Why 31,000 Kaiser Permanente nurses are on strike | Questions & Answers

Starting today, 31,000 nurses at Kaiser Permanente are on strike as they seek a new contract.

Nurses with the United Nurses Associations of California/Union of Health Care Professionals (UNAC/UHCP) delivered a strike notice Jan. 15. Nurses are striking at Kaiser Permanente’s facilities in California and Hawaii.

Here’s a rundown on the key issues involving the dispute.

Q: How many facilities are involved?

A: Nurses are striking at more than two dozen hospitals and clinics across California. The UNAC/UHCP is part of the Alliance of Health Care Unions, which represents Kaiser employees across the country.

Q: How long will the strike last?

A: It’s unclear. The union didn’t specify a date for the end of the walkout, indicating the strike will continue until they have a deal.

Q: What are nurses seeking?

A: The union cites safe staffing levels at the top of its list of concerns. Union leaders say staffing shortages are leaving nurses with too much work, and that inadequate staffing is posing risks to patient care and driving nurse burnout.

The union is also looking for better compensation. Nurses say Kaiser’s offer isn’t keeping pace with higher costs for housing, food and healthcare. The union is also seeking retirement benefits.

Charmaine S. Morales, RN, president of UNAC/UHCP, said nurses aren’t walking out “to make noise.”

“We’re authorizing a strike to win staffing that protects patients, win workload standards that stop moral injury, and win the respect and dignity Kaiser has denied for far too long,” Morales said in a statement.

The union produced a report arguing that the system is focusing on profits at the expense of patients, sitting on $66 billion in reserves even as nurses face insufficient staffing and patients see rising premiums.

Q: What is Kaiser Permanente offering?

A: The health system says it is offering the “strongest compensation package in our national bargaining history.”

Kaiser Permanente says it is offering a 21.5% pay increase over the entire contract, including a 16% hike within the first two years of the deal. Kaiser Permanente says other provisions, such as step increases and other adjustments, raise the total increase to about 30%.

Kaiser Permanente says the system would see nearly $2 billion in added payroll costs with that offer.

Q: How long have negotiations taken place?

A: Kaiser Permanente and the union leaders have been in talks since May, but they haven’t been able to reach an agreement?

Q: Has there been any progress?

A: Greg Holmes, Kaiser Permanente’s executive vice president and chief human resources officer, said in a message to union members Jan. 21 that there has been “substantial progress, including economic progress with individual unions at the local tables.”

But Holmes says national union leaders have impeded progress, which led the system to pause national bargaining. Holmes said a UNAC/UHCP leader tried to “coerce an agreement by threatening to release information of purportedly unlawful and unethical conduct to gain concessions at the national bargaining table.” Holmes said last month that Kaiser won’t be involved in a cover-up and invited the union to share examples of inappropriate contact.

Kaiser Permanente also accused union leaders of withholding information needed for staffing during the walkout, including a text message that said: “The goal is to get Kaiser confused so they don’t know how to staff the hospital.”

Morales, the UNAC/UHCP president, said Jan. 16 that Kaiser Permanente needs to get back to negotiating.

“Kaiser can end this whenever they choose by coming back to the table and bargaining in good faith,” Morales said. “Until they do, we are done waiting. Striking is the lawful power of working people, and we are prepared to use it on behalf of our profession and patients.”

Q: Has Kaiser Permanente had a strike this large before?

A: While a strike involving 31,000 nurses represents a large walkout, Kaiser Permanente unions engaged in a bigger strike in 2023. More than 75,000 workers walked off the job in what labor leaders called the largest healthcare worker strike in U.S. history. The two sides reached an agreement within days after the strike began.

Q: Why does this strike bear watching?

A: Kaiser Permanente is one of the nation’s largest health systems. The system operates 40 hospitals and hundreds of clinics. So when Kaiser negotiates contracts with its unions, other health systems pay attention.

Steve Wasson, chief data and intelligence officer for Strata Decision Technology, tells Chief Healthcare Executive® that Kaiser’s contracts often establish precedents in other negotiations. He said that happened after the Kaiser strike and eventual deal a few years ago.

“When some of these large organizations lock in new contracts … It sets the market,” he says. “It kind of locks the market in. And so there's a trickle effect.”

Earlier this month, nearly 15,000 nurses in New York City engaged in a 10-day strike in a contract dispute with three New York health systems. The union and management still have yet to reach a deal in that dispute, though the union said over the weekend there is a resolution on a provision regarding health benefits.