The California Single Payer Movement Paul Y. Song, MD Board Member – PNHP CALIFORNIA

The Problem In CAlifornia CA has the largest number of people in the US without health insurance – 6.9 million. CA has the largest number of people in the US without health insurance – 6.9 million. Employees in businesses of all sizes in CA are more likely to be uninsured than in the US. Employees in businesses of all sizes in CA are more likely to be uninsured than in the US. Nearly 1/3 of the uninsured in CA have family incomes of $50,000 or more. Nearly 1/3 of the uninsured in CA have family incomes of $50,000 or more. 53% of CA’s uninsured children are in families where the head of the household worked full-time in % of CA’s uninsured children are in families where the head of the household worked full-time in % of the uninsured in CA are Latino. 60% of the uninsured in CA are Latino.

SB 810 The California Universal Care Act Introduced February 18, 2011 Introduced February 18, 2011 Author: State Senator Mark Leno Author: State Senator Mark Leno Similar legislation has been passed twice before Similar legislation has been passed twice before Both times vetoed by Governor Schwarzenegger Both times vetoed by Governor Schwarzenegger Requires no new spending Requires no new spending CA Federation of Teachers estimates that SB 810 would save over $300 Million on healthcare costs CA Federation of Teachers estimates that SB 810 would save over $300 Million on healthcare costs SB 810 would save over $20 Billion in year one on reduced administrative costs and $29 Billion overall SB 810 would save over $20 Billion in year one on reduced administrative costs and $29 Billion overall

SB 810 Legislative Digest Establishes California Healthcare System Establishes California Healthcare System Creates California Healthcare Agency Creates California Healthcare Agency Healthcare Commissioner (appointed by Governor) Healthcare Commissioner (appointed by Governor) Receives all healthcare payments Receives all healthcare payments Is the sole payer of healthcare costs Is the sole payer of healthcare costs Duplication of coverage for benefits provided by CHS is prohibited Duplication of coverage for benefits provided by CHS is prohibited

SB 810 Chapter 7 (Other provisions) The division becomes operative when the Secretary of CA HHS notifies the Secretary of the Senate and Chief Clerk of the Assembly that the Healthcare Fund will have sufficient revenues, or receives the federal waiver, whichever date is later. The division becomes operative when the Secretary of CA HHS notifies the Secretary of the Senate and Chief Clerk of the Assembly that the Healthcare Fund will have sufficient revenues, or receives the federal waiver, whichever date is later. Except the Premium Commission which goes into effect on Jan 1, 2012 if passed. Except the Premium Commission which goes into effect on Jan 1, 2012 if passed.

SB 810 Legislative Digest On 1/31/12 - Failed in the CA Senate (two votes short!) – Six Democrats voted no or abstained!!! On 1/31/12 - Failed in the CA Senate (two votes short!) – Six Democrats voted no or abstained!!!

Organizational Moves Strengthened PNHP CA Strengthened PNHP CA Increased our organizational capacity Increased our organizational capacity Active engaged board which meets monthly Active engaged board which meets monthly Increased our staff Increased our staff Executive Director Executive Director Education and Outreach Coordinator Education and Outreach Coordinator Shearer Student Fellow Shearer Student Fellow Development Consultant Development Consultant Grant Writing Intern Grant Writing Intern Added two local chapters – Humboldt/Del Norte and Sonoma Increased donations through a annual Gala/Awards Ceremony and Launched a major donor program – Caregiver’s Circle

Coalition Building Campaign for a Healthy California Campaign for a Healthy California California Alliance for Retired AmericansCalifornia Alliance for Retired Americans California Health Professional Student AllianceCalifornia Health Professional Student Alliance CA Nurses AssociationCA Nurses Association CA OnecareCA Onecare Communication Workers of America District 9Communication Workers of America District 9 Democracy for AmericaDemocracy for America Green PartyGreen Party Healthcare for AllHealthcare for All CA League Of Women VotersCA League Of Women Voters Progressive Democrats for AmericaProgressive Democrats for America Single Payer NowSingle Payer Now PNHP CAPNHP CA

Coalition Building Worked closely with CA One care on fundraising, entertainment industry outreach, and building netroots. Worked closely with CA One care on fundraising, entertainment industry outreach, and building netroots. Created a new affiliates category for partnering organizations. Created a new affiliates category for partnering organizations. Have connected with 28 different organizations and coalitions this years. Have connected with 28 different organizations and coalitions this years. Developed a new relationship with the Courage Campaign a 750,000 member grass roots progressive advocacy organization. Developed a new relationship with the Courage Campaign a 750,000 member grass roots progressive advocacy organization. CA Federation of Teachers – Instrumental on Prop 30. CA Federation of Teachers – Instrumental on Prop 30.

Advocacy/Education Developed and grew our Speakers and Writers Bureaus. Developed and grew our Speakers and Writers Bureaus. Community Clinic Outreach Program. Community Clinic Outreach Program. California Health Professional Student Alliance. California Health Professional Student Alliance. Grassroots advocacy (community roundtables, political events, undergraduate lectures, faith organizations). Grassroots advocacy (community roundtables, political events, undergraduate lectures, faith organizations). Introduced a resolution at the CMA to support single payer. Introduced a resolution at the CMA to support single payer. Advocated for SB 810 and HR 676. Advocated for SB 810 and HR 676. Some members became more politically active and connected with single payer candidates. Some members became more politically active and connected with single payer candidates.

Long Range Goals Continue to educate the public Continue to educate the public Develop and package an effective message Develop and package an effective message Use traditional and new media Use traditional and new media Continue to educate and recruit the entertainment industry Continue to educate and recruit the entertainment industry Grow the Coalition of Statewide Organizations Reach out to small businesses and other non-traditional groups who are burdened by healthcare costs (minority groups, faith based organizations, etc.) Elect Supportive Legislators Form a PAC with teeth Target key state assembly and senate races

Long Range Goals Prepare to defend against an insurance industry onslaught – advertising, ballot initiative, lobbying Prepare to defend against an insurance industry onslaught – advertising, ballot initiative, lobbying Develop a field and media campaign Develop a field and media campaign Obtain Federal Waivers PPACA state innovation waiver in 2017 Medicaid, SCHIP, ERISA waivers Medicare waiver (requires new federal legislation) McDermott Bill Develop a Watchdog Arm to prevent backsliding!

Funding? $50 Million over the next 5 years$50 Million over the next 5 years Funding Sources :Funding Sources : Super Major Donors Super Major Donors Labor Labor Foundations Foundations Business Support Business Support Netroots – micro donations Netroots – micro donations