California Road Map for Affordable and Accessible Health Care

Health care is a right for all, not a privilege for just the wealthy. As governor, I will build a health care system that not only works for everyone in California, but that specifically takes the necessary steps to move our state towards a single-payer system.

This monumental, but necessary challenge is going to take a leader who understands our state’s finances in and out, because if you can’t manage a budget, you’re not going to get single-payer passed. We also need a leader who has worked creatively to come up with solutions to our health care needs in the past.

When our state saw Californians retiring without any savings, I helped create Secure Choice — a retirement plan that is set to herald in the most significant change to retirement savings since Social Security was enacted in the 1930s, by helping up to 7.5 million Californians retire with dignity and respect, with almost no cost to the state. When Congress tried to take an ax to the Affordable Care Act (ACA) and put our state’s health clinics in jeopardy, I found $20 million and came up with the idea for ‘lifeline grants,’ to keep these community health clinics’ doors open. I not only have a record of finding solutions to the complex logistical problems, but the complex budgetary problems facing our state’s health care system.

I am the only candidate Californians can trust to manage our state’s finances and get us to single-payer responsibly. As governor, Californians will have access to the quality, affordable medical care they not only need, but deserve.


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The first stop on the road to better health care is resisting those who would do us harm. Here in California, we’ve enjoyed great benefits under the Affordable Care Act, with millions of formerly uninsured Californians getting coverage, including nearly all of our state’s children. One-in-three Californians has coverage through the Medi-Cal expansion. Millions of young adults have benefitted from staying on their parents’ plans until the age of 26.

In addition to the sheer number of people with coverage, the quality of coverage has dramatically improved as well. Plans are required to cover essential health benefits, including mental health and substance abuse services, maternity care, prescription drugs, and emergency services. No one can be denied coverage or charged more for having a pre-existing condition, and insurance companies can no longer impose lifetime or yearly limits on coverage. These benefits have saved millions of lives.

Unfortunately, the progress we’ve made under the ACA is under attack. When Congress last year attacked Obamacare and clinics like Planned Parenthood, I took bold action. I came up with the idea for ‘lifeline grants’ — so California’s 1,200 community health clinics could keep their doors open — because these clinics are critical for providing health care services to local communities.

As governor, I will stand up to those in Washington who would roll back the gains we have made or threaten our coverage and care. We will protect access to health care for all Californians and lead the charge for the rest of the country, to ensure we don’t lose ground.

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Despite the Affordable Care Act’s success in dramatically increasing health care coverage, it’s still unaffordable for many. Our next step in fixing health care is to overhaul the wasteful, bureaucratic system we currently have that enables too many health care providers to put profits before care. Every person has a right to affordable high-quality health care.

I support Bernie Sanders’ Medicare for All plan at the national level and will do everything in my power as governor to support its passage. This bill will ensure that every single American has access to Medicare’s guarantee of quality health care — including preventative services to find and treat health issues early — in their local community.

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With a lifetime record of finding pragmatic solutions to the state’s most pressing challenges, I am committed to finding a fiscally responsible way to move to a universal system. But I’m not content to wait for a new federal Administration to get the approvals needed for single-payer — I want to provide Californians with additional assistance on affordability as soon as possible.

While Congress debates Medicare for All, California should move forward with establishing a single-payer health care system and focus on two of the most important components of what people support in a single-payer system: universal coverage and reigning in skyrocketing health care costs, including premiums and deductibles.

We must also provide assistance with affordability as soon as possible to guarantee that no Californian spends more than a certain percentage of their income on their health care coverage. We can also pass other structural steps to a single-payer system now, like providing a public option, without federal approval.

Mental and behavioral health must continue to be an integral part of any plan moving forward. The Affordable Care Act guaranteed that all plans cover mental health and substance abuse services as essential health benefits. We must continue to make improvements to guarantee equal and timely access to quality and affordable care.

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I am 100 percent committed to moving California towards a single-payer system. But while we’re on the journey to get there, we can take some steps now to bring down the costs of health care for all Californians.

The fastest way to reduce the state’s health care costs is by helping people stay healthy, and reducing the number of people with preventable, chronic conditions, like diabetes and heart disease. We must strive to make California the healthiest state in the nation. We need to make sure our children get a healthy start: that they have safe places to live; access to affordable and healthy food in their neighborhoods; safe places to play and exercise; clean, breathable air, and clean water to drink. Californians must have access to basic primary care and mental health services so we can help people avoid illnesses, control chronic conditions, and detect problems before they escalate into major medical issues.

Even when we do that, we’re still left with the remnants of a complicated and elaborate fee-for- service model of medicine that drives up costs. We currently pay for every procedure done by a medical professional. This system creates incentives for more tests, procedures, and surgeries. This makes medical care much more expensive than it should be.

We should be rewarding the quality and efficiency of medical care, not the quantity of procedures. We need to create incentives for keeping people healthy, not just treating them when they are injured or sick. The only way to assure our health care system places patients before profits is to tie patient health outcomes to reimbursements. In other words, the healthier the patient, the fewer the errors, the fewer the hospital complications, and the higher the patient satisfaction, which all leads to the system being reimbursed.

This is especially important in the area of mental health. Primary care physicians, who may be the first ones to recognize a mental health problem, often can’t take the time to properly diagnose and treat issues. There are economic incentives to keep office visits short and to maximize the number of patients seen. Often, the treatment of mental health problems must compete with other medical issues, such as treating chronic illnesses or providing preventative health services. There should be economic incentives for identifying and creating integrated care plans for mental health treatment.

Finally, we must also address concerns over the cost of prescription drugs. In the richest country on earth, people shouldn’t have to forgo prescribed medicine because the cost is too high. California has already taken an important step in addressing this issue by making drug prices, for both public and private health plans, more transparent. However, we must enact pharmaceutical price controls if we want to stop price gauging and assure that providers are prescribing drugs that have the greatest benefit, the safest track record, and offer the best value.

We can move now on many of these necessary proposals without waiting for the federal action we’ll need to help finance a single-payer system, but it will take a leader with the a record of coming up with creative solutions to our financial and logistical health care hurdles. California will lead on the important issue of single-payer, and I am committed to getting us there.