The single payer health care debate has been relatively quiet inCalifornia since Senate Bill 562, The Healthy CaliforniaAct, was tabled by the Speaker of the Assembly at the end of July.But the conversation is about to heat up again in California — andat the national level. For employee benefit advisors who aren’tfascinated by the legislative process, or who think we have a longway to go before a concrete policy could actually be implemented,the single payer debate can be a distraction. But it’s important tobe aware of the issue, since it could have a major impact on thecurrent employee benefits landscape. Here are four things alladvisors should know about the current state of single payer inCalifornia and beyond.

1. California Senate Bill 562, “TheHealthy California Act,” is not dead. The bill was approved bythe State Senate on June 1, 2017, and then moved on to the StateAssembly. In a surprise move, Speaker of the Assembly AnthonyRendon delayed the bill in the Assembly Rules Committee for furtherdiscussion and debate. It will be revisited in January 2018, andcould continue its progress through the state legislature andultimately land on the Governor’s desk for approval in 2018. It’simportant for advisors to know that this particular bill proposesan extreme form of universal coverage known as single payer, whichwould eliminate the private insurance industry in California,including health insurance carriers, brokers and employer-sponsoredbenefits. It would replace not just health insurance (includingMedicare and Covered California), but dental, vision, workerscompensation and long-term care insurance, with a state-runprogram.

2. On August 24, 2017, Speaker Rendon announced that he wasestablishing an interim Select Committee on Health Care DeliverySystems and Universal Coverage, made up of Assembly members. TheCommittee will hold informal hearings to discuss various methods of health care delivery andfunding, including Medicare for all, single payer, hybrid systemsand Affordable Care Act expansion. The committee will hold a numberof hearings once the legislative session ends in September. Whilethe Committee doesn’t have the authority to move SB562 forward, itwill certainly bring more attention to the issue.

3. A ballot initiative called the “California Healthcare Roadblock Removal Act” was submitted byEnact Universal Healthcare forCA, Inc. to the California Attorney General Xavier Becerra onAugust 18, 2017. The ballot initiative process gives Californiacitizens a way to propose laws and constitutional amendmentswithout the support of the Governor or the Legislature. Theinitiative was assigned Initiative#17-0019 and is currently awaiting title and summary. Thelanguage of the initiative proposes a single-payer type system inCalifornia, but it is poorly written and incomplete, and may besent back to the author before it can move ahead. If the AttorneyGeneral decides to make it an active measure, supporters willcollect signatures with the intention of getting it qualified forthe November 2018 ballot, where the residents of California willapprove or deny it.

4. At the national level, Vermont Senator Bernie Sanders will beintroducing his highly-anticipated “Medicare for All” bill in September, after Congressreconvenes. His plan is an expansion of the current Medicare system, whichis a federally-funded basic level of health care. While he hasacknowledged that his proposal is unlikely to pass aRepublican-controlled Congress, his popularity, along withwidespread frustration about the failed reforms to the AffordableCare Act, will propel this issue into more of a nationaldebate.

While it’s clear the idea of some type of universal health caresystem is gaining popularity, there is also a lot of confusionabout what these various proposal would actually do, andterminology is consistently being misused by many, including themedia and those leading the charge. It’s important for advisors tounderstand the difference between “universal care” (which wouldprovide a basic level of care but also leave room for privateinsurance), “Medicare for All” (expansion of the current federalprogram) and “single payer” (a government run plan with no privateinsurance option). It’s also important for advisors to understandthat supporters of universal health care see this as a socialmovement, and they are passionate and vocal about this issue. It’simportant for advisers to be active participants in this debate,using rational, informed voices with clients, colleagues,legislators and even friends and family, since this is an issuethat could have an exceptional impact on our businesses and ourindustry.