SACRAMENTO — The unceremonious collapse of California’s single-payer health care legislation — without so much as a vote — has the left desperate for answers.
Instead of serving as a liberal model for national Democrats, Sacramento ended up this week in the same place as Washington: with a single-payer bill that galvanized the party’s left flank but gained little traction as moderates balked and powerful opponents closed ranks.
The result has demoralized progressives and demonstrated the boundaries of their influence, even in a state like California, where Democrats control more than two-thirds of the Legislature.
The bill’s failure “illustrates what an uphill battle we have ahead of us,” said David Campos, a California Democratic Party official and single-payer advocate who is running for state Assembly. “I think we need to figure out where we go from here as a progressive movement,” he added.
The health care defeat is just the latest setback for the progressive movement amid signs the party is recalibrating its stances on policing and criminal justice. Elected officials from San Francisco to New York City have ramped up their tough-on-crime rhetoric in response to an uptick in violent incidents and a rash of organized property crimes that have left Democrats vulnerable to political attacks from the right.
The national reckoning over policing — and in particular, the “defund the police” campaign — appears to be losing steam in California; Gov. Gavin Newsom has sought more money for law enforcement, and San Francisco Mayor London Breed has moved to broaden police surveillance powers after decrying the “bullshit that has destroyed” the city.
Intraparty rifts have deepened over oil production bans that threaten labor union jobs, as well as land-use restrictions that deter housing construction. Environmental progressives are getting regularly drowned out by demands for more housing and jobs in the state.
And despite championing single-payer during his 2018 gubernatorial run, Newsom himself took a pass on the latest bill and avoided discussing it in much detail when asked last month. The governor has slow-walked the idea since taking office in 2019, only going so far as to establish a commission that is studying various costs and options.
The outcome also demonstrated how Sacramento is not the automatic progressive-policy machine people assume. An anti-evictions bill opposed by real estate groups stalled for lack of votes the same night. Business interests, law enforcement and the oil industry can still marshal decisive influence, often working with centrist Democrats.
“California, for as progressive as it is, there’s still a lot of purple here,” said Democratic consultant Roger Salazar, a Democratic consultant who works mainly on ballot initiatives and was once a spokesperson for former Gov. Gray Davis. “While the state has its liberal and progressive cores in San Francisco and Los Angeles, there’s a much more moderate swath.”
California Democrats have struggled for years to realize a health care ambition enshrined in the party platform. But those efforts have repeatedly died as formidable political opposition and the prospect of steep tax hikes proved too much to overcome.
“This was a moment of maximum leverage for progressives,” said one Democratic lawmaker who asked not to be named in order to speak candidly, “and their failure to even get a vote was a huge defeat.”
The debate has driven wider schisms between liberal and moderate Democrats and fomented campaign threats against incumbents unwilling to support the bill — a tactic that failed in the days before the vote and may have even backfired.
Assemblymember Ash Kalra, the bill’s author, had to weigh the merits of exposing fellow Democrats to political repercussions when he knew his legislation was doomed to fail.
This year was supposed to be different. In 2017, Assembly Speaker Anthony Rendon faced a ferocious backlash for shelving an unfunded single-payer bill. This time, Rendon worked with Kalra’s office for months to craft viable legislation, only to watch the bill shrivel in the Assembly without a floor vote.
Recriminations swiftly followed. Rendon appeared to blame Kalra for tabling his own bill. The California Nurses Association excoriated Kalra, and progressives unloaded on the lawmaker in a caustic video meeting Monday night for not forcing his colleagues to go on the record.
“We need to know who we need to replace and who we need to get rid of, and it seems like you are among them,” Ron Placone, one of the 300 some activists on the call, told Kalra. He accused the lawmaker of being “at best cowardly, and at worst deceptive.”
The San Jose Democrat told activists he had good reason to avoid a futile exercise that would have fallen short of the 41 necessary votes by double-digits.
“By putting them in that position, knowing that bill was not going to pass anyway, it would have further alienated them, and I think that would have made it harder to get them on board,” he said.
Kalra repeatedly urged the progressive activists to focus on electing lawmakers who will support single-payer and to come back next year to present a new bill before a more receptive Legislature.
Some Democrats believe the nurses and the party’s left flank overplayed their hands. Kevin Liao, a Democratic consultant who was formerly Rendon’s spokesperson, argued that calling a vote only to have it “go down in flames” could have had greater repercussions.
“(Kalra) did the homework, he put in a ton of work to get to that point, and for that to be rewarded by activists threatening to primary him really just shows you how the dialogue on this particular topic has really gotten out of hand,” Liao said, referring to some who want to back a harder-line challenger against the lawmaker in June.
State Sen. Scott Wiener, a single-payer supporter, came to Kalra’s defense and described the single-payer bill as “harder than anything I’ve ever done.”
“If a bill gets destroyed on the floor, that can make that bill toxic for years to come,” Wiener said.
Amar Shergill, the party’s progressive caucus chair, said the outcome underscores the need to elect progressive leaders, especially in Democratic strongholds.
“This is not an issue of forcing members in conservative districts to vote progressive,” he said. “We want Assembly members in progressive districts to vote progressive.”
The long-shot proposal hemmed Democrats in between powerful competing forces: progressives on one side and a formidable coalition of business and health care groups on the other. Republicans eager to make single-payer health care a campaign issue pummeled Democrats over a raft of proposed tax increases to fund the bill.
The issue is certain to continue animating Democratic campaigns in California. Jennifer Esteen, a nurse and vocal single-payer advocate who is seeking an open Assembly seat, said she hoped supporters could channel their disappointment into electing more single-payer Democrats.
“I want to see some bravery. I want to see some difference in movement in our Legislature,” Esteen said, “because if we don’t have the bravery and political will in the California Legislature, where we have our supermajority, where will we have it?”