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California’s Single-Payer Push Returns With CalCare Refiled and $552 Billion Cost in Focus

Supporters point to federal Medicaid cuts to argue the current system is untenable.

Overview

  • Assemblymember Ash Kalra reintroduced a procedural bill to establish CalCare, envisioning universal, no-cost care at the point of service for all residents regardless of income or immigration status.
  • The California Legislative Analyst’s Office estimates CalCare could cost up to $552 billion annually, a figure larger than the entire state budget.
  • The renewed push has high-profile backing, with gubernatorial candidate Tom Steyer endorsing single-payer and figures such as Betty Yee, Xavier Becerra, and Tony Thurmond also supportive.
  • Opponents cite Medi-Cal’s strains—about 15 million enrollees including an estimated 1.6 million undocumented immigrants, low reimbursement rates, and provider shortages affecting over 7 million residents—as warnings about feasibility and access.
  • Context from recent policy shifts includes Congress’s 2025 Medicaid cuts projected to reduce California’s funding by roughly $30 billion a year, Covered California reporting a 32% drop in new enrollment, and proposed HHS rules allowing high-deductible “skinny” plans starting in 2027.