A Background History of SB 840 - The California Universal Healthcare Act (Kuehl)

Spring 1998       Health Care for All-California (HCA) helps draft Senate Bill 2123, which calls for a universal single payer health care system. The authors are Senators Barbara Lee (Oakland) and Diane Watson (Los Angeles). HCA leads a campaign for organizational endorsements. SB 2123, as revised and passed by the Senate Health and Human Services Committee, calls for a comparisonof different models of financing universal health care, including single payer.

Summer 1998     HCA helps draft Senate Concurrent Resolution 100, which calls for a study to compare different models of financing universal health coverage. Each model must provide the same high quality benefits, which are defined in the bill. The content of SCR 100 is authorized by Senate President, John Burton, and supported by leaders of the Assembly and the Senate.

Spring 1999       HCA helps draft SB 480, which requires: 1) a process for stakeholders to address the issues facing the state in providing universal health coverage; 2) a report from the California Health and Human Services Agency (CHHS) to the legislature on the results of the process and the universal health coverage study; and 3) enactment of universal health coverage for all California residents by a "date certain," July 1, 2003. The author is State Senator Hilda Solis (Los Angeles).

Summer 1999     HCA initiates a statewide organizational endorsement campaign to pass SB 480. Hundreds of organizational endorsements are sent to the legislature. With the date certain provision removed, the bill passes the Senate and the Assembly. The endorsement campaign continues. Newspaper editorials and op-eds call for Governor Gray Davis to sign SB 480, which he does.

Winter 2000      By the authority of leaders of the Assembly and the Senate, a panel of national health care experts, the Universal Health Care Technical Advisory Committee (UHCTAC), meets to review the status of the study, evaluate different proposals for conducting the study, and issue a report of recommendations. The UHCTAC report draws on HCA's own recommendations, which include: the government should be the client for the study; advocates of a particular model of universal health coverage should devise that model; methods and assumptions used for the study should be transparent; there should be competitive bidding by modelers; and the quality criteria defined in SCR 100 should be applied to each model.

Spring 2000       HCA initiates a statewide organizational endorsement campaign to augment the budget so that CHHS can implement SB 480. The legislature approves $600,000. Governor Davis authorizes $200,000.

Summer 2000     HCA initiates a statewide organizational endorsement campaign to have Governor Davis apply for a federal grant from the Health Resources and Services Administration (HRSA) to conduct a comparative analysis of different models of universal health coverage. The funds would enable implementation of SB 480. HRSA’s budget can only fund 11 of the 20 proposals HRSA approves. California is among the nine states not awarded a grant.

Fall 2000             HCA initiates a statewide organizational endorsement campaign to augment the federal budget. With support for the campaign from U.S. Representative Nancy Pelosi (San Francisco), Congress increases HRSA's budget by $15 million. California's “Health Care Options Project” (HCOP) receives $1.2 million.

Spring 2001       HCA initiates a statewide organizational endorsement campaign to guarantee full participation by representatives of the Legislature and health care stakeholders in the SB480/HCOP process, and to have CHHS utilize the recommendations of the UHCTAC report. The Senate and Assembly budget subcommittees for health hold hearings about implementation of SB480/HCOP and support HCA's goals.

Summer 2001     CHHS creates the Advisory Group for the SB480/HCOP process. There are representatives of state and local governments and a broad range of health care stakeholders. CHHS approves nine proposals for the study. There are three universal single payer proposals -- including HCA’s own plan, Cal Care -- and six proposals that increase coverage through public program expansions, employer and/or individual tax credits, subsidies and/or mandates, or combination approaches. HCA initiates a campaign to have CHHS contract for an analysis of how well each proposal satisfies health care quality measurements, in addition to how much each proposal expands health coverage and how much the expansion costs.

Fall 2001         CHHS contracts with The Lewin Group to analyze and compare the cost and coverage impacts of the nine proposals, using a micro-simulation model. CHHS also contracts with AZA Consulting to analyze the quality and access impacts of the proposals.

Winter 2002       CHHS and the California State Library/California Research Bureau sponsor five public symposia, which are held in Fresno, Oakland, Manhattan Beach and Sacramento (twice). The authors describe their proposals, and the Lewin Group and AZA Consulting report their findings. The authors use public input to revise their proposals.

