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California Proposition 186, Single Payer Healthcare System (1994)

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California Proposition 186 was on the November 8, 1994 general election ballot in California as an initiated constitutional amendment, where it was overwhelmingly defeated.

Proposition 186 would have established a "single payer" health care system. Under this system, the California government would have administered and financed health care coverage. This would have replaced most private health insurance programs.

Election results

Proposition 186
ResultVotesPercentage
Defeatedd No6,110,89973.4%
Yes 2,212,691 26.6%

Text of measure

The ballot title was:

Health Services Tax. Initiative Constitutional Amendment and Statute.

The ballot summary was:

  • Establishes health services system with defined medical, prescription drug, long-term, mental health, dental, emergency, other benefits; available to California residents, replacing existing health insurance, premiums, programs.
  • Services funded by tax upon employers, individuals, with stated exemptions, cigarette/tobacco products surtax, existing federal, state, county health care funds, if authorized; proceeds deposited into Health Security Fund. Health benefit providers, authorized costs, paid from fund.
  • Elected Health Commissioner administers fund/system, coordinates with federal law.
  • Provides cost controls; annual expenditure limits based on prior year expenditures, unless adjusted.
  • Creates advisory Policy Board, Consumer Council.

The fiscal estimate provided by the California Legislative Analyst's Office said:

  • Total funds for a state-administered health system potentially exceeding $75 billion annually, including $40 billion to $50 billion from new state taxes. Costs could be less or greater than funds.
  • Potential state and local government savings in the hundreds of millions of dollars annually over time if these governments limit their contributions to the new health care system.
  • Potential state revenue losses initially as much as a few hundred million dollars annually. Long-term effect on state revenues is uncertain, but probably not major in context of the total state economy.

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