In just over a year, Californians will go to the polls and elect a new governor. For the first time recently the four Democratic front-runners shared a stage for a debate-style, 90-minute discussion. And they had more than the venue in common.

Perhaps unsurprisingly since they are all from the same party, they expressed similar views on the Trump administration, the need for affordable housing in the Golden State, immigration, and the benefits of an organized labor force. Where they diverged, however, is around an issue that many Californians are watching carefully: single-payer healthcare.

Vermont Senator Bernie Sanders has been admirably, if not quixotically, banging the Medicare-for-all drum for twenty years, regardless of the degree of warmth the existing administration is likely to feel toward the concept. And despite the fact that polls show that many Americans like the idea, and despite the fact that for the first time Sanders has several Democrats signing on to his bill, it’s not hard to concede that universal healthcare at the federal level won’t happen any time soon (if ever). After all, Trump is busy using executive orders as weapons to seriously hobble the Affordable Care Act (ACA), seemingly in frustration over it surviving repeated attempts at GOP repeal.

CA lawmakers amenable to single-payer on principle … the reality of paying for it stirs dissent

But here at home, single-payer healthcare doesn’t quite sound like the stuff of dreams. Even when lawmakers say they don’t know how the state can pay for it, they usually admit they like the idea (as reflected in the measure with energy enough to reach the state capital). This is a marked difference from the hostility with which healthcare-for-everyone is deflected by the current D.C. regime.

Estimates for single-payer healthcare in California put the annual cost between $330 and $400 billion. And a consistent criticism of proposal advocates is that they have not outlined a realistic way for the state to cover that hefty price tag.

Lt. Gov. Newsom: “not going to wait around” for Washington to get on board

Although the race is still young, the current Democratic front-runner is Lt. Gov. Gavin Newsom. He noted that according to a study conducted by UCLA, Californians currently pay more than $367 billion for healthcare each year. This includes money paid into public and private insurance programs. And individual taxpayers are footing 70% of this cost.

“It’s a question of leadership,” Newsom said. “This is what they said about Social Security and Medicare — ‘You can’t do it.’ The fact is the money exists in the system. The money is not being well invested. A single-payer system provides the ability to provide more efficiency and more cost controls … I’m not going to wait around for the debate to unfold in Washington, D.C.”

Former L.A. Mayor Villaraigosa: without a funding plan, it’s “pie in the sky”

Former Los Angeles Mayor Antonio Villaraigosa agrees with Newsom that conceptually, single-payer healthcare is a good idea for the state, but he breaks with his gubernatorial opponent when he says that behaving as if it can work in the absence of a plan to fund it is akin to “selling snake oil.”

“When you’re governor, you’ve got to make the tough choices,” Villaraigosa said. “You can’t just say I want pie in the sky, because that doesn’t put food on people’s tables.”

State Treasurer Chiang: advises a strategy to “scale up”

State Treasurer John Chiang’s views were more in line with Villaraigosa’s than Newsom’s. Chiang also gave a thumbs-up to the notion of insuring all Californians under a single-payer system; however, he worried about the consequences of the state trying to bite off more than it can chew.

“We have to figure out how to scale up,” Chiang said. “We don’t have to go all in [and] provide all the services at once.”

Former state schools chief Eastin: “We can do it”

Former chief of state schools, Delanie Eastin, was arguably the biggest fan of Senate Bill 562 (which may be shelved at the moment, but isn’t dead). The measure would provide all Californians with comprehensive and total healthcare, without deductibles, copays, or premiums, and regardless of immigration status.

Still, as critics pointing to the cold harsh light of reality versus the soft glow of expectation might predict, beyond the mention of instituting a new gross receipts tax, Eastin didn’t have any hard-and-fast plan for how California might afford to implement universal healthcare.

“I’m not sure exactly. But it’s doable,” Eastin said. “We can do it if we put our minds to it.”

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