California Democrats Revive Single-Payer Health Care Push

Candidates promise universal coverage, but obstacles remain

Published on Mar. 4, 2026

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California Democratic candidates for governor are once again campaigning on the promise of a government-run single-payer health care system, despite past failures to implement the policy. While the idea of "Medicare for All" has become a progressive rallying cry, the estimated $392 billion annual cost and the need for federal approval pose significant hurdles. Candidates like Tom Steyer and Katie Porter have endorsed the policy, but experts say the perennial promises are often "aspirational" rather than realistic.

Why it matters

The push for single-payer health care in California highlights the ongoing debate over the role of government in providing universal coverage. Proponents argue it would save the state money in the long run, but opponents warn of higher taxes and a "new, unwieldy government bureaucracy." The issue also reflects the broader tension within the Democratic party between moderates and progressives on health care policy.

The details

Establishing a single-payer system in California would require approval and cooperation from the federal government, which the Trump administration is unlikely to provide. It would also likely necessitate significant state tax increases, though advocates say it would ultimately save money through lower drug prices and administrative savings. Previous attempts to pass single-payer legislation in the state have failed, with one high-profile effort in 2022 flaming out due to lack of legislative support.

  • In 2018, Gov. Gavin Newsom launched a commission to study single-payer health care and asked for a federal waiver to allow it, but the Trump administration rejected the request.
  • In 2022 and 2024, state Assemblymember Ash Kalra introduced bills to establish a single-payer system, but the legislation did not gain enough support to reach the governor's desk.

The players

Tom Steyer

A billionaire Democratic candidate for California governor who previously opposed single-payer health care but now supports it, telling party delegates "we need a single-payer health care system in California."

Katie Porter

A former U.S. Representative and Democratic candidate for California governor who has endorsed a single-payer system, declaring she would "deliver single-payer health care" if elected.

Ash Kalra

A Democratic state Assemblymember who has introduced bills to establish a single-payer health care system in California, but has faced challenges in garnering enough legislative support.

Gavin Newsom

The outgoing California governor who campaigned on a promise to implement single-payer health care but was unable to deliver on that pledge during his time in office.

John Myers

A spokesperson for the California Chamber of Commerce, which generally opposes tax increases and the creation of a "new, unwieldy government bureaucracy" to oversee single-payer health care.

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What they’re saying

“It's easy to make promises. We all want to see the plan.”

— Daniel Panush, health care policy consultant (lostcoastoutpost.com)

“Sometimes it feels like single-payer is the future health system of California, and always will be.”

— Daniel Zingale, former strategic adviser to Gov. Gavin Newsom (lostcoastoutpost.com)

“There's a reason that similar proposals have failed to gain traction in the past: The effort is more symbolic than serious.”

— John Myers, spokesperson, California Chamber of Commerce (lostcoastoutpost.com)

What’s next

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The takeaway

This case highlights growing concerns in the community about repeat offenders released on bail, raising questions about bail reform, public safety on SF streets, and if any special laws to govern autonomous vehicles in residential and commercial areas.