As a nurse, one of the most frustrating feelings in the world is when patients refuse or delay health care because they are afraid of the cost. We see it all the time: Patients faced with life-threatening or life-altering injury or illness who, instead of being allowed to simply focus on getting better, are instead anxious about surprise bills that can themselves be life-threatening or life-altering. That’s why nurses believe in guaranteed health care for all, and it’s why our union supports California Assembly Bill 1690 (AB 1690), which would create CalCare, a universal, single-payer health care system for all Californians. We have fought for decades and backed similar legislation year after year to win such a system.

Nurses know that passing legislation to create CalCare is of life-and-death urgency and the most critical step towards guaranteeing health care for all Californians.

That’s why we don’t support the approach proposed in SB 770, which would put the bureaucratic cart before the health care horse. Last month, lawmakers introduced SB 770, a bill seeking to spur state agencies to start negotiating for waivers from the federal government to establish a state single-payer system. This could delay significant legislative progress on CalCare until 2028 — five more years of waiting for policy that Californians need now!

While we consider the author, Senator Scott Wiener, an ally and a friend to nurses, we strongly disagree with the approach taken in his bill, for a number of reasons.

First, there’s no point in beginning negotiations on these waivers right now. In fact, it’s legally required that a law establishing CalCare would need to pass before the federal government would even approve them. Yes, eventually we will need federal waivers, but not now. Without CalCare already established under law, the new bill will only add more unnecessary red tape to the process, potentially stymying any progress we can make in the short term.

Our fear is that this bill may be used as yet another stall tactic from elected officials who want to shout their support for CalCare on the campaign trail, but won’t vote where their mouth is once in office.

Second, this approach is not necessary. No changes in federal law and no new state laws are required to secure the waiver authorities necessary to implement a single-payer system in California. In fact, the Affordable Care Act already has provisions to make the establishment of a state-level single-payer system easier. Legislative efforts to address waivers before CalCare takes shape are an unnecessary bureaucratic hurdle to add to the already complicated process of making a single-payer system a reality in the Golden State.

Finally, pursuing this approach would cause unacceptable delay, at a time where transitioning away from our for-profit insurance system to CalCare is more critical than ever. The last thing our patients need is more red tape getting between them and the health care they need. There are 3.2 million Californians with no insurance and millions more underinsured, and we’re still in the middle of a deadly pandemic that has taken more than 100,000 Californians from us. The pandemic has demonstrated that we need bold, urgent action to address the health care crisis in our communities, and it will remain an on-going issue given the impacts of long Covid.

Nurses know what our patients need. We are patient advocates at the bedside, on the strike line, and in the halls of political power. We know our patients needed single-payer health care yesterday instead of the crisis of care the hospital industry has created by putting profits before patients. We know our patients need lawmakers to champion this goal with urgency, expediency, and the expert wisdom of health care providers like us, our patients, and our communities.

If you believe we need to pass guaranteed health care for all Californians now and want to let Sacramento know you won’t stand for stall tactics. The Senate Health Committee will vote on SB 770 on Wednesday, April 19. You can take action by calling Health Committee Chair Susan Talamantes-Eggman today and ask her to vote NO on SB 770. Call Chair Eggman at: 916-651-4005

And if you want to show your support for guaranteed health care for all Californians, please sign our petition calling on the legislature to stop making excuses and pass CalCare NOW: http://calcarepetition.org/

Sandy Reding is a registered nurse and a president of California Nurses Association