Go to any rally in favor of Medicare for All or any protest of the healthcare industry’s practices, and chances are, you’ll see the nurses. Easily identifiable by their red shirts and signs, sometimes clad in scrubs or PPE that marks them as medical workers, they are often the loudest voices at these events, and no wonder: The main nurses’ union, National Nurses United (NNU) is probably the most prominent left-wing activist organization in all of the labor movement. NNU doesn’t just passionately support Medicare for All—a natural cause, given its membership—but has campaigned for a tax on Wall Street and endorsed Bernie Sanders in both 2016 and 2020. Though it has only around 150,000 members, a fraction of the membership of union giants like the SEIU, NNU punches above its weight politically, both in terms of money (it donated more than $7 million to pro-Democrat PACs in 2020) and in-your-face activism.
NNU Came Out of a Fighting Tradition
The union formed in 2009 when several nursing unions came together under a single umbrella organization. The most prominent of these was probably the California Nurses Association, which had fought for and won a first-in-the-nation law mandating a nurse-to-patient ratio in state hospitals. When then-governor Arnold Schwarzenegger attempted to avoid implementing the law in the mid-2000s, nurses protested at one of his events, to which he replied that the union was a “special interest” and he was “always kicking their butts.” The union jumped all over that intemperate remark and subsequently got the staffing ratio they had been seeking.
That battle and others were orchestrated by RoseAnn DeMoro, who went on to run NNU with a pugilistic streak. This included a “Heal America, Tax Wall Street” campaign in 2011 that asked lawmakers to tax financial transactions. Nurses protested at congressional offices and on Wall Street; when the ideologically compatible Occupy Wall Street broke out months later, NNU members set up first aid stations in several cities.
Medicare for All is Their Signature Issue
The California Nurses Association, now an affiliate of NNU, was the driving force behind the 2017 push for single-payer healthcare in California. Though Democrats controlled a supermajority in the legislature, the bill didn’t pass after Assembly Speaker Anthony Rendon refused to bring it up for a vote, saying that the legislation as written was “woefully incomplete.” This led to cries of betrayal from nurses and other single-payer advocates, some of whom even attempted to get Rendon recalled. (NNU did not directly support the recall effort.) Though other labor groups backed Rendon’s decision, NNU joined protests against him during one of the state’s most bitter political spats.
NNU usually explains its support for Medicare for All as a consequence of its members knowing how badly the current healthcare system is failing patients. “I have watched as patients refuse the medications, procedures and care they need because they cannot afford the costs of their copays or deductibles,” NNU President Jean Ross told Congress last year. “I have watched as insurance corporations refuse to cover the care that is required for the health and well-being of my patients. I’ve seen hundreds of patients who show up in the emergency room because they cannot afford the costs of preventive care, both those with and without insurance coverage.”
But nurses may also have pragmatic reasons for backing single-payer healthcare. As an NNU organizer told GQ in 2019, hospitals often try to cut costs by reducing nursing salaries and shifts; the union believes that under Medicare for All, more money would flow to nurses. (The American Nurses Association, which is much larger than NNU, disagrees.)
Where the Union Goes From Here
NNU’s chief priorities have shifted slightly during the COVID-19 era, with the union focusing on demands that Congress ensure that nurses get sufficient PPE. But overall, Medicare for All remains the union’s lodestar. In 2016, its Super PAC contributed $4.7 million—by far its largest independent expenditure—to support Bernie Sanders. In 2020, the union supported Sanders again, but with his campaign running aground, NNU will have to go back to lobbying for Medicare for All in an unfriendly D.C. climate. If Republicans retain control of the Senate, as seems likely, there will be even less of a chance for bold progressive healthcare policies at the federal level.
That leaves the issue to the states, particularly California, which is the most progressive state in the nation and, single-payer advocates believe, is wealthy enough to cover an ambitious government takeover of the health insurance system. Governor Gavin Newsom has signaled that he would be open to single-payer, and though the issue is no longer top-of-mind for many, Medicare for All supporters point to the pandemic as proof that wholesale changes are required to protect Americans’ health. But one thing’s for sure: When the debate restarts in earnest, NNU will be on the front lines.
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