California’s single-payer bill, SB 840, the California Health Insurance Reliability Act (CHIRA), introduced by state Sen. Sheila Kuehl (D-Santa Monica), passed key milestones during the current legislative session and is headed for the second phase of its consideration by the state Senate and Assembly early next year.

The measure, introduced by Kuehl last February, passed the Senate, 24-14, on May 31. The Assembly Health Committee approved it, 9-4, on July 6. The bill now passes to the Assembly Rules Committee. Kuehl will introduce a companion measure on funding in January 2006.

SB 840 would cover all Californians under a single-payer plan, based on residency rather than employment or income, while cutting overall health care costs. No deductibles or co-payments would be charged. Patients could choose their own doctor, and no one would be denied coverage for a pre-existing condition.

Coverage would include hospital, medical, surgical and mental health; dental and vision; prescription drugs and medical equipment such as glasses and hearing aids; emergency care including ambulance; skilled nursing care after hospitalization; substance abuse recovery programs; health education and translation services; transportation to covered services, diagnostic testing and hospice care.

“SB 840 eliminates the insurance companies’ role as we know it in health coverage, except for a small market for services such as cosmetic procedures which the state wouldn’t fund,” Andrew McGuire, executive director of the Health Care for All-California coalition, said in a telephone interview. He said many workers now employed in the health care industry would continue to be needed in their present jobs, but would work for the state instead.

McGuire said he anticipates a “big negative propaganda campaign by the insurance and pharmaceutical industries” when the financing is made public.

“Privatization of health insurance leads to more people being uninsured,” McGuire said. “The only way risk can be minimized is to expand the risk pool as much as possible. HMOs on the other hand constantly try to shrink the pool and cut out those needing the most services.”

Despite their growing health coverage burden, support from employers both small and large has yet to surface, McGuire said. Though they, too, will ultimately have to think about saving money, he said, a deep distrust of government funding stands in the way. However, he noted, “the two most successful health programs — Medicare and veterans health services — are government-funded.”

McGuire said a major grassroots campaign to get mayors and city councils to support SB 840, with events in 365 cities, will be waged in the coming year. The Los Angeles City Council voted earlier this month to support Kuehl’s measure.

While the details of funding are still being worked out, the outlines are clear. SB 840 is to be paid for through funds already being spent on health care by federal, state and county governments, and by affordable, means-tested insurance premiums replacing all current payments by both employers and consumers. It is estimated that the bill would cut California’s total health care spending by some $20 billion in its first year of operation.