California's recent push for universal healthcare coverage has been a long time in the making.
The first efforts for a single-payer initiative date back to 1994, when Proposition 186 was on the state ballot and defeated by voters, according to Kaiser Family Foundation.
In 2000, the state launched a $1.2 million effort, known as the Health Care Options Project, to study universal healthcare strategies. The research suggested single-payer plans were most cost efficient and tied to the highest-quality health outcomes, according to HealthCare for All-California, a nonprofit advocacy group pushing for universal healthcare.
Five different single-payer bills have been introduced since 2003, most of which failed to pass the legislature. One bill, Senate Bill 840, was approved by lawmakers in 2006 and 2008 but was vetoed by then Gov. Arnold Schwarzenegger both times.
The tides changed earlier this month, when Gov. Gavin Newsom signed SB 770, which directs the state's HHS to outline requirements for a federal wage application focused on universal healthcare coverage in partnership with the federal government.
California is planning to apply for a waiver to allocate Medicare and Medicaid federal funds for what may be a single-payer system in the future, according to the Los Angeles Times. The system would be financed entirely by state and federal funds to cover all residents.
"With this signature, California takes a historic step toward universal healthcare," said Sen. Scott Wiener, D-San Francisco, author of the bill, in a statement reported by the Times. "The state will now begin answering the complex questions of how we can access federal financing to fund a universal healthcare system like single-payer."