Taxing Billionaires to Save California Healthcare: Tax Scholar David Gamage Explains the Wealth Tax Debate

As California confronts looming healthcare funding shortfalls and widening wealth inequality, a new proposal to tax the state’s billionaires has ignited a fierce political debate. Supporters argue the measure would generate billions to offset cuts to programs like Medicaid and the Affordable Care Act, while critics—including Governor Gavin Newsom—warn that the tax could drive the ultra-wealthy out of the state.In this interview, journalist Joshua Scheer speaks with leading tax scholar David Gamage about the proposal, which would impose a one-time 5% wealth tax on California billionaires payable over five years. Gamage, who helped develop the policy and previously worked on Affordable Care Act regulations, explains why billionaires often pay dramatically lower effective tax rates than high-earning professionals—and why fears of a mass billionaire exodus may be overstated.The conversation also explores how modern tax strategies like “buy, borrow, die” allow vast fortunes to grow largely untaxed, the historical roots of wealth taxation dating back to the Gilded Age, and why California could once again set a national precedent in tackling extreme wealth concentration.