By Dale Russakoff
Washington Post Staff Writer
Tuesday, May 22, 2007

The California Nurses Association, one of the nation's largest unions of registered nurses, announced yesterday that it was affiliating with the AFL-CIO to join the labor federation's campaign for universal health insurance.

Rose Ann DeMoro, executive director of the 75,000-member nurses' union, said that after a century as an independent union, the nurses joined the AFL-CIO because of what they see as unprecedented momentum for comprehensive health-care reform. She said her union opposed any reforms that would leave private insurers as the system's gatekeepers and chose the AFL-CIO because of its vote this year to support a single-payer system under which one entity would finance all health care.

"You can't achieve a national health care system without the labor movement. It's never happened in any country," said DeMoro, whose union has members outside California through its national group, the National Nurses Organizing Committee. The move gives the AFL-CIO 325,000 registered nurses as members.

The nurses' decision underlines continuing tension between the AFL-CIO and Change to Win, a rival federation of unions that broke away from the AFL-CIO in 2005, led by the Service Employees International Union, a prominent player in health care. The SEIU has organized nurses aggressively, and its president, Andy Stern, has publicly allied with business groups to try to forge a political consensus behind universal health care.

But Stern has not made a single-payer system a precondition, saying he is open to any plan that would cover all 46 million uninsured Americans. DeMoro called that "the most salient factor in our decision" to join the AFL-CIO rather than the SEIU. The California nurses bring to 11 the number of unions in the AFL-CIO representing nurses, including such seemingly disparate groups the United Auto Workers, the United Steelworkers and the Communications Workers of America. The California Nurses Association, practicing what then-Oakland Mayor Jerry Brown called "elegant militancy," was the first to win a state law setting safe ratios of nurses to patients in emergency rooms and hospitals.

Steve Francy, executive director of RNs Working Together, a coalition within the AFL-CIO, said the individual unions were collaborating to set safe staffing levels, ban mandatory overtime and organize more hospitals. He said 18.7 percent of registered nurses nationally were unionized as of 2004, the latest figures available.