Sanders' speech to the influential California nurses' union in San Francisco came shortly after Republican Sen. John McCain announced he would vote "no" on the latest GOP effort to roll back President Barack Obama's health care overhaul law. Sanders praised McCain for following his conscience, but he said the fight to preserve — and expand — access to health care is far from over.
"Tell (Republicans) they will pay a heavy political price," he said. "While we have got to wage an all-out battle to defeat this horrific legislation, we have also got to understand, in terms of health care maintaining the status quo is not enough."
The California Nurses Association was a particularly receptive audience for Sanders' calls for a government-funded universal health care system. The union pushed aggressively this year to create such a system in California, only to see it shelved by Democratic Assembly Speaker Anthony Rendon who called it "woefully incomplete."
Rendon's move spurred marches and rallies at the Capitol. He has since pledged to study the issue and revisit it next year. Sanders made no mention of the California bill, but his national legislation mirrors the California plan in many ways. His bill has attracted 16 co-sponsors, including California Sen. Kamala Harris, in a nod to the increasing openness of Democrats to get behind a single-payer system.
"Brothers and sisters, we understand that the fight for a Medicare for all, single-payer system is not going to be easy," he said. "We're going to be taking on the drug companies, the insurance companies. We're going to be taking on the medical devices companies. But you understand and I understand that when the American people stand up together, we're gonna win this fight."
Earlier in the day Lt. Gov. Gavin Newsom, a candidate for governor, gave a full-throated endorsement for California's bill and pledged to make universal health care a reality in the state if he wins the governorship in 2018. The nurses' union endorsed his candidacy early.
"Because of your leadership, this state has never been closer to universal health care," Newsom said. "I'll make this crystal clear: If we can't get it done next year, you have my firm and absolute commitment as your next governor I will lead the effort to get it done."
Sanders' proposal would hand government the responsibility of ensuring most Americans, with people no longer owing premiums and co-payments. Like the California proposal, it so far provides no details on how the plan would be financed. A single-payer system in California is estimated to cost $400 billion annually, and Rendon shelved the bill in part because it outlined no way to cover those costs. Sanders hasn't provided details about what his plan would cost, but a similar measure he introduced during the 2016 campaign boasted a $1.4 trillion annual price tag.
Sanders remains a favorable choice among party activists to be the 2020 Democratic presidential nominee. He campaigned aggressively in California in 2016, but he lost the state to Democratic nominee Hillary Clinton by six percentage points.
He faced a more adoring reception Friday than top California Democrats have received lately in San Francisco. Sen. Dianne Feinstein took heat last month for calling for patience in dealing with President Donald Trump, while young immigrants shouted over House Speaker Nancy Pelosi last week for not pushing hard enough for comprehensive immigration reform. The criticism displayed continued angst among the Democratic party's base about its direction as it tries to win back a Congress and White House controlled by Republicans.
The nurses' union hasn't shied away from criticizing the Democratic establishment. After Rendon shelved the single-payer bill, they displayed signs with a knife reading "Rendon" stabbed in the back of California's grizzly bear.