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FRIENDLY FIRE: Sometimes the loudest opponents can come from your own side.

That’s certainly true with the quest for a single-payer health care system in California, where the greatest debate of the day is playing out between groups that are seemingly working toward the same goal.

Divisions among single-payer proponents are only widening in the uphill battle to overhaul California’s entire health care system — an undertaking that would require permission from the federal government..

A bill winding through the legislative process — SB 770, from state Sen. Scott Wiener, a San Francisco Democrat — would create an advisory group and a timeline for starting informal discussions with the federal government on the necessary paperwork to get a new system going.

But strategic and ideological fissures have formed around when to start engaging the feds and how incrementally to proceed. The California Nurses’ Association, a fervent and outspoken single-payer advocate, argues the state has done more than enough studying of the issue. The federal government, CNA says, has been clear that a state would need to pass single-payer legislation before it can ask for permission to carry it out.

The group’s latest proposal to set up a single-payer system known as CalCare, from San Jose Assemblymember Ash Kalra, still contains few details and won’t be introduced in earnest until early next year. It will closely hew to a bill from last year that never made it to the floor, but that advanced further than previous attempts in the Democratic-supermajority Legislature.

Wiener and proponents of his bill think the two proposals can go hand-in-hand, but the CNA disagrees. Its leaders argue that the two approaches are mutually exclusive — and that SB 770 isn’t even a single-payer bill.

“There is a growing coalition that is preparing and getting ready to be behind a single-payer bill in early 2024,” said Jasmine Ruddy, an assistant director on CNA’s CalCare campaign. “I think that there is a faction of that movement that is interested in a different direction that is not single-payer health care, and we will always be opposed to that.”

The nurses’ union is spending the year doing outreach and organizing for CalCare, including monthly trainings and canvassing, as well as series of local town halls attended by supportive elected officials like Wendy Carillo (D-Los Angeles), Dave Cortese (D-San Jose), Damon Connolly (D-San Rafael) and, of course, Kalra. They’re also pushing out materials to supporters, directing them how to bring down SB 770.

But Healthy California Now, the coalition of groups behind Wiener’s bill, isn’t interested in tangling with CNA, which could antagonize key allies.

“I guess it takes two to tango, and we’re kind of not up for that dance,” said Michael Lighty, president of Healthy California Now.

Getting this bill through the Appropriations Committee and then through the Assembly isn’t a slam dunk; neither is the governor’s signature.

And if everything goes according to plan, the voters will eventually get a say. That’s where the real fight begins.

HAPPY WEDNESDAY AFTERNOON! Welcome to California Playbook PM, a POLITICO newsletter that serves as an afternoon temperature check of California politics and a look at what our policy reporters are watching. Got tips or suggestions? Shoot an email to [email protected] or send a shout on Twitter. DMs are open!

FEINSTEIN FALL — California’s senior senator was back in the headlines today, with news of a fall that cast further doubt on her future in Congress.

The 90-year-old Sen. Dianne Feinstein fell in her San Francisco home on Tuesday, her office confirmed. As a precaution she went to the hospital, where she was cleared of any serious injuries and returned home that night, a spokesperson said.

It’s the latest in a series of setbacks for Feinstein, who is retiring next year but continues to face calls to step down earlier amid health problems and signs of confusion. Majority Leader Chuck Schumer said that he spoke to Feinstein after the fall and that she is back home and doing well.

Meanwhile, at an annual summit at Lake Tahoe, Sen. Alex Padilla and former Speaker Nancy Pelosi assured attendees that Feinstein was fine. Padilla said he spoke to his fellow senator after the incident, and Feinstein asked him, “Why all the fuss?” — Lara Korte

DIRTY WATER: It may be summer, but it’s a crappy time to be a surfer in San Diego. Untreated sewage spilling north from Tijuana, Mexico, has forced public health officials to close popular beaches for months on end. The recent closures have prompted increasingly desperate calls by local politicians for funds to fix deteriorating wastewater infrastructure on both sides of the border.

Today, Newsom joined the chorus. In letters to President Joe Biden and Democratic leaders in Congress, he asked for money to fix an existing treatment plant in San Diego. The plant was already too small to handle all the polluted water spilling over from Tijuana, and is now in need of major repairs. Local officials have said that a previous allocation of $300 million was not nearly enough.

Beachfront communities in southern San Diego are also pressuring Newsom to declare a state of emergency. — Camille von Kaenel

MORE BACKLASH IN CHINO: A Southern California teachers union is challenging local school board members for banning pride flags and requiring staff to share transgender students’ identities with parents. The Associated Chino Teachers filed a charge of unfair labor practice against the district today, piling onto a California Department of Justice probe into the newly seated board’s “forced outing” policy.

The complaint argues that Chino Valley Unified officials should have bargained over the policies and that the flag ban limits protected union speech. California has some of the nation’s strongest labor laws, which teachers continually use to have more say in how their schools are run.

“Chino has already been struggling to attract teachers; the extreme views being imposed on the district and unfavorable publicity the Board is garnering will only make it more difficult,” union President Brenda Walker said in a statement. — Blake Jones

KEEPING NATURAL GAS: A California energy regulator gave a grudging thumbs-up to a plan to extend the lives of three lumbering natural-gas-fired power plants in Southern California that planners say could help the state avoid blackouts.

The Energy Commission said the state isn’t yet ready to give up the so-called peaker plants that are capable of powering roughly 2.5 million homes when extreme heat taxes the grid the way it did last September. Despite the state’s aggressive pursuit of a carbon-free energy future, it doesn’t have enough power from battery storage or other sources to guarantee it can keep the lights on when solar power drops off during hot summer evenings, commissioners said.

The explanation did little to mollify dozens of residents from one the state’s most polluted areas, who urged the commission to honor past promises to close the plants in Ormond Beach, Long Beach and Huntington Beach.

“We are tired,” Lucia Marquez, an advocate with the Central Coast Alliance United for a Sustainable Economy, told the commission today. “We’re tired of asthma and cancer claiming our neighborhoods. We’re tired of the broken promises that this will be the last extension.” — Wes Venteicher

“California lawmakers want to make social media safer for young people. Can they finally succeed?” by the Los Angeles Times’ Queenie Wong: Samuel Chapman had no idea that drug dealers targeted teens on Snapchat until his 16-year-old son died from a fentanyl overdose.

“San Francisco exodus: City may never recover population loss as other parts of Bay Area grow,” by the San Francisco Chronicle’s Roland Li and Adriana Rezal: A permanently shrunken population in San Francisco could mean a weaker economy, as businesses are already struggling to fill some positions and retailers have closed, citing falling foot traffic.

“Can California salmon survive Trump water plan backed by House Republicans in spending bill?” by The Sacramento Bee’s Gillian Brassil: A Trump administration plan for delivering more water to Central Valley farmers — bottled up in court by opponents for almost four years — could be returned from legal limbo this summer by House Republicans.

“Sacramento, ordered not to clear homeless camps, did it anyway. ‘Oversights,’ city says,” by the Los Angeles Times’ Cari Spencer

“Federal court sides with conservative students in dispute over ‘anti-communist’ campus fliers,” by the Los Angeles Times’ Jeremy Childs

“Experts surprised by the number of California teen fentanyl deaths in 2022,” by the San Francisco Chronicle’s Jill Tucker