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Single-payer health care advocates rip Gavin Newsom for ‘flip-flop’

The California Nurses Association didn’t just endorse Gavin Newsom for governor in 2018; the powerful union drove a giant red bus around the state with Newsom’s face plastered on the side of it.

Written underneath: “Nurses Trust Newsom. He shares our values and fights for our patients.”

Now, though, the nurses union is ready to throw Newsom under the bus.

The California Nurses Association, which endorsed Gavin Newsom in his 2018 gubernatorial campaign, campaigned around California with his photo on the side of this bus, shown in San Diego during the California Democratic Party convention in 2018.

The California Nurses Association, which endorsed Gavin Newsom in his 2018 gubernatorial campaign, campaigned around California with his photo on the side of this bus, shown in San Diego during the California Democratic Party convention in 2018.

Joe Garofoli / The Chronicle 2018

Six months before Newsom appears on the primary ballot seeking re-election, a top nurses union organizer just called him a flip-flopper. Another top union leader told me that Newsom is “at war” with their top priority.

Why? It’s all about single-payer health care — the nurses’ foundational issue. A bill creating a single-payer system, AB1400, is moving through the Legislature after getting delayed last year, and so far the governor has been uncharacteristically silent about it.

That’s a change. Newsom earned the union’s endorsement largely because he openly and loudly — as only he can — supported single payer. The nurses were thrilled, as not a lot of governors had made such a pledge, let alone one leading the world’s fifth-largest economy. If California were to adopt single payer, “the rest of the country will follow,” Vermont Sen. Bernie Sanders, its leading national advocate, predicted back in 2017.

Not only did the nurses’ endorsement bolster Newsom’s credibility among California progressives, but his stance set him apart from his top 2018 Democratic rival, former Los Angeles Mayor Antonio Villaraigosa, who had accused Newsom of “selling snake oil” for supporting single payer without identifying a funding source.

Newsom fired back, to the nurses’ delight.

“I’m tired of politicians saying they support single payer but that it’s too soon, too expensive or someone else’s problem,” Newsom tweeted in September 2017.

But last week, union leaders said Newsom did just that.

When Newsom rolled out his state budget, it included a plan to extend health benefits to low-income undocumented residents of all ages — long a desire of progressives. Newsom touted that California would be “the first state in the country to achieve universal access to health coverage.”

Universal access to coverage is great, the nurses agreed, and the proposal is expected to fly through the Democratic supermajority in the Legislature. Advocates point out, however, that access to health care is not a single-payer health care system that covers every Californian. A single-payer system would include no co-payments, and no health insurance companies. (But yes, higher taxes.)

What about single payer?

“The ideal system is a single-payer system,” Newsom responded during his budget rollout. “In the meantime, I’m doing what I said I was going to do, and that’s advance the cause of universal health care.”

But that’s not what Newsom promised, nurses union organizer Alyssa Kang told single-payer activists on a conference call last week.

“So we want to be absolutely clear: This is a flip-flop from a governor who said … ‘I’m tired of politicians saying they support single payer but that it’s too soon, too expensive or someone else’s problem,’” Kang said. “This is absolutely unacceptable, and he cannot be allowed to have it both ways.”

Stephanie Roberson, the government relations director for the California Nurses Association, told me she “can’t even put into words the deep disappointment.”

“This is this is a shot across the bow to single payer, in my opinion,” Roberson said. “He is at war with single payer.”

Roberson emphasized that the union is “200 percent” in support of Newsom’s proposal to extend health insurance to every Californian. But she also said it helps him politically delay addressing single payer.

“It is cover for him to not cash in on his campaign promise,” Roberson said. “It is an about-face to the movement.”

A brief reminder about the nurses union. You don’t want to be their adversary. Ask former California Gov. Arnold Schwarzenegger and wannabe governor and former eBay CEO Meg Whitman.

When few others would take on the popular movie action star on early in his first term, the nurses union dogged Schwarzenegger with 107 demonstrations within a year, kneecapping his sky-high approval rating. Similarly, they torpedoed Whitman’s 2010 gubernatorial campaign. Nurses ridiculed the billionaire by following her around California with a pearl-draped actress dressed as “Queen Meg” riding in a horse-drawn chariot.

Of course, those two were Republicans, and Democrat Newsom has been a longtime friend and partner of the nurses. Advocates know that the single-payer movement needs Newsom’s support to make this transformative change happen, because there is a long, arduous legislative and political slog ahead.

Not only does AB1400 have to make it through the Legislature, but so does a companion piece of legislation, ACA11, which would create the funding mechanism to generate the billions in new taxes to finance the new system — which, as everybody including the advocates know, is what gives voters pause.

Single-payer opponents are already lining up. The California Chamber of Commerce put single payer on its annual “job killer” legislation list before January was half over. One GOP consultant told me that loathing of single payer will help Republican House candidates facing tough re-election campaigns this fall get their voters out — even though it is a state issue.

Prepare for many months of single-payer sparring. Assembly Member Ash Kalra, D-San Jose, the bill’s author, told me that the tax measure to fund single payer probably wouldn’t be before voters until November 2024, which Democrats are hoping would be a friendlier electorate in a presidential election year.

He’s ready. Insiders tell me that Kalra gets high marks for patiently playing the long game here.

He spent months courting Speaker Anthony Rendon, D-Los Angeles, who drew the nurses’ ire in 2017 when he tabled a previous attempt at single payer, calling it “wholly incomplete.” Kalra also spent time with Assembly Member Jim Wood, D-Healdsburg. One early victory: The Wood-chaired Assembly Health Committee passed the measure last week. This week, it goes before the Assembly Appropriations Committee.

Newsom’s backing could smooth an arduous legislative path. The challenge for single-payer advocates: What political leverage do they have over a governor who appears likely to coast to re-election? Not only does Newsom not have a big-name Republican opponent yet, he doesn’t have a Democrat challenger whom single-payers advocates could rally behind.

Only one thing could get Newsom to announce his support of AB1400: if the Legislature passes it and puts it on his desk.

“Ultimately, single-payer health care is going to happen because of a movement, not because of an individual — whether that person is an Assembly member or a governor,” Kalra told me. “The people are going to have to demand it.”

Kalra chooses his words carefully. He knows Newsom’s support is essential.

“I don’t benefit, and the movement and this bill and what I’m trying to do doesn’t benefit by condemning other people,” Kalra said. “I believe that if we get legislation through the Legislature, and bring it before the governor, that’ll be his moment to look in the mirror and decide why he serves. I do that every day.”

Joe Garofoli is The San Francisco Chronicle’s senior political writer. Email: [email protected] Twitter: @joegarofoli