Spring 2002       The Lewin Group and AZA Consulting submit their final documents to CHHS. At the end of his presentation at the last symposium at the capitol, John Shiels of The Lewin Group says, “One of the major claims of the single payer advocates for a long time has been that we could cover more people, for more services, for less money. Our study is showing that, for these very carefully designed plans, that's true. To the best of our ability to estimate it, that's true.”

Fall 2002            HCA convenes monthly meetings in Sacramento with a wide range of organizations to lay the basis for a grassroots movement to support a single payer bill in the 2003 legislative session. Several Assembly Members and Senators compete to be selected by the organizations as the author of the bill. Sen. Sheila Kuehl (Santa Monica) is chosen. The legislation is developed from recommendations from the public, health care stakeholders and features from the three HCOP single payer proposals.

Winter 2003       Sen. Kuehl introduces SB 921, The Health Care for All Californians Act. The Health Care for All Californians Campaign is established, composed of a growing number of organizations that endorse the bill. Regional meetings are held to involve local organizations in the campaign.

Spring 2003       A large lobbying campaign helps to get passed SB 921 by the Senate, but the bill is reduced to “intent” language.

Spring 2004       The Assembly Health Committee passes SB 921. The bill goes no further. It has 26 co-authors (6 Senators and 20 Assembly Members) and more than 500 statewide or local organizations are endorsers. HCA raises $90,000 to hire The Lewin Group to analyze the financial impact of SB 921 (April 2004 version).

Winter 2005      Sen. Kuehl releases The Lewin Group report. The findings show the model on which SB 921 was based can cover every Californian with a comprehensive health plan that reduces costs and controls health cost inflation. If the model were implemented in 2006, the cumulative savings between what would be spent without the plan and what would be spent under it would be $8 billion in the first year and $343.6 billion from 2006-2015.

Spring 2005       Sen. Kuehl introduces SB 840, the California Health Insurance Reliability Act, which substantially amends SB 921. Advocates garner hundreds of endorsements from organizations, thousands of letters of support from individuals, and place op-eds in many newspapers. The Senate passes SB 840.

Summer 2006     A huge lobbying campaign by advocacy organizations and unions helps get SB 840 passed by the Assembly. Due to amendments in the Assembly version, SB 840 is returned to and passed by the Senate for concurrence. It has 43 co-authors (13 Senators and 30 Assembly Members). Gov. Arnold Schwarzenegger’s op-ed in the San Diego Union-Tribune explains why he will veto SB 840. It generates a lot of press coverage, as well as criticism by advocates of SB 840. On August 12, the “365-City Campaign” is launched in Morro Bay. Each following day there’s an event in support of SB 840 in a different city. It’s a project of OneCareNow, which is initiated by HCA, in partnership with other organizations, who soon form the State Strategy Group.

Spring 2007       Sen. Kuehl reintroduces SB 840, renamed the California Universal Healthcare Act. At a special Assembly Health Committee educational hearing, Sen. Kuehl shows the HCA video, “The Healthcare Solution: California OneCare,” which is posted on YouTube (search “onecarenow”). SB 840 quickly has 43 co-authors (15 Senators and 28 Assembly Members). Sen. Kuehl also introduces SB 1014, which specifies the tax rates to help finance SB 840. Hearings on SB 840 are packed with supporters. The California Nurses Association hosts two large rallies at the capitol. The second features Michael Moore, who testifies at an educational hearing chaired by Sen. Kuehl. Moore also hosts two sneak previews of SiCKO, one for advocates and one for legislators and staff. The Senate passes SB 840. The Assembly Health Committee also passes SB 840.
Summer 2007     Throughout California where SiCKO is shown at movie theaters, flyers explaining SB 840 are distributed. Each flyer has a postcard with prepaid postage. Over 30,000 postcards in support of SB 840 are collected in a few weeks. On August 11, the 365-City Campaign ends with a rally of 3,000 in front of Los Angeles City Hall. Speakers include Sen. Sheila Kuehl, Lily Tomlin, Lt. Gov. John Garamendi, U.S. Congressman Dennis Kucinich, Secretary-Treasurer Emeritus of the United Farm Workers Dolores Huerta, Executive Treasurer of the L.A. County Federation of Labor Maria Elena Durazo, and spokespersons from the State Strategy Group. The 2007-2008 “365 Campaign” is launched. A Field Poll (Aug. 22) shows that 36% of California voters favor replacing the current employer-based system with one operated by the state -- a jump of 12% since December. The poll shows single payer has the most support of all health care proposals.