member who was chief architect of Healthy San Francisco. “If anything, I would say he did his best to undermine it.”
While Newsom favored the thought of common well being care in San Francisco, he didn’t publicly help the requirement for eating places to contribute to staff’ well being advantages, in line with Ammiano and others who labored on Healthy San Francisco. But the Board of Supervisors voted unanimously for Healthy San Francisco, blocking any likelihood for a veto, after which Newsom signed it into regulation.
After it handed in 2006, the Golden Gate Restaurant Association sued San Francisco, arguing unsuccessfully that forcing eating places to chip in on staff’ advantages was in battle with a federal regulation governing worker advantages. “We went to court three times, and three times we won,” Ammiano stated. “Where was Gavin? He never entered that fray. He never supported it, never did anything publicly.”
San Francisco progressives, like Ammiano and others, have by no means cared for Newsom’s pro-business stance (Newsom has owned wine outlets and quite a few different small companies with about 700 staff), or what they see as his slick persona when he was mayor from 2004 to 2011. Among some circles in San Francisco, Newsom was referred to as “Mayor Press Release,” which means he had a variety of massive concepts however little follow-through.
The San Francisco League of Pissed Off Voters, a progressive political group that places out a voter information, known as Newsom a “substanceless glad-hander” who “has been flashing fake smiles, pretending to be progressive for the cameras. … He’s a machine-politics climber who claims to fight for the dispossessed but never seems to get around to actually doing anything for them.”
But whilst a vocal critic of Newsom, Ammiano stated he plans on voting for him as governor. “There is no third option,” Ammiano stated. “I don’t believe in not voting, and I could never do Cox.”
A governor would face quite a few hurdles in essentially restructuring the state well being care system to cowl everybody, together with getting buy-in from the feds and confronting opposition from insurers and others invested in the established order.
But Newsom’s supporters say that a governor, not less than, would have extra authority than a mayor.
“The state has much more power over health care delivery than the county of San Francisco,” stated Katz, now president and CEO of NYC Health + Hospitals. “There are many more levers when you are the governor than when you are the mayor.”
Ken Jacobs, chair of the Center for Labor Research and Education at UC Berkeley and a member of the council that helped craft Healthy San Francisco, agreed.
For occasion, Newsom may push to develop Medi-Cal — the general public insurance coverage program for low-income Californians — to incorporate undocumented immigrants, stated Jacobs, co-author of Universal Health Care: Lessons From San Francisco. Also, he may prevail upon legislators to institute a state mandate for medical health insurance and supply state subsidies to assist cowl the fee.
That wouldn’t meet the definition of “single-payer” however would faucet a wide range of sources to pay right into a system that aspires to cowl everybody.
Whatever strategy he takes, Jacobs stated, “Gavin Newsom took the issue of health care very seriously as mayor, and I would expect him to do so as governor.”
Kaiser Health News (KHN) is a nationwide well being coverage information service. It is an editorially impartial program of the Henry J. Kaiser Family Foundation which isn’t affiliated with Kaiser Permanente.