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This story was originally published by CalMatters. Sign up for their newsletters.

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Every day, Californians struggle to afford medications or wait weeks or months for mental health appointments. Thousands in the “sandwich generation” juggle caring for elderly parents with raising children.

Those are top health care issues Californians want to see the next governor address, according to a recent poll. The candidates vying to succeed Gov. Gavin Newsom offered views on them – and addressed the Trump administration’s coming cuts to safety net programs – at a recent forum at UC Riverside organized by philanthropic foundations.

“The reality is too many Californians face barriers to health and wellness in our state,” said Richard Tate, president and CEO of the California Wellness Foundation, one of the organizations sponsoring the event. He said the forum was planned to take place in the Inland Empire, where residents experience some of the largest disparities in health outcomes.

Four candidates, all Democrats, took part in the forum. Former U.S. Secretary of Health and Human Services Xavier Becerra, State Superintendent of Public Instruction Tony Thurmond, former Los Angeles Mayor Antonio Villaraigosa and former State Controller Betty Yee all agreed that state response to federal cuts will require them to push for efficiency in the health care system – and look for new sources of revenue. They disagreed on how to fund the state’s response.

To better understand the health care issues in the nascent gubernatorial race, CalMatters also reached out to frontrunners not in attendance: former Congresswoman Katie Porter, Riverside County Sheriff Chad Bianco and former Fox News Host Steve Hilton. All three polled well in a recent California Wellness Foundation survey. None of them returned interview requests or answered questions about their health policy priorities or vision by the deadline.

Becerra touts experience standing up to Trump

If elected, Becerra pledges to be the state’s “health care governor” — a title that Gov. Gavin Newsom also often embraced.

Becerra, 67, touted his experience responding to a public health emergency and negotiating lower drug prices in President Biden’s cabinet. He did so for medications such as blood thinners, diabetes drugs and others as part of a Medicare drug negotiation program. And as a former state Attorney General, he sued the previous Trump administration 123 times. He positioned himself as a strong opponent to federal cutbacks to health.

“We will not take a knee to what Donald Trump has done to health care,” Becerra said. “We will not go backwards.”

An estimated 3.4 million Californians will lose coverage as a result of the Trump administration’s cuts to the Medicaid program as approved in this year’s federal spending plan. And if Congress does not renew the enhanced premium subsidies for the Affordable Care Act by the end of year, another 400,000 who buy health plans through Covered California could be priced out.

Filling those gaps is a tall order for the state, but he said it is worth reviewing the tax code to make sure billionaires are paying their fair share to help fund the safety net.

“We can be rational when it comes to our tax book. But then let’s put the money where it should be on health care,” Becerra said. “I can tell you right now, there is too much money being misspent.”

That’s because spending should be prioritized on preventive care and on keeping people well in the first place, he said.

“We need to provide for (people) at the front door, not in the emergency room.”

Thurmond floats single-payer system for California

Among Thurmond’s boldest visions is that of creating a state-run single-payer system, where a public entity handles health care financing – acting as insurer, paying providers, and covering medical costs for all. That’s an idea once floated by Newsom, but abandoned because of its expense and complexity.

Thurmond, 57, says his support of a single payer system stems from watching his brother die from a rare liver disease. His brother couldn’t afford health insurance, he said, and stopped going to the doctor even though he was sick.

But a system like that would take years to set up, hundreds of billions of dollars and would also require federal approval.

More immediately Thurmond said he’d seek legislation to expand requirements for employers to provide quality health care to their workers. “We have many employers in this state who require their employees to get health care through public assistance. And if you do that as an employer you’re going to be held to account,” Thurmond said. “On the flipside…If you’re doing the right thing we’ll reward you with tax credits.”

Like Becerra, Thurmond also supports the idea of taxing the wealthy to increase funding for health care.

If elected, Thurmond pledged to work with Congress to restore the cuts to Medicaid and other safety net programs that the Trump administration made in its most recent federal spending plan.

Villaraigosa: ‘Focus on the basics’

Villaraigosa, 72, says he wants to go back to basics. In a state budget, that means prioritizing public safety, health care and education, in that order, he said.

Villaraigosa pitches himself as more pragmatic than his opponents. He doesn’t support a single-payer system; he argues that it’s unrealistic because the state can’t afford the upfront costs and because the Trump administration, which would need to approve such plans, would reject it.

From left, former Mayor of Los Angeles Antonio Villaraigosa, and former Speaker of the California State Assembly and former California State Controller Betty T. Yee speak during the “Health Matters: A Conversation With Our Next Governor” debate at UC Riverside on Nov. 7, 2025. Photo by Leroy Hamilton

State response to a federal administration that is gutting the safety net, he said, will require innovative solutions and a health care system that is more efficient — what exactly that would look like is to be determined.

“I’m not going to sell you snake oil. It is going to be tough to provide that care, but I’m absolutely committed to it,” Villaraigosa said.

Alone among forum participants, Villaraigosa was less interested in increasing taxes to create more revenue, sidestepping the question and only saying that he’d like to look for ways to “grow the pie.”

“We already have the highest taxes in the United States of America and the highest cost of living,” he said.

But like his opponents, Villaraigosa said he wants to grow the mental health workforce — to do so, you have to incentivize people with adequate pay, he said. “The issue is access because people can’t get a doctor to give them care when they get seven bucks for that visit,” he said.

Yee wants strict accountability

Betty Yee, a 68-year-old former State Controller, wants to be an accountability governor.

Like her opponents, Yee listed improving mental health access as a high priority. Part of the reason Californians struggle to find appropriate care, she said, is because regulatory agencies aren’t robustly enforcing the state’s mental health parity law, which requires insurers to cover physical and mental health conditions equally.

“We are not looking at our health systems in terms of whether they are continuing to build a robust provider network to deal with mental health for our diverse populations,” Yee said. “So we actually need some better oversight with respect to what is currently the law here in California.”

Yee is an advocate for growing what’s working. Anti-poverty programs, such as the earned income tax credit and the young child tax credit, have been successful in putting extra dollars in the pockets of low-income Californians, Yee says. She says she’d like to be “bolder” with these refundable tax credit programs and expand them to help alleviate some of the financial burden for caregivers, especially those in the sandwich generation.

From left, former U.S. Secretary of Health & Human Services Xavier Becerra, California Superintendent of Public Instruction Tony Thurmond, former Mayor of Los Angeles Antonio Villaraigosa, and former Speaker of the California State Assembly and former California State Controller Betty T. Yee speak during the “Health Matters: A Conversation With Our Next Governor” debate at UC Riverside on Nov. 7, 2025. Photo by Leroy Hamilton

Yee said California cannot replace federal cuts with borrowing alone; she supports raising taxes for the highest earners to fund the safety net.

“But before we do that,” Yee said, “I want to be sure we’re making the case that we’re making our health care system much more efficient, and that we really are going to have a much better shot at increasing access and affordability for Californians.”

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Supported by the California Health Care Foundation (CHCF), which works to ensure that people have access to the care they need, when they need it, at a price they can afford. Visit www.chcf.org to learn more.