Kaiser Strike Sees Thousands Walk Out in California, This Time With No End in Sight

A monthslong labor dispute over staffing and compensation at Kaiser Permanente escalated into an open-ended strike beginning Monday, threatening to disrupt operations at dozens of hospitals and clinics across California and Hawaii.

Thousands of nurses, physical therapists, midwives and other health professionals voted to walk off their jobs for days or even weeks to pressure California’s largest private employer to concede ground on top union demands, at a time the industry faces financial headwinds.

The United Nurses Associations of California/Union of Health Care Professionals, which represents about 31,000 employees, accuses Kaiser of squeezing patient care and staffing for revenue as it expanded to other states — a claim that the nonprofit organization denies, arguing it meets all staffing and safety requirements.

Picketers on Monday morning outside Kaiser’s Oakland Medical Center, near the employer’s headquarters, said wages need to keep up with inflation and the cost of living after they accepted smaller pay raises during the pandemic. Many also participated in a larger five-day strike in several states in October as part of the Alliance of Healthcare Unions and a one-day walkout in September.

“We’re fighting for our livelihoods, we’re fighting for patient care,” said Jessica Servin, a nurse anesthetist in San Francisco. She said patients are facing long waitlists for appointments and surgeries and struggling to get necessary care in a timely manner.

“I believed their values and their mission statement,” said Servin, who joined Kaiser as a nurse almost 20 years ago. “It feels like they’re deviating from the foundation of why Kaiser was built. It feels kind of sad to be here and realize that Kaiser is choosing profit over patients.”

Kaiser said its health care workers earn more on average than those at other employers and dismissed claims that the quality of its patient care is at risk, pointing to a turnover rate that the organization said is much lower than it is for the rest of the industry. Executives said they aim to balance managing growing payroll costs with keeping care affordable for more than 12 million people Kaiser serves, most of them in California.

“These negotiations come at a time when health care costs are rising, and millions of Americans are at risk of losing access to health coverage,” Lionel Sims, senior vice president of human resources at Kaiser Northern California, said in a statement. “This underscores our responsibility to deliver fair, competitive pay for employees while protecting access and affordability for our members. We’re doing both.”

Hospitals, emergency rooms, pharmacies and nearly all medical offices will remain open during the strike, while patients will be contacted in advance if their care is affected, according to Kaiser. The employer plans to reschedule some surgeries and other procedures.

Disruptions could be larger in Southern California, where about 28,000 UNAC/UHCP members are based, making up the vast majority. The union represents just 2,800 members in Northern California, including physician assistants and speech therapists, and 200 in Hawaii.

For months, the union has sought a 25% pay increase over a four-year contract, but management has stuck to its offer to raise wages by 21.5%, calling it the strongest compensation package in Kaiser’s national bargaining history. Since the October walkout, the employer said it reached tentative agreements with other Alliance unions, strengthening staffing and scheduling.

“It is disheartening that UNAC/UHCP leaders continue to talk about improving care, when this strike, and their actions over the past several months, are really all about higher wages,” Sims said.

Kaiser, founded in 1945 in Oakland, employs more than 180,000 people in nine states and the District of Columbia. As a nonprofit health plan and care provider, Kaiser said it reinvests its revenue into running and improving its hospitals, clinics and community programs, emphasizing preventive medicine.

The company rebounded from a net loss of about $4.5 billion in 2022 to positive net income from operations and investments in later years, posting nearly $13 billion in 2024 and $8 billion for the first three quarters of 2025, according to its most recent financial results.

This month, the U.S. Department of Justice announced Kaiser agreed to pay $556 million to settle allegations that it defrauded Medicare to increase reimbursements by pressuring doctors in California and Colorado to alter medical records and add diagnoses after patient visits.

Brian Mason, UNAC/UHCP’s lead negotiator, said the company floated cutting retirement and health care benefits for newer union members, which would neutralize higher wages. He said management has also refused to bargain on proposals that would allow workers to give patients the care and time they need, though Kaiser disputes that.

“Nobody wants to go to an appointment when you’re sick and feel like you’re being rushed because your provider has to get to the next patient and the next,” Mason said. “This strike is to ensure that patient care continues to be the best that it can be and that Kaiser doesn’t continue down this financial-lies path where they’re treating health care like a hedge fund.”

Sanne Jacobsen, a nurse anesthetist in Oakland, said providers are overbooked and left out of scheduling conversations. She said that the company has struggled to recruit and retain staff.

“It’s delayed appointments, delayed surgeries… and in places like the clinics where people are getting physical therapy, those physical therapists don’t have adequate time to actually treat the patients well,” Jacobsen said.

Staffing ratios and wages became top concerns for health care workers as the sector has increasingly consolidated and executive pay has soared, according to labor experts.

More than 15,000 nurses at three major hospitals in New York went on strike this month, and hundreds more in Grand Blanc, Michigan, remained at the picket line under freezing conditions. Nurses in five other states are threatening walkouts, according to the website nurse.org.

One factor in Kaiser’s reluctance to commit to additional payroll costs is an uncertain financial forecast under the Trump administration, said John Logan, who chairs the labor and employment studies program at San Francisco State University. Federal policies that are expected to increase the number of uninsured Americans could affect Kaiser’s bottom line.

“Kaiser management wants to give itself as much flexibility and wants to avoid making concrete, enforceable commitments to the union in terms of staffing levels and working conditions that it might see are going to be a huge liability in that changing environment,” Logan said.

The union points to Kaiser’s $66 billion in reserves as proof that it can afford improved staffing and benefits, though the company said that the funds are for long-term commitments such as pensions and building maintenance, not ongoing payroll increases.

Still, frontline employees want executives to invest more of the nonprofit organization’s financial income on its workforce and patient care, said Rebecca Givan, an associate professor in the School of Management and Labor Relations at Rutgