Could that be changing?

Yes. Fifty-six percent of likely voters surveyed last spring by the Public Policy Institute of California favored a single-payer system—but nearly half pulled their support if it meant higher taxes.

In any case, raising taxes is always a tough sell among lawmakers—two-thirds of them would have to approve—but especially in an election year, when voters can turn against them. And Gov. Jerry Brown, who has the rest of this year in office, has said he’s reluctant to sign off on such a system because of its expense and the lack of a guaranteed way to pay for it. Lawmakers appear to be waiting for a new administration to take over rather than risk a veto.

Even if a single-payer proposal were approved and Washington OK’d federal funds for it, there could be an additional hurdle: Voters’ permission would be needed if the expense of such a system caused the state to exceed its constitutional spending limits. There are ways to design a system that may not violate those limits.* But if a proposal were too complicated or voters were mad about a tax hike to pay for it, they could say no, sending lawmakers back to the drawing board.

*This sentence was added for context 4/16/18