The nation’s largest healthcare workers strike is over, but there’s still no deal

While more than 75,000 Kaiser Permanente union workers wrapped up their strike last week, it didn’t signal an end to the contract dispute with the California-based system.

More than 75,000 Kaiser Permanente union workers went on strike last week, and the system has yet to reach a deal with labor. The two sides have been negotiating for months, and SEIU-UHW workers picketed on Labor Day, as seen in this photo. (Image credit: SEIU-UHW)

The two sides remain apart on key aspects of the agreement: staffing levels and compensation. On Monday, the Coalition of Kaiser Permanente unions warned of the possibility of a second strike next month if they can't reach an agreement.

Nurses, pharmacists, radiology technicians, home health aides, and other healthcare workers engaged in a strike beginning early Wednesday morning, and the walkout ended Saturday morning. The Coalition of Kaiser Permanente Unions called it the largest healthcare worker strike in U.S. history.

The Coalition said the next negotiating sessions are scheduled for Oct. 12 and 13.

A spokesman for Kaiser Permanente said the system is looking forward to resuming talks.

“We look forward to reaching a new agreement that continues to provide our employees with market-leading wages and benefits, and ensures our high-quality care is affordable and available to meet our members’ needs,” Kaiser Permanente said in a statement.

The contract with the Coalition of Kaiser Permanente Unions expired Sept. 30. Unions held strike authorization votes last month in California, Colorado, Oregon, Washington, Virginia, and Washington, D.C. An overwhelming number of union workers agreed to a walkout.

Kaiser said patient care continued throughout the walkout, and said most procedures were not delayed. The system said most routine surgeries were performed as scheduled, and ambulatory appointment access was “close to normal.” The system said access to non-hospital pharmacies was impacted slightly in the northern California and Oregon markets, but some members opted for mail-order options.

Based in Oakland, Calif., Kaiser Permanente operates 39 hospitals and more than 600 other medical offices in several states. Kaiser’s health plan serves nearly 13 million members.

Dave Regan, president of SEIU-United Healthcare Workers West, has focused on staffing concerns as a key issue that must be resolved. SEIU-UHW represents more than 60,000 workers.

“Kaiser executives refuse to acknowledge how much patient care has deteriorated or how much the frontline healthcare workforce and patients are suffering because of the Kaiser short-staffing crisis,” Regan said in a Sept. 22 statement.

Kaiser Permanente said last week that it has met the goal of hiring 10,000 new Coalition-represented employees in 2023, three months before the end of the year. Kaiser has also said its turnover rate is well below the industry average, signifying the system’s commitment to its workers.

The Coalition has said it’s looking for a four-year pact with raises of 6.5% in each of the first two years and 5.75% in each of the final two years. Kaiser Permanente is offering increases ranging from 3% to 4% in each year of a new four-year contract, depending on the market.

Kaiser Permanente also says it’s offering minimum wages for all employees ranging from $21 to $23 in 2024, depending on the market, with the minimum wage range rising to $23 to $25 in 2026.

Union leaders say they are also seeking protections against outsourcing and subcontracting. The Coalition says it is looking for assurances that the revenue cycle workforce won’t be outsourced.

Kevin Holloran, senior director of Fitch Ratings, said that while some procedures may have been delayed, he didn't think the strike would have a serious financial impact on Kaiser Permanente's operations.

"One assumes parties will continue to talk after this short-lived strike, and Kaiser will do everything they can to keep any disruption to their membership to a minimum," Holloran told Chief Healthcare Executive®. "I also take the short strike period and what seems to be willingness to pick up again with negotiations as a positive long-term signal.

While the Kaiser Permanente strike generated enormous national media attention, hospitals have seen other high-profile labor battles recently.

In January, thousands of nurses in New York went on strike before reaching an agreement on a contract. About 15,000 Minnesota nurses took part in a three-day strike in September 2022, and they threatened a second walkout in December, but labor and management agreed on a deal.

Rebecca Love is chief clinical officer of IntelyCare, a nurse staffing agency, and a well-known advocate for reforms in the nursing profession. In an interview with Chief Healthcare Executive® before the Kaiser Permanente walkout, Love said recent strikes illustrate that concerns about staffing surpass demands on pay.

She notes in recent strikes, management and labor reached agreements on compensation, but they didn’t finalize contracts until brokering deals on staffing concerns.

“To get nurses back off the picket line and back into work, it is coming down to one thing: Give a safe ratio so we can provide the care to the patients that they deserve,” Love said.