THIS TIME ON CODE WACK!
As healthcare costs skyrocket and Americans face new coverage threats, California advocates are pushing for something bigger than simple fixes around the edges. We’re joined by longtime healthcare organizer Michael Lighty, who breaks down the fight for single payer, what’s at stake in 2026, and why unity may be the key to winning guaranteed healthcare for all.
Michael is the president of Healthy California Now and has organized, advocated, and developed policy for single-payer Medicare for All nationally and in California for more than 30 years. This is the second episode in a two-part series with Michael Lighty.
Check out the Transcript and Show Notes for more!
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SHOW NOTES
WE DISCUSS
Let’s talk about your organization, Healthy California Now, and its bill SB 770. What is their political agenda in 2026?
Lighty: “Healthy California Now is a coalition of community-based organizations and unions that support a system of guaranteed healthcare based on single-payer financing and demand an equitable system that addresses the cultural disparities in care and ensures that we all get the healthcare we need.
“… we will be organizing our own stakeholder engagement meetings, maybe on Zoom, maybe in person, but we’ll be organizing in support of a single-payer healthcare system in California.
“At the same time, we are setting up a 501 (c) (4) where we will hopefully be able to engage in political work in 2026 for the first time to accompany our issue advocacy work.
“And then of course, specifically, there’s a governor’s race. We wanna make sure that all the candidates are educated on the importance of establishing a single-payer system in California and that they’re prepared to implement such a system when they become governor. So one of our key tasks is, regardless of which governor candidate you may support, make sure that they understand that they need to address the crisis in healthcare.”
“SB 770 establishes policy principles for a single-payer financing system called Unified Financing that would guarantee healthcare to all Californians in consultation with the federal government, and initiates a process to achieve that so that the legislature can approve it and send it to the voters.”
How does SB 770 align with CalCare, the California single payer bill introduced by the California Nurses’ Association … or does it?
Lighty: “CalCare seeks to establish a single-payer system through the actions of the legislature and signature by the governor, which would then be presented to the federal government for support. The result of that would come back to the legislature for financing and also ultimately be sent to the voters for voter approval.
“Both SB 770 and CalCare seek to establish a system that guarantees healthcare to every Californian on an equitable basis, every resident of California, and both CalCare and the SB 770 process require legislative approval and require a waiver from the federal government indicating the federal government’s support and what they will finance, and ultimately voter approval.”
Do you think that CalCare and SB 770 represent different strategies? Can they work together?
Lighty: “I think they represent complementary strategies. I think in this period we can’t afford to exaggerate our differences. How are we going to pass? Because [either effort] is gonna require voter approval and the industry is gonna spend a hundred million, 200 million [dollars] against it. So how can we expect to win if we’re divided?
“… what we have to do, I think, is find unity and develop a unified strategy. And so for some of us in Healthy California Now, that may mean being more engaged in the effort to pass CalCare. For CalCare supporters, that may mean ‘Let’s engage in the SB 770 stakeholder process to put forward our policy preferences for a single payer system in California.’ Because of course, the 770 process is there to be utilized for advocacy that will go to the legislature. Similarly, the CalCare legislation is there for advocates to say, ‘Yeah, that’s the policy we want to establish, and the legislature should adopt it.”
“So they don’t necessarily have to be in conflict. … 770 it doesn’t prescribe anywhere near the level of detail that CalCare does, right? That’s one of the strengths of CalCare. It’s a very well-developed policy program. 770 is a much more general set [of] these principles.
“So, you can fit the CalCare policy into SB 770. What SB 770 offers is a way to maybe address some of the more politically broad elements of CalCare and figure out a way to put them in a system design that might have a greater chance politically. But that doesn’t mean that they’re incompatible….
“But as someone who worked on prior bills and the initiatives, uh, to pass single payer in California, going back to 1994, I think we need to do as much work organizing work on a unified basis because our ultimate challenge is political.”
Helpful Links
Michael Lighty, The Sanders Institute
CalCare Fact Sheet, California Assemblymember Ash Kalra
SB 770 Fact Sheet, California State Senator Scott Wiener
Legislation Paves Way For States to Lead the Way on Single-Payer Health Care, Public Citizen
Nurses advocate for ‘Medicare for All’ despite setbacks, Sacramento Valley Union Labor Bulletin
Clarifying the Facts on Medicare for All in California, Healthy California Now
Episode Transcript
Read the full episode transcript.
Guest Biographies: Michael Lighty
Michael Lighty, President, Healthy California Now, has organized, advocated, and developed policy for single-payer, Medicare for All nationally and in California for over 30 years.
He is a founding Fellow of the Sanders Institute, and he was the Healthcare Constituency Director for Bernie 2020. He is a consultant for the National Union of Healthcare Workers.
Most recently, he co-wrote and was a leader in the successful campaign to enact CA SB 770. He worked for 25 years for the California Nurses Association/ National Nurses United, including as the director of public policy.
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