CRNAs have practiced nationwide for close to a century. Governors sign opt out laws for the benefit of the population of their states to insure that they will be assured of indisputably safe anesthesia care provided by CRNAs. I might add that NO negative outcome data exists in the opt out states relative to CRNA delivered anesthesia. In marked contrast, the A$A acts to protect it's members income by resurrecting the long failed AA experiment. This is done by buying state legislative votes with A$A PAC money. While the A$A carries YOUR water to protect themselves and their income, you run along behind like the neophyte amateurs that you are, allowing your MDA masters complete control over you and the income that you generate for them. That guaranteed (by law!) income is the only reason that the A$A props up your "profession". These are the indisputable facts.