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, 41 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.