California doctors, hospitals and insurers announced on Monday the formation of a coalition to fight California Democrats’ promise to pass a $400-billion-per-year single-payer health care plan.

Lieutenant Governor Gavin Newsom, leading in the mid-July Public Policy Institute of California poll for governor by a commanding 55 percent to 31 percent margin over Republican John Cox, felt confident enough on August 16 to go all-in at the Los Angeles Deciders Forum for a controversial single-payer healthcare plan, according to the Los Angeles Times.

A single-payer state-sponsored health plan titled “SB-562: Healthy California” passed the California Senate this spring was sent to the State Assembly for a confirming vote. Medical groups, businesses and health care plans lobbied to kill the legislation.

Despite having Democrat super-majorities and a Democrat governor, Speaker of the Assembly Anthony Rendon (D-Los Angeles) pulled SB-562 after the nonpartisan Legislative Analyst’s Office estimated a state run single-payer plan would cost over $400 billion per year and require hundreds of billions of dollars in new taxes.

Newsom’s speech reviving the single-payer plan seems to have generated a swift reaction from doctors, hospitals, small business, employers, and health plans, who have joined together into a campaign called “Californians Against the Costly Disruption of Our Health Care.”

Ned Wigglesworth, political strategist for the new coalition, told the Sacramento Bee: “As long as proponents plan to bring this back time and again, we think it’s important to have a strong, unified presence to oppose it.”

One reason critics oppose the plan, in addition to cost, is that there simply may not be enough doctors in the state to provide care to everyone, including illegal aliens. According to the USC Center for Healthcare Journalism, California already has a severe lack of physicians in poorer regions, such as the Inland Empire. The California Health Care Foundation found that in 2016, the San Bernardino-Riverside-Ontario metropolitan area had 120 physicians per 100,000 people versus a 194-per-100,000 state average. But both compare unfavorably to the U.S. average of 257 doctors per 100,000 people.