Democratic presidential candidate Sen. Bernie Sanders on Monday became more than an afterthought to front-runner rival Hillary Rodham Clinton as the 185,000-member National Nurses United, the nation’s largest female-dominated labor union, announced its endorsement.

The Vermont senator held a “Brunch with Bernie” at the union’s headquarters in Oakland and communicated with members around the country by phone.

Calling their support a “major, major step forward” for his campaign, Sanders told an enthusiastic crowd of hundreds of nurses — all wearing red shirts emblazoned with “Bernie” — that “you are there bringing babies into this world, and you are there when people leave this world.”

He drew energetic cheers from the overwhelmingly female crowd when he called for a single-payer or “Medicare for all” health care system, saying “our vision is that when people get sick, they should be able to get health care regardless of their income — because it is a right in this country.”

“Why in God’s name,” he asked, “are we the only major country on Earth that doesn’t do it?”

Taking on ‘billionaire class’

Sanders also called for free tuition for public institutions of higher education, and for making the wealthy who have profited from Wall Street “pay their fair share” in taxes, adding, “the billionaire class can’t have it all.”

Earlier RoseAnn DeMoro, the executive director of National Nurses United, which includes the California Nurses Association, praised Sanders as the only candidate to align with nurses on issues such as a single-payer health care system, income inequality, “holding Wall Street accountable” and climate change.

“He’s the real, real deal,” DeMoro said. The union’s members made their choice based on candidates’ responses to a questionnaire. “You name it, he’s there for us — the poll was overwhelming for him.”

Disappointed with Clinton

DeMoro said many female members of her union were inclined at first to endorse Clinton because “she’s a woman who is breaking the glass ceiling.” But DeMoro, a national vice president of the AFL-CIO’s executive council, said that there was disappointment with Clinton after a July 29 council meeting with the candidate.

The Democratic front-runner, DeMoro said, was “so evasive” on the major Asian trade deal known as the Trans-Pacific Partnership — which she said affects thousands of American jobs — and on single-payer health care, which her members see as a “bedrock issue which affects lives.”

By contrast, she said, Sanders “made it clear you will never have to wonder which side he is on.” She said he told union leaders, “I see myself as part of you. This is not a conventional moment; we are fighting for the future of this country.”

Sanders, a self-described democratic socialist, has said the Affordable Care Act, otherwise known as Obamacare, doesn’t go far enough and he supports a single-payer system that would provide health care to all Americans. He has argued that Medicare, which provides near-universal coverage to Americans older than 65, should be extended, and he opposes the Trans-Pacific Partnership trade deal.

‘Robin Hood tax’

He also authored Senate Bill 1731, calling for a so-called Robin Hood tax on Wall Street speculation that he has said could raise millions for free college tuition and health care programs.

“I wish Hillary Clinton had Bernie Sanders’ politics — and it would be a no-brainer,” DeMoro said. “But how do you stake your credibility on a candidate who won’t stand on the issues?”

The organization’s announcement Monday underscores what DeMoro said has been an increasingly ambitious political agenda for the female-dominated union, which has grown markedly in the last few years.

“Nurses have to pick up all the pieces ... they have to assist people who have been abandoned by society on many social programs,” DeMoro said.

Nurses’ ‘road map’

And with the presidential election next year, the union’s goal has been to “connect with other groups on social issues” and establish a “road map” for political change that would “heal America” on fronts that include not just health care, but also environmental health and income inequality issues, she said.

She might have included race relations on that list.

During the rally and in response to a question about his views of the Black Lives Matter movement, Sanders urged “a revolution in criminal justice” and accountability when police use excessive force.

It was his first response since a rally in Seattle on Saturday was disrupted by Black Lives Matter protesters who took over the mike and held up a banner reading “Smash Racism” to some boos from the audience of about 15,000.

“When we talk about creating a new America, at the top of our list is ending racism in all its ugly forms,” Sanders said Monday. “We have more people in jail than China, which is a communist, authoritarian country,” he said. “Our job is to create a criminal justice system which does everything possible ... (so) police departments do not look like military occupiers.”

DeMoro said she is nonplussed by some Democrats who have complained that Sanders isn’t a registered Democrat — and that in the past he supported Ralph Nader’s campaign for the presidency.

“There are so many Democrats who are beholden to corporate interests and to Wall Street,” she said. “It’s not the Democratic Party that we once knew ... and it puts labor leaders in a horrible position.”

“If they’re demanding everyone fall in line for Hillary, then you’ve got a disaffected membership,” she said.