Ninety Years of Health Insurance Reform Efforts in California

Assembly Speaker Fabian Nunez cited the California Research Bureau (CRB) report, Ninety Years of Health Reform Efforts, on the floor of the California Assembly while arguing for ABX 1 1, Nunezís bill which would establish universal health care coverage in California. Noting Californiaís history of failures to enact universal health care legislation which the report summarizes, the Speaker said it was time for California to finally address Californiansí health care needs.

Early in 2007 Governor Arnold Schwarzenegger, Nunez and Senate Pro Tempore Don Perata submitted proposals to establish a comprehensive health care coverage program. Discussions were held throughout the year. Late in 2007 the Governor and the Speaker negotiated the final proposal and reached a compromise. The Senate Pro Tempore did not participate in those negotiations. As the result of the Governorís and Speakerís leadership ABX 1 1 was adopted in the Assembly on December 17, 2007 by a vote of 46 to 31 and was defeated by the Senate Health Committee on January 28, 2008 by a vote of 7 to 1. Once again the efforts to provide health care coverage to all Californians were for naught.

In Ninety Years of Health Reform Efforts CRB Senior Health Researcher Michael Dimmitt Ph.D encapsulates the decades of popular and legislative universal health care deliberations to which the California Speaker referred. The earliest effort to establish universal health care coverage in California was Senate Constitutional Amendment 26 which Governor Hiram Johnson signed in 1917 and which was placed on the ballot in 1918. Later, Governor Earl Warren submitted at least four proposals to the Legislature. Overall, the report shows, the Legislature has considered 41 bills since 1918. There have also been 4 ballot propositions during the same interval with no program permanently established.

National efforts to establish a universal health care coverage program go back at least as far as Teddy Rooseveltís Progressive Party Platform in 1912. In 1994, Senator Robert Dole and President Bill Clinton each made a proposal for a restructuring of the health care coverage system. Most recently, President George W. Bush proposed a health care program to increase the number of people with insurance coverage. Also, the majority of candidates for president in 2008 offered proposals to reform health care coverage.

Ninety Years of Health Reform Effort was widely distributed in the fall to the Governorís office staff, legislators, legislative staff, executive branch departments and interest groups. The report increased the awareness of the stateís efforts to achieve universal health care coverage. Likewise the report summarized how similar the antecedents of ABX 1 1 were to it. The CRB report filled in many gaps for the policy makers and interest groups. The report informed the debate on the efforts to establish a comprehensive health care coverage program.

With the defeat of ABX 1 1 and an uncertain future for a comprehensive health care coverage program, the CRB has submitted a grant proposal to the California HealthCare Foundation requesting funding for a series of seminars on issues related to health care reform. The seminars will extend the discussion on establishing a comprehensive health care expansion and continue the California Research Bureauís role in providing non-partisan policy neutral health policy research to the executive and legislative branches of California State Government. The target audience for the seminars would be gubernatorial staff, Legislators, legislative staff and executive departmental staff.

For further information please contact CRB Senior Health Researcher Michael Dimmitt Ph.D at (916) 657-2645 or email at



The California State Library

  © 2004 The California State Library.  All rights reserved.

The California State Library
914 Capitol Mall ē P.O. Box 942837 ē Sacramento, CA 94237-0001