Seema Verma eliminated any doubts that the Trump administration might allow California to move forward with plans for a single payer health care system. The head of the Centers for Medicare and Medicaid Services spoke to the Commonwealth Club of California on Wednesday.

One analysis estimated the state could use $225 billion dollars existing federal health care dollars to help cover the more than $300 billion dollar annual price tag. Without that current federal health care funding, the state would be on the hook for the entire amount.