Political Notes: Bay Area Assembly candidates back single-payer health care

  • by Matthew S. Bajko, Assistant Editor
  • Monday May 16, 2022
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LGBTQ Assembly candidates Shawn Kumagai, left, Jennifer Esteen, who are running in the 20th District race, and James Coleman, running for the 21st District seat, weigh in on single-payer health care. Photos: Kumagai and Esteen, courtesy the campaigns; Coleman, Morgan McCarthy
LGBTQ Assembly candidates Shawn Kumagai, left, Jennifer Esteen, who are running in the 20th District race, and James Coleman, running for the 21st District seat, weigh in on single-payer health care. Photos: Kumagai and Esteen, courtesy the campaigns; Coleman, Morgan McCarthy

A legislative push to establish a universal health care system in California may have stalled this year, but the calls for the state to move toward a single-payer form of medical care are expected to only grow louder in the years to come. It is an issue being discussed on the campaign trail in various Bay Area races for legislative seats.

Among the Democratic candidates who returned the Bay Area Reporter's questionnaire that asked where they stood on the issue, there is near universal support for single-payer health care. But slight differences can be seen in how the candidates would legislatively move it forward.

California lawmakers have for years debated the issue but have failed to coalesce around what form it should take and how to pay for it. In January, Assemblymember Ash Kalra (D-San Jose) pulled his Assembly Bill 1400 from being voted on due to it being clear he didn't have the support needed to advance it out of the Assembly.

The bill, co-authored by bisexual Assemblymember Alex Lee (D-San Jose), would have created a single-payer health care system known as CalCare. Kalra had worked with Assembly Speaker Anthony Rendon (D-Los Angeles) on setting up a separate funding mechanism to pay for it via a tax on large businesses and people earning incomes of over $150,000. But it was met with intense lobbying against it from corporate and medical interests.

Locked in a tough reelection race for his seat, Lee isn't shying away from the issue and has pledged to continue fighting for universal health care should he win a second term. He is running for the renumbered 24th Assembly District seat that straddles Alameda and Santa Clara counties.

"For the wealthiest state in the wealthiest nation in the world, our spending on health care outcomes is abysmal," notes Lee on his campaign website. "Many Californians still lack health insurance and, even when they do have health insurance, they cannot afford the egregious copays, predatory fees and costly drugs. The COVID-19 pandemic has shown us that employment-based health care does not work. Only by guaranteeing health care for all can we ensure the physical and mental health of our people as well as our economy."

Supporters of single-payer are turning to this year's legislative races to see if they can increase the number of legislators committed to establishing such a system of health care in the state. In the race this spring for the vacant 17th Assembly District seat in San Francisco, the eventual winner Matt Haney had sparred with his gay opponent, David Campos, on who would be a stronger advocate in Sacramento for a CalCare-type bill.

Rendon last week named Haney the assistant majority leader of policy and research. In that role Haney will lead the Assembly Office of Research and Policy, overseeing a staff of policy experts who will "do a deep-dive actionable analysis of the pressing issues California is facing," they noted in an announcement.

"I'm thankful to the speaker for entrusting a new assemblymember with such an important leadership position," stated Haney, expected to easily win a full two-year term in his Assembly seat on the November ballot. "I represent a district known for innovation, and I plan to bring that spirit to the Research and Policy Office."

Across the bay in the race for the open 20th Assembly District seat in Alameda County, gay registered nurse and union leader Jennifer Esteen and gay Dublin City Councilmember Shawn Kumagai both told the B.A.R. they support reforming the state's health care system. But they differ on how to approach doing so.

"I support universal health care by the most practical and expedient means possible," Kumagai, who would be the first out lawmaker of Japanese descent, wrote in his questionnaire.

Esteen, aiming to be the state's first Black female LGBTQ legislator, told the B.A.R. she would sign on as a sponsor of a CalCare bill should she be elected to the Assembly seat.

"As a nurse I see firsthand the impacts of a broken and expensive health care system, and I will be a day one champion for CalCare and single payer healthcare," Esteen told the B.A.R. "I will immediately act to ensure communities know what's going on inside Sacramento, and we can work together on passing healthcare for all, building more affordable housing, and fully funding our public education system."

During a May 13 editorial board meeting with the B.A.R., Esteen said she would start with a rewrite of Kalra's bill and would want to bring more stakeholders to the table from the get-go in order to build more buy-in for the legislation. As for the criticisms about the cost of such a health care system, Esteen argued there is already the money to fund it from what people currently have to pay out-of-pocket for their medical needs, what businesses are charged for their employees' health insurance, what insurance companies charge, and in the costs borne by taxpayers via local governments' expenses for providing medical care to those unable to afford it and who end up in emergency rooms or the jails.

"I think of the amount of money we will save when we have universal health care because people have easier access to care, to preventive health care services so they are not going to the emergency room for crisis care, which is also expensive," said Esteen, who also supports taxing wealthy individuals to help offset the costs of a single-payer system. "Fuck yeah, taxes are going to happen, and the money already exists. We already pay so much."

In an editorial board meeting with the B.A.R. May 12, Kumagai also said he had problems with how AB 1400 was written. He suggested a more incremental approach toward the establishment of something like CalCare, as called for in the bill, is needed.

"I would love for us to move to a single-payer system or a multi-payer system with a government option. Ultimately, it is going to be a long road," predicted Kumagai, who works as the district director for Assemblymember Rebecca Bauer-Kahan (D-Orinda). "I was not supportive of Kalra's bill as written, but I am not going to vote against whatever final form it ends up in. I want to be there and be part of those discussions."

As for the separate funding mechanism to pay for CalCare that would have gone before the state's voters, Kumagai told the B.A.R., "I thought it was just dead on arrival. I don't think we can do a sweeping (reform measure) like that with that much taxation on it in one fell swoop. We need to do this in bite-size chunks."

Noting that the state's current Medi-Cal government-backed health care system is a fee-for-service model, Kumagai argued California should be moving toward a values-based care model.

"My goal as a legislator would be that we focus on better patient outcomes," he said. "Whatever carrots and sticks we can use to move in that direction, I am supportive of those reforms."

The two out candidates are running to succeed Assemblymember Bill Quirk (D-Hayward), who opted not to seek reelection this year. He has endorsed labor leader Liz Ortega, who is straight and did not return the B.A.R.'s questionnaire.

The top two vote-getters next month will advance to the November general election. With the three relatively unknown Democrats splitting the vote among their party members, speculation has increased in recent days that one of them could face off against the Republican candidate, retired laboratory scientist Joseph Grcar.

Were that to happen then the race would, for all practical purposes, be over following the results of the June contest with the Democratic primary winner near assured of being elected to the Assembly seat. For as Kumagai noted, there is no chance of seeing Grcar win the heavily Democratic district if he advances to the fall ballot.

Peninsula race

In the race for the open 21st Assembly District seat on the Peninsula, bisexual South San Francisco City Councilmember James Coleman is another vocal backer for universal health care. He had supported seeing AB 1400 be adopted and had authored a resolution for his council to endorse universal single-payer health care at both the state and federal levels.

"It is a shame that the United States is the only Western country that does not guarantee health care as a human right," Coleman told the B.A.R. "Our system is inefficient as much as it is unethical — tens of millions of residents in the United States are either uninsured or underinsured. The United States exhibits some of the worst healthcare outcomes despite spending much more than many other developed countries on healthcare. I fully support a universal single-payer healthcare system."

The issue of medical care is of particular importance to the state's LGBTQ residents, added Coleman, noting they are at risk of myriad health concerns due to discrimination and stigma they face because of their sexual orientation and gender identity.

"Our LGBTQ+ communities disproportionately report having experienced mental illness, are disproportionately impacted by HIV, and often struggle to afford the costs of gender-affirming care. I will fight for universal single-payer healthcare, which includes gender-affirming, mental health, and reproductive care," Coleman pledged.

He is in a crowded field of seven candidates seeking the Assembly seat. It is being vacated by Assemblymember Kevin Mullin (D-South San Francisco), a leading candidate to succeed retiring Congressmember Jackie Speier (D-San Mateo/San Francisco).

Other Democrats in the race include San Mateo City Councilmember Diane Papan, whose late father, Lou, had held the seat in the 1970s and 1980s; Redwood City Mayor Giselle Hale; and county community college board member Maurice Goodman. The only other candidate to return the B.A.R.'s questionnaire, though, was attorney and tenant advocate Alison Madden, who noted she has supported universal health care for decades.

"I have since the 1980s. We need Medicare for all, and in California we can and must reintroduce the California Care bill that did not pass this past legislative session," wrote Madden. "The person who formerly held AD 21 was a supporter, and I contacted their office, by phone and email, to express my support and was assured that my assembly member did support it. I would continue to do so."

Even at the local level candidates support moving to a single-payer model in order to save money in city and county budgets. Gay Pleasant Hill City Councilmember Ken Carlson, vying to be the first out Contra Costa County supervisor in the race for the open District 4 seat on the board, told the B.A.R. he would support efforts to study what savings the East Bay county could see under such a system of health care.

"There are around 30 million Americans without health insurance. The majority of America's uninsured work at jobs that provide no health benefits," noted Carlson. "I support the idea of a publicly funded single-payer or 'Medicare for All' system."

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