Don’t ask Gov. Gavin Newsom about Democratic lawmakers’ proposal to create a state-funded single-payer health care system — he hasn’t read it.

“I have not had the opportunity to review that plan, and no one has presented it to me,” Newsom said Monday while unveiling his record-high $286.4 billion budget proposal — which includes an estimated $45.7 billion surplus — for the fiscal year that begins July 1. (For more details, check out this comprehensive budget breakdown from CalMatters’ Alexei Koseff.)

Newsom pivoted back to his own “first in the nation” plan, which would expand access to Medi-Cal, the state’s health care program for low-income Californians, to all eligible residents regardless of immigration status starting in January 2024.

But the proposal still falls short of Newsom’s own promise — announced on the campaign trail in 2018 — to replace a complex patchwork of insurance programs with a single state-funded plan. And it puts him in the awkward position of running for reelection without clearly signaling to Californians that single-payer health care remains one of his top priorities.

Contrast that with the Legislature, where a key committee today is set to consider a bill that would create a universal health care program called CalCare. The committee’s leader, Democratic Assemblymember Jim Wood of Santa Rosa, has already vowed to move the bill forward.

But Newsom, long a proponent of setting “big, hairy, audacious goals,” seemed to strike a more cautious and incremental approach on Monday, emphasizing the importance of “dealing with reality” and “pragmatism” amid another COVID surge.

• Newsom: “I think that the ideal system is a single-payer system, I’ve been consistent with that for well over a decade. … The difference here is when you are in a position of responsibility, you’ve gotta apply, you’ve gotta manifest, the ideal. This is hard work. It’s one thing to say, it’s another to do. And with respect, there are many different pathways to achieve the goal.”

Other interesting tidbits from Newsom’s budget press conference:

• He said California has plans to “contract and manufacture its own insulin at a profoundly reduced cost,” but declined to provide more details.
• He wants to postpone California’s mandated gas tax increase — “a $523 million gas tax holiday of sorts” — expand business tax credits and pay off $3 billion in unemployment insurance debt, ideas that GOP lawmakers said they had originally proposed.
• He said “changes need to be made” to state regulators’ controversial proposal to reform a wildly successful rooftop solar incentive program.
• He noted that although the budget plan invests in reproductive rights, it doesn’t call for a “mass expansion” in funding to help out-of-state women seek abortions in California.
• And he said taxpayers will likely see “substantial” rebates due to a law forbidding the state from spending more tax dollars per Californian than it did in 1978, once adjusted for inflation, though the exact amount won’t become clear for months.