CalMatters is a nonprofit, nonpartisan newsroom committed to explaining California policy and politics.

Tens of thousands of Kaiser Permanente health care workers are prepared to walk out on a three-day strike Wednesday that would affect patients across California.

The contract between the health care giant and a coalition of eight unions representing 75,000 workers nationwide expired Saturday. Workers in the union span a wide variety of professions, including pharmacists, phlebotomists, licensed vocational nurses and support staff. Although the walkout would also affect facilities in Colorado, Oregon, Virginia, Washington, and Washington, D.C., more than 90% of coalition workers are in California.

In a statement over the weekend, the union coalition said parties “remain far apart” on important issues like pay and staffing, although negotiations are expected to continue until midday today.

“So far, there is no light at the end of the tunnel,” union leaders said in a statement Saturday.

At the end of Monday, however, Kaiser executives characterized the impasse more moderately.

“A strike is not inevitable, and it is certainly not justified,” Kaiser said in a statement.

At issue is pay and staffing adequacy as health care workers exit the profession en masse, citing burnout and stress from the COVID-19 pandemic.

The coalition wants a 24.5% raise over four years and a $25-per-hour minimum wage for all workers across the U.S. Kaiser has offered 12.5% to 16% raises over four years depending on the state and a $21 minimum wage for most of its workers, but a $23 minimum wage for California workers.

A “Honk for healthcare workers” sign is posted during a strike by Kaiser Permanente health care workers outside a Kaiser facility in Sacramento on July 25, 2023. Workers are on the picket lines to protest a patient care crisis and unsafe staffing at Kaiser hospitals. Photo by Rahul Lal for CalMatters.

Thousands of temporary workers have been hired to fill vacancies in preparation for Wednesday’s walkout, which would last until 6 a.m. Saturday.

“Should a strike occur, our hospitals and emergency departments will remain open. Our facilities will continue to be staffed by our physicians, trained and experienced managers, and staff, and in some cases we will augment with contingent workers,” the Kaiser statement Monday said.

Dozens of California hospitals

Kaiser has an outsized footprint in California, controlling half of the private insurance market with more than 9.4 million members. It also operates three dozen hospitals and more than 500 medical offices in the state.

Last year, Kaiser’s mental health workers in Northern California striked for 10 weeks over caseloads and long wait times. The strike coincided with a state investigation into whether the health insurer was providing members timely and adequate access to appointments. That investigation is ongoing, a spokesperson for the Department of Managed Health Care told CalMatters.

Sonya Allen-Smith, a radiology technologist in Oakland, has worked for Kaiser for 15 years. She said the bargaining stalemate comes down to staffing shortages. Her department is operating at half capacity with only five out of 10 positions filled. The wait time to get an X-ray is often so long that patients give up and go home, she said.

“As a frontline worker, we see patient care crises every day. We know the crisis can’t be solved unless Kaiser executives are committing fair labor practices and taking action by investing in the workforce,” Allen-Smith said.

Allen-Smith is a member of the coalition’s common interests committee, which assists with bargaining. The union coalition has charged Kaiser with unfair labor practices for failure to share information required for bargaining and refusing to bargain over items covered in the current contract, said Renée Saldana, a spokesperson for Service Employees International Union-United Healthcare Workers West, the largest of the coalition’s unions.

While Kaiser contends that it has one of the lowest attrition rates in the industry and will have hired 10,000 new employees by the end of the month, Saldana said the coalition has outstanding questions about whether new hires are being used to fill existing vacancies or to staff new facilities as Kaiser looks to rapidly expand across the country.

Kaiser strike looms with bill on Newsom’s desk

With the threat of a strike looming, Gov. Gavin Newsom is considering signing a measure to institute a $25 health care worker minimum wage in California. Newsom has until Oct. 14 to decide on a health care minimum wage, but even if he signs the bill it won’t change the coalition’s bargaining demands since it represents members in five other states, Saldana said.

“California is high-cost, but so is Hawaii, so is Washington, D.C., so is Seattle. It’s expensive to live everywhere,” she said.

Kaiser maintains that it offers the highest salaries of all its competitors, but California workers say inflation has squeezed everyone.

“It’s become very difficult to make a living without having to look for a second job,” said Rolando Medina, a behavioral health worker at Kaiser Simi Valley. “Wages haven’t kept up with what inflation is.”

Medina, who has worked for Kaiser for 13 years, makes about $35 per hour, but a tank of gas now costs $90, cutting deeply into his family’s budget.

“I remember the days where being a Kaiser Permanente employee was, you know, the thing people look forward to, but I definitely feel like that has changed,” Medina said.

Up in Oakland, Allen-Smith said her colleagues are frustrated and serious about Wednesday’s strike.

“They’re ready. People are ready to walk,” she said.

Supported by the California Health Care Foundation (CHCF), which works to ensure that people have access to the care they need, when they need it, at a price they can afford. Visit to learn more.