Nurses’ Campaign to Win CalCare: Our Plan for Fall 2021

Well before the Covid-19 pandemic, nurses have long understood the need for single-payer, guaranteed health care for all. Nurses know all too well the deep failings of our fragmented, profit-driven health care system, and California is no exception. 3.2 million Californians have no health insurance at all. Over a third of Californians report delaying or skipping necessary care due to cost. California’s rural hospitals have been closing at breathtaking pace since the 2010s began. These were problems that all predated the arrival of the SARS-CoV-2 virus in California.

The pandemic has exposed just how deep the rot in our health care system goes. Hospitals have consistently prioritized their profit margins over the safety and well-being of nurses and patients. They’ve forced nurses to take care of more patients than they could safely care for, restricted access to personal protective equipment, and fought nurses who tried to claim workers’ compensation for contracting the virus at work caring for Covid patients while, more often than not, inadequately protected. As a result, 42 nurses so far in California have died.

Meanwhile, insurance companies continue to collect ever increasing monthly premiums, and their executives enjoyed record profits as the pandemic raged and working people lost their livelihoods. Hospital CEOs have also enjoyed record profits in the last year. There’s a phrase for a system that seeks to take advantage of crises afflicting the many to enrich the few: disaster capitalism. The US health care system in a pandemic is disaster capitalism at its most brazen.

These structural failures alone aren’t responsible for the pandemic, but they have resulted in needless death and suffering. A robust public health system that can coordinate a proper pandemic response and puts the safety of health care workers and patients above profits would have gone a long way toward both controlling the pandemic earlier and minimizing the damage it caused. That’s why, in California, the nurses’ prescription for the pandemic is CalCare.

CalCare is the name of the program that would be implemented by Assembly Bill 1400, a bill introduced in February 2021 by Assemblymember Ash Kalra and sponsored by the California Nurses Association. If enacted, it would guarantee health care to all Californians. This bill is based on the seven core principles of CalCare:

  1. Universal coverage to all Californians as a human right
  2. A single, public program that would pay for all necessary and appropriate care for California residents
  3. Comprehensive benefits, including medical, dental, vision, reproductive care, long term care, and more
  4. Freedom to choose the doctors and hospital of your choice, with no narrow networks restricting what provider you can see
  5. Care that is free at the point of service, with no copays, deductibles, or prior authorizations
  6. A just transition for the workers who may be displaced or otherwise affected by the switch to CalCare; and
  7. Patient care based on patient need, with no financial incentives to delay or deny care, provided based on the professional judgment of your care provider, not corporate boardrooms

AB 1400 will accomplish all these things and more. CalCare will help reverse many of the structural inequities in our health care system that disproportionately hurt low-income communities and communities of color. It will save families and businesses thousands in annual health care costs by cutting out the bloat and waste of our fragmented, for-profit insurance system, while making critical investments in health infrastructure in the areas of the state that need it most.

We’re incredibly proud of what’s written into AB 1400 — but legislation means nothing until it is signed into law. And unfortunately, the for-profit health corporations that currently run our system don’t want CalCare, and they’ll spend everything they have to in order to defeat us.

To build a movement strong enough to win, we have to build a mass movement across every corner of the state. We did that work with so many of you in the first part of 2021. In February, we held a CalCare statewide Day of Action with thousands of participants in 23 car caravans rallies around the state. We passed resolutions in dozens of city councils, neighborhood councils, and various social justice organizations. In April, we held a second statewide Day of Action of CalCare SpeakOuts throughout the state, where we uplifted the voices of those who need guaranteed health care the most.

Unfortunately, the primary author, Assemblymember Ash Kalra, announced in April that he was pulling the bill from consideration until January 2022, citing the need to build more support in the legislature before we could go forward. We were deeply disappointed by the decision to hold the bill for the year. But that means now is the time for us to organize and prepare.

A lot of work must be done, and time is short. For AB 1400 to have a chance at becoming law, it needs to pass through the entire Assembly in the month of January. It must clear both the Assembly Health and Appropriations committees and pass via simple majority on the Assembly floor. We have less than half a year to prepare for the bill’s return and only a month to pass it once that happens.

Thankfully, public opinion is on our side. A recent poll showed that 67 percent of likely voters and 85 percent of Democrats in California support a single payer system. Our job is to bring more of that support actively into our movement — our job is to organize.

We recently announced our plan for the next 5 months in a statewide activist strategy call, where we heard from speakers like LA Chargers running back Justin Jackson and co-founder of Be a Hero Ady Barkan.

The first part of the plan we unveiled is our brand new CalCare District Leaders program. We announced a list of 33 priority districts throughout the state of California where we feel there is an opportunity to really build a strong base of support. Some of these districts have key members of the Assembly Health or Appropriations committees. Some are Democratic Party strongholds where the member hasn’t signed on yet despite the vast majority of their constituents supporting single payer. Some members on the list are cosponsors of AB 1400, but we feel like they could do more to help the bill move forward. Here’s that list:

If you live in one of these districts and want to be a CalCare District Leader, sign up here.

We’re recruiting volunteers to step up and be district leaders for each of these Assembly districts. If you live in one of these districts — we need your help. Sign up here to get plugged in.

District leaders, supported by CNA, will organize in their communities, host text banks and phone banks, collect petition signatures, organize a legislative visit with their Assemblymember, and more. This work will not only help us build immediate momentum to get the bill passed, but it will also help us build a more enduring movement that continues to build strength year-round.

The second part of our plan is our Text from Home Program. We’re texting voters throughout the state of California to identify supporters and pull them into the movement. This tactic has already paid off: Since the start of this year, volunteers with our campaign have identified nearly 22,000 voters in California who support CalCare. Many of those voters joined our last statewide strategy call and are getting plugged into the campaign to win. This sort of work is critical for building the size of our movement throughout the state of California. If you can volunteer with us to send texts, sign up here to get plugged in.

For the third part of our plan, we’re excited to announce CalCare Fest, a virtual statewide Day of Action on Saturday, September 25th. We need to publicly launch our fall efforts in as huge a way as possible, and we need all hands on deck. (If you missed CalCare Fest, click here for a recording.)

Finally, we will continue our organizing around the Healthy California for All Commission. This is Governor Newsom’s Commission to explore pathways to universal health care. The commission has been meeting regularly, and it is scheduled to deliver a report to the legislature and the Governor in early 2022. We need to keep showing up to those meetings in droves like we have been doing so well. We must make our voices heard to ensure that that report contains a strong recommendation for single payer and not inadequate half-measures. To join us for the next meetings, sign up here to get plugged in.

Make no mistake: the policy of CalCare is right, the only thing missing is the political will to get it done. Systemic change never comes easy: it comes when people stand up and demand better than they are getting. We must build a movement that is ready to stand up and fight for the system we all know we deserve.

With this plan, we can build the kind of support and power we need to be prepared for January 2022. But we can’t do it without you. We need you to take action with us in one or more of the ways above — and we can’t wait to work with you.

When we fight, we win!

National Nurses United is the largest union of nurses in the US. NNU is leading the fight for Medicare for All on behalf of our patients and our communities.