Gov. Gavin Newsom signed a unified healthcare financing bill, Senate Bill 770, into law on Oct. 7th. California has become the first state in the country to pass such a bill, paving the way towards greater healthcare equity and accessibility.
The bill requires the secretary of California Health and Human Services Agency (CalHHS) to consult with stakeholders and the federal government to pursue a waiver framework for a comprehensive package of medical, behavioral health, pharmaceutical, dental, and vision benefits. By Nov. 1st, 2025, the CalHHS secretary is required to provide the legislature and Newsom with a report of the finalized waiver framework.
Michael Lighty, president of Healthy California Now, spoke with State of Reform on the importance of SB 770 days before it was signed. The bill established a framework for California to create a systemwide unified financing approach for healthcare that is committed to guaranteeing services that are not based on profit or financial incentives.
“A fundamental principle of SB 770 is that we can create a healthcare system statewide that guarantees healthcare on an equitable basis. And so, what we’re able to do if the governor signs the bill, is initiate discussions with the federal government on how we can utilize federal money and support to create such a system.”
— Lighty
Under SB 770, patients will not have to worry about insurance copayments and deductibles—which sometimes ring up thousands of dollars before insurance kicks in. Additionally, patients will no longer face the difficulty of finding providers who are in-network.
“All those disparities between the different types of coverage would go away,” Lighty said. “There wouldn’t be an ability [for] any entity in the healthcare system to deny care or create a financial incentive to deny care that is deemed medically necessary.”
SB 770 will provide a single level of care for everyone, regardless of age, income status, employment status, immigration status, and other factors. While California continues to make changes to its Medi-Cal system, Lighty said some of the remaining issues can only be solved through systemwide reform.
“It’s very impressive—the coverage expansions that California has achieved, and it is, I think, a real testament to the advocacy of BIPOC communities in particular, to make those changes,” Lighty said. “In some ways, our achievements are so good that we may have achieved all we can within the existing system.
Therefore, a unified financing system that provides financing for all services for everyone, everywhere in California, and eliminates these disparities, eliminates the financial barriers to care, establishes a statewide commitment to equitable care, is the next logical step.”
The Healthy California For All Commission issued a report earlier this year, which found that transitioning to a unified healthcare financing system that eliminates differences between private and public health insurance would save Californians $158 billion per year in healthcare spending by 2031, while averting 4,000 deaths annually.
Lighty said small businesses in California will significantly benefit from SB 770, since many cannot afford to provide employees with employee-sponsored health insurance.
“Now, all of a sudden, they have a level playing field because everybody has health insurance. For workers, that means that money that currently goes into their health coverage, which is essentially a transfer from their employer to the insurance company, can now go into their pocket instead. Those savings will increase wages and pensions.”
— Lighty
Legislators and advocates in the state have attempted to pass bills relating to healthcare for all, but have been unsuccessful. Healthy California Now worked with CalHHS to address any concerns they had about the original version of SB 770, and Lighty said they were able to address those issues.
SB 770 requires the governor, CalHHS, community stakeholders, and the federal government to work together on implementing the new financing system. Lighty said collaboration is the heart of SB 770.
“That process will result in the best possible system of universal healthcare for California.”
— Lighty
Opposition to SB 770 came primarily from health insurance companies. The California Association of Health Plans shared a letter of opposition earlier this year, which was also signed by America’s Physician Groups, the Association of California Life and Health Insurance Companies, California Agents and Health Insurance Professionals, and CalChamber.
The letter of opposition cited how California has made strides to the healthcare delivery system, and that SB 770 “forces” Californians into a new system with no ability to opt-out.
“Studies continue to show Californians are satisfied with their healthcare and want to build on this progress, not destroy their ability to choose private coverage for their families,” stated the letter of opposition. “Moving to state-run government healthcare could eliminate consumers’ choice of physicians, hospitals, and other providers.”
In face of opposition, Lighty said there is still work to be done.
“We’ll be celebrating by getting to work,” Lighty said. “We’ve got a lot to do, but it will be an historic victory, because it really says California is going to figure out how to guarantee healthcare for everybody—that’s a big deal.”