California’s Single-Payer Health Care Down But Not Out?

Michael Lighty is a leader of the Healthy California NOW coalition formed to support Medicare for All in California, and the former healthcare constituency director for Vermont’s Independent Senator Bernie Sanders’ presidential campaign in 2020. Michael was the national director of the Democratic Socialists of America from 1989-93 and now serves on the Steering Committee for DSA’s Medicare for All campaign. Previously, he was the director of public policy for National Nurses United and the California Nurses Association. Michael and I conducted the interview below via email.

Seth Sandronsky: What happened to the single-payer health care bill in the state Capitol on January 31, and why?

Michael Lighty: Assembly Bill 1400 was scheduled to be voted on by the California Assembly, but the author – Ash Kalra (D-San Jose) -determined it lacked the 41 votes to pass so was pulled rather than going down to defeat in a recorded vote.

This reflected the misleading opposition by the health insurers and their industry allies who sought to protect their high prices and profits. It also shows that sufficient organizational support had not been organized to get Democratic legislators to vote yes. Yet, there remain good opportunities to move the principles and program of single payer in California this year.

SS: Not to show your cards to single-payer opponents such as the California Chamber of Commerce, but what is on tap moving forward to build adequate organizational power to win single-payer health care for all Californians in 2022?

ML: The Healthy California for All Commission will issue a final report in April that we expect will put forward steps toward achieving single-payer financing. The Commission has received extensive studies and testimony on the costly, fragmented and wasteful current healthcare system that fails to provide equitable care to all – we need to utilize that analysis and the report to urge Democratic Governor Newsom to secure the federal support and resources from the Biden administration necessary for single payer. The legislature can this year start to build the infrastructure for a new equitable system of guaranteed healthcare for all Californians.

SS: How could such legislative building of infrastructure to win single-payer health care for all begin?

ML: Health4All that covers undocumented residents is a start and establishing a statewidehealthcare budget and other cost control mechanisms are necessary now and essential for single payer. We need to unwind the privatization and stop the profit making in the Medi-Cal (Medicaid outside of Calif., ed.) program which can lead toward the new non-profit, public system. A state purchasing pool for pharmaceutical drugs is another reform that has been on the table.

SS: What lessons are there for other states from California’s experience in the struggle to win single-payer health care for all?

ML: This effort has shown the power of the grassroots, tapped into the popular support for Medicare for All and shown the necessity to build broad and deep organizational support and how we need to generate consistent leadership from the Governor.

SS: Thank you for your time, Michael.

ML: My pleasure, Seth, thank you!


Seth Sandronsky is a Sacramento journalist and member of the freelancers unit of the Pacific Media Workers Guild. Email