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SACRAMENTO, Calif. — Within hours of assuming workplace Monday, Gov. Gavin Newsom issued a defiant problem to the Trump administration with sweeping plans to increase well being protection to extra Californians, pushing for a single-payer system and insurance coverage for undocumented younger grownup immigrants.
He additionally known as for brand new state-funded subsidies to assist folks afford medical insurance, coupled with a requirement that every one Californians have medical insurance. And he signed an govt order that directs state companies to work collectively to barter prescription drug costs.
Newsom revealed his proposals on Facebook Live, following a combative inaugural speech earlier within the day wherein he vowed to face as much as a “corrupt” administration in Washington and lead California alongside a progressive path.
“Every person should have access to quality, affordable health care,” Newsom mentioned in his inaugural speech. “Far-away judges and politicians may try to turn back our progress. But we will never waver in our pursuit of guaranteed health care for all Californians.”
Newsom had campaigned for a single-payer system, and he mentioned Monday that he remained dedicated to it. In a letter to President Donald Trump and congressional leaders, Newsom known as on the federal authorities to permit California and different states to create a single-payer payer program.
U.S. Rep. Ro Khanna (D-Calif.), who’s working with Newsom, mentioned Congress must cross a invoice that offers states permission to create their very own well being care applications and nonetheless obtain federal funding.
While that request looks like a protracted shot within the Republican-controlled Senate, Khanna mentioned he and different Democratic lawmakers wish to begin hearings within the Democratic-controlled House of Representatives — in preparation for when there’s a Democrat within the White House.
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“Realistically, we’re looking at 2021 before this could become law,” Khanna mentioned.
Newsom’s out-of-the-gate transfer on single-payer displays a transparent shift from his predecessor, Democratic Gov. Jerry Brown, who had described the bold proposal — which might price an estimated $400 billion annually — as financially inconceivable.
Newsom’s announcement additionally offers momentum to advocates of single-payer each in California and nationally.
“This is a necessary first step in getting this program together,” mentioned Stephanie Roberson, director of presidency relations on the California Nurses Association, a gaggle that has been among the many most outspoken advocates for single-payer within the state. “This is definitely a campaign promise that has come to fruition for us.”
As a candidate, Newsom had additionally backed increasing well being care to young adults who’re within the nation illegally — a Democratic plan that died in finances negotiations final 12 months when Brown balked on the estimated price: $140 million for the primary 12 months.
Newsom mentioned his finances, scheduled to be launched Thursday, will put aside state funding to increase Medi-Cal, California’s model of the federal Medicaid program for low-income folks, to eligible adults as much as age 26. That would make California the primary state to supply full Medicaid advantages to unauthorized immigrant adults.
In 2016, California opened Medi-Cal to all youngsters as much as age 19, no matter their immigration standing. Since then, more than 250,000 youngsters have enrolled.
Immigration and well being care advocates estimate that greater than 100,000 younger adults aged 19 to 25 might enroll if Newsom’s proposal is adopted by the state legislature.
“The truth is we need every single adult to be covered. That’s the best way to make sure people thrive,” mentioned Almas Sayeed, with the California Immigrant Policy Center. “But we’re thrilled that he is picking up a part of this campaign — and this early on.”
Newsom additionally needs California to develop into the primary state to supply subsidies to middle-class households who wrestle to purchase medical insurance. Under the Affordable Care Act, individuals who earn greater than 400 p.c of the federal poverty degree — about $48,500 a 12 months for a person or about $100,000 for a household of 4 — don’t qualify for federal monetary help to assist them buy their very own insurance policies. Newsom’s plan would offer state subsidies to people incomes as much as $72,840 and households of 4 incomes as much as $150,600.
To pay for these subsidies, for which the brand new governor didn’t put a price ticket, Newsom mentioned he’ll ask the Democratic-controlled legislature to impose a well being protection requirement on Californians — and a penalty for individuals who don’t comply.
The federal tax penalty for uninsured folks beneath the Affordable Care Act went away on Jan. 1, a provision of the Republican tax invoice of 2017.
A state mandate to have insurance coverage will be the most controversial piece of Newsom’s proposals, mentioned Larry Levitt, a senior vice chairman on the Kaiser Family Foundation. “There would be real concerns raised of whether coverage is affordable enough to require people to get it,” he mentioned. “Pairing the expansion in subsidies for people in the middle class with the individual mandate may make the mandate more palatable.” (Kaiser Health News, which produces California Healthline, is an editorially unbiased program of the inspiration.)
In different strikes that don’t require legislative approval, Newsom signed an govt order creating the brand new place of California surgeon common, who he mentioned would promote preventive care and spotlight well being disparities throughout California.
The new governor additionally signed an order directing state companies to collaborate on buying prescribed drugs.
Currently, state companies negotiate individually with drug corporations for prisons or veterans, for instance.
There are varied methods the state might consolidate prescription drug buying, and a few would require federal approval, mentioned Erin Trish, affiliate director of the USC Schaeffer Center for Health Policy & Economics. A consolidated negotiator might obtain decrease costs, however that might require limiting the variety of coated medicine, Trish mentioned. “You have to be willing to exclude coverage of drugs to have meaningful bargaining leverage to change prices,” she added.
This and Newsom’s different first-day proposals underscore that California has a governor who intends to concentrate on well being care, Trish and different coverage consultants mentioned.
“This is an issue that he cares about, that California cares about, that he has experience on and strong opinions on,” she mentioned. “This is the Newsom administration putting the stake in the ground, saying we are going to take on health care.”
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