The trade group for doctors is one of the most influential medical lobbies in California and has long opposed efforts to establish a single-payer system in the state, arguing it is not economically feasible and would erode physician autonomy. California lawmakers failed multiple times to pass legislation in support of single-payer in recent years. In 2022, legislative analysts estimated the cost of operating such a system could top $391 billion a year and said it would require passing new taxes on California residents and businesses.
The association endorsed Becerra in the crowded race for governor on April 28, as he quickly rose to become a frontrunner in the two weeks after Eric Swalwell dropped out. Becerra’s sudden popularity in the polls and scramble to secure additional campaign financing have forced him to clarify the nuances of his policy positions, including single-payer.
Matt Mahan, Democratic gubernatorial candidate for California, from left, Xavier Becerra, Democratic gubernatorial candidate for California, Chad Bianco, Republican gubernatorial candidate for California, Steve Hilton, Republican gubernatorial candidate for California, Tom Steyer, Democratic gubernatorial candidate for California, and Katie Porter, Democratic gubernatorial candidate for California, during a gubernatorial debate at KRON Studios in San Francisco, California, on April 22, 2026. (Jason Henry/Nexstar/Bloomberg)
Becerra’s campaign website links to a video of him testifying before Congress in 1994 in support of a single-payer plan, proclaiming, “healthcare is a right, not a privilege.”
On March 23, 2026, the anniversary of the passage of the Affordable Care Act, Becerra wrote in a social media post: “I proudly helped write it, pass it, and defend it in court. Now I’m ready to go further as Governor and deliver single-payer health care for our state.”
But more recently, his message was significantly subdued.
“A single payer system is the right goal — but it’s not possible under this administration, and right now we have a crisis on our hands,” wrote Jonathan Underland, a campaign spokesperson, in a statement to KQED on Thursday. “Trump is slashing Medi-Cal and handing tax breaks to billionaires while millions of Californians risk losing their coverage.”
Indeed, Bravo relayed that Becerra said as much in his meeting with the medical association, telling the doctors his top focus was how to cope with the funding losses from H.R.1, President Trump’s Big Beautiful Bill that is expected to drain $9.5 billion per year from California safety net programs, including Medi-Cal, which provides free health coverage to more than 14 million low-income Californians.