California progressives' single-payer health care dream could cost the state half a trillion dollars a year, according to the California Legislative Analyst's Office. Several candidates for governor have promised a government takeover of the state's health insurance system. Billionaire Tom Steyer, billionaire, and California State Assemblyman Ash Kalra have proposed legislation to create "CalCare" which aims to replace private health insurance with a state-run monopoly. CalCare's annual cost is estimated at up to $552 billion, more than the entire state budget. However, even if California could afford such a program, it is not clear how the state could run it. The state has been losing residents and business to lower-tax states like Texas, Nevada, and Florida for years and its expansion of Medi-Cal has led to tens of billions in multi-year budget deficits. The proposed legislation would also impact physician supply, leading to steep pay cuts and decreased patient numbers.