In 2006 and 2008, it passed the legislature, only to be vetoed by Arnold Schwarzenegger. In 2010, it stalled on the final day of legislative session. But come 2012, Democratic State Senator Mark Leno hopes the fourth time will be the charm for single-payer health care.
Leno: "It is not socialized medicine. It is a public-private partnership - publicly-funded, privately-provided health care so that your doctor does not change, your hospital, your clinic do not change. The only thing that changes is who pays."
But with strong opposition from health insurance and business groups, single-payer was a tough sell even before the federal health care overhaul. Now, Leno says, it's tougher still.
Leno: "So it just takes a little more time, a little bit more explanation. The federal government gave clearance to states to go a step further and provide even broader, more universal health care."
… if it's within cost and expands coverage. But Patrick Johnston with the California Association of Health Plans says changing course now makes no sense.
Johnston: "The California legislature is not going to pass a bill and add the taxes that put all of the burden for providing all of the health care on the state government."
A 2008 report from California's nonpartisan legislative analyst said single-payer would require more than $100 billion in taxes each year. Johnston says lawmakers who support single-payer want it both ways.
Johnston: "They bifurcate the issue politically and vote to give people the good parts, which is free health care, and then they never get around to voting for the hard part, and that is taxing everybody to pay for it."
The bill faces a January 31st deadline to pass the Senate.