What is the California Roadblock Removal Act, and How Does it Relate to SB562, the Healthy California Act (aka Single Payer Health Care)?

This article was originally posted on LinkedIn.

In my last article in BenefitsPRO, I provided an update on the single payer movement in California and at the national level. I included a point on a recent ballot initiative that was filed in California:

A ballot initiative called the “California Healthcare Roadblock Removal Act” was submitted by Enact Universal Healthcare for CA, Inc. to the California Attorney General Xavier Becerra on August 18, 2017. The ballot initiative process gives California citizens a way to propose laws and constitutional amendments without the support of the Governor or the Legislature. The initiative was assigned Initiative #17-0019 and is currently awaiting title and summary. The language of the initiative proposes a single-payer type system in California, but it is poorly written and incomplete, and may be sent back to the author before it can move ahead. If the Attorney General decides to make it an active measure, supporters will collect signatures with the intention of getting it qualified for the November 2018 ballot, where the residents of California will approve or deny it.

After attending the legislative update sessions at the fantastic CAHU Health Care Retreat last week, I wanted to provide some clarification on what I wrote in BenefitsPRO. I thought that this ballot initiative was backed by the California Nurses Association (CNA), the same organization that is backing Senate Bill 562. In California, laws like this can proceed on two possible tracks, as a bill that passes through the state legislature, or as a ballot initiative that is voted on by the public. While the CNA started with the legislative process (SB562 is currently being held in the Assembly), I had heard from the Healthy California organization a few months ago that the CNA would also pursue the ballot initiative process for a November 2018 vote. I thought this was the beginning of that process.

In reality, the California Roadblock Removal Act is not backed by the CNA, and is not a single payer proposal. Rather, it is a proposal to remove the *roadblocks* that currently exist in the state that would prevent SB562 from moving forward, including a part of the state constitution that limits how tax revenues are spent. (That would have to be changed so that the revenues from the SB562-related tax increases would all go into the Health California Trust Fund.) So this ballot initiative is more of a companion piece to SB562, rather than a pivot away from the legislative process.

In the opinion of the legislative consultants who work with CAHU, the initiative is not likely to move forward in its current form because (1) it is poorly written and (2) it violates the “single issue” requirement because it proposes multiple legislative changes to remove the roadblocks. But it is on the table, and it’s currently a part of the overall single payer movement in the state, so it warrants watching.