California took another step closer to enacting a single-payer health law yesterday. If signed by Governor Jerry Brown, California becomes the first state to provide what is sometimes described as "Medicare-for-All". The bill is very controversial as it advanced this far without a clear path for funding the massive $400B price tag. For perspective, that is more than twice the entire state budget. The Healthy California Act would replace the Affordable Care Act (Obamacare) and every form of health insurance in California. It effectively eliminates health insurance and replaces it with a state-run system. That includes your employer-based benefits... medical, dental and vision - all gone and replaced with a state-run system. But right now it's just a bill and has to go through the process.

The legislative process…

If you remember your high school civics class (or ABC's School House Rock) you may recall that a bill is made into law through a lengthy process. It starts as an idea (authored in the Senate in this case), gets drafted into a bill (a very vague draft in this case) and gets introduced by the house of origin (in the Senate on 2/17/17). It goes through a first reading on the floor, then to Committee hearings (Senate Health Committee in this case) and letters of support or opposition are considered and passed by majority.

Bills passed by committees are read a second time on the floor in the house of origin and then assigned to a third reading. Bill analysis is prepared prior to third reading, explained by the author, discussed by the Senate and voted on by a roll call vote.

That’s what happened today. SB 562 passed with a vote of 23-14.

SB 562 will now go to the Assembly where the process is repeated. If SB 562 is amended by the Assembly, it must go back to the Senate to agree on the changes. If agreement cannot be reached, the bill is referred to a two-house conference committee to resolve differences. Three members of the committee are from the Senate and three are from the Assembly. If a compromise is reached, the bill is returned to both houses for a vote.

If both houses approve the bill, then it goes to Governor Brown. The Governor can sign the bill into law, allow it to become law without his signature, or veto it. A governor's veto can be overridden by a 2/3rds vote in both houses. Most bills go into effect on the first day of January of the next year.

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