California 2026 governor hopefuls come out strong for single-payer health care

***Candidates agreed the state should pursue universal health care, but were less clear on implementation

SAN FRANCISCO — Four California governor hopefuls made big promises on single-payer health care but skimped on details Sunday during a candidate forum at a health workers’ union conference in San Francisco.

The candidates — state Sen. Toni Atkins, Lt. Gov. Eleni Kounalakis, state Schools Superintendent Tony Thurmond and former state Controller Betty Yee — all said they supported establishing a single-payer health care system in California, renewing aspiration for a lofty goal progressives have tried but failed to accomplish on state and national stages.

But none offered a definitive plan to pay for the proposal, or said how it would get federal approval should former President Donald Trump return to the White House.

“We don’t have single-payer in this state and in this country because people haven’t had the political will to bring it forward,” Thurmond said.

Sunday’s forum, hosted by the National Union of Healthcare Workers, was the first public debate between candidates running in an already-crowded race to succeed the term-limited Gov. Gavin Newsom. Lisa Matthews of the Associated Press moderated the forum alongside POLITICO’s Melanie Mason and Laurel Rosenhall of the Los Angeles Times.

Notably missing was Los Angeles Mayor Antonio Villaraigosa, who declared his candidacy earlier this summer. The forum also did not include likely candidates such as Attorney General Rob Bonta.

The party familiars agreed on plenty: no to the death penalty, yes to phasing out the sale of gas-powered cars by 2035 and yes to unemployment benefits for striking workers, the latter of which faltered in the Legislature earlier this year.

But candidates offered more platitudes than solutions when asked how they would build more housing, address homelessness and solve the state’s pension funding shortage, among other issues. And while the candidates were mostly in lockstep agreement on stage, there was less agreement on statewide ballot measures.

They were murky on Proposition 36, a November ballot measure strengthening drug and theft penalties that enjoys broad public support in recent polling. While all had reservations about the measure, only Yee definitively opposed it.

“It is setting up false promises,” Yee said. She argued the state should instead double down on investments in mental health and re-entry programs.

Atkins said she was “concerned about how it is written” and would likely not support Prop 36. Kounalakis said she knew her position but wanted to keep her vote private, and Thurmond said the measure was “clear on accountability” but opposed putting “people in jail who have a substance abuse problem.”

The candidates split on Proposition 35, a measure to make permanent a tax on certain health care plans in order to fund California’s Medi-Cal program. Nearly two-thirds of Californians supported the measure in recent polling.

“It forces us to live within those needs and not always do drastic cuts to healthcare,” said Atkins, who joined Thurmond in supporting the ballot measure.

Some health care leaders say Prop 35 is necessary to prevent state leaders from dipping into funds designated for health care when scrounging for cash to cover state budget shortfalls. But Newsom has warned the ballot measure could blow a $12 billion hole in the 2027 budget by locking funds the state anticipated it would have control over, should it need them.

“The devil’s in the details, and I never want to shoot ourselves in the foot without sunshine,” said Yee. She opposed the measure, saying it was negotiated behind closed doors and could face resistance from the federal government, which must sign off on changes to California’s Medi-Cal funding.

Kounalakis said she was neutral on Prop 35. “The governor has said that this can be handled through the budgeting process, and he’s asking for more flexibility.”

On reparations for slavery, all four candidates said they would support creating a state agency to implement reparations programs. Thurmond delivered a particularly forceful endorsement: “As a descendant of slaves, you know damn well I support reparations.”

That’s somewhat of a break from Newsom, who faced backlash from some reparations advocates weeks ago for introducing last-minute amendments on legislation that would have created a state reparations agency and a reparations fund. They claim his changes stalled the bills and forced the Legislative Black Caucus to hold them in the final hours of session.