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California's long history of efforts at health care reform

FILE - In this May 16, 2016, file photo, California state Sen. Ricardo Lara, D-Bell Gardens, speaks at a rally at the Capitol in Sacramento, Calif. California lawmakers are considering an audacious proposal that would substantially remake the state's health care system by eliminating insurance companies and guaranteeing coverage for everyone. Lara, who wrote the bill with Democratic Sen. Toni Atkins of San Diego, says they're working on details.
Rich Pedroncelli/AP
State Sen. Ricardo Lara (D-Bell Gardens) is the co-author of the latest single-payer health care bill in the legislature.

The California Senate is set to vote on a bill that would create a state-run health care system this week. It's far from the first time the state has contemplated such a major reform. In fact, attempts to improve how health care is handled in California date back 100 years.

"Given this picture of increasing cost, health care inefficiencies, and the uncertainty created in Congress, it is critical that California chart our own path," Sen. Ricardo Lara (D-Bell Gardens) told the senate appropriations committee last week.  He's the author of SB 562, which would create a single-payer system.

While Congressional involvement in health care has waxed and waned over the last century, California lawmakers keep bringing up different approaches to tackling the rising costs of treatment. Since 1918, the state has considered programs to cover the state’s low-income population, plans to mandate employer-sponsored health insurance and different models of universal health care.

Single-payer health care, a system in which the state pays doctors and hospitals directly, has gained momentum among Democrats over the last decade.

"We went from no Medicare to Medicare in the 60s. And if they can do it, we can do it," said L.A. County Supervisor Sheila Kuehl, who championed single-payer bills in the 2000s as a state senator.

All of the attempts to set up a single-payer system in California have foundered over the challenge how to pay for them. In 2006 and 2008, Kuehl’s bills got the closest to becoming law, passing out of the senate and assembly. But Gov. Arnold Schwarzenegger vetoed them, citing their high price tags.

Today, SB 562 could face a similar situation. Lara estimates the state would need to raise around $200 billion dollars to fund a single-payer system. Gov. Jerry Brown has voiced strong concerns about the cost, and may follow his Republican predecessor's example if the bill makes it to his desk.

Scroll through the timeline below to explore the history of single-payer in California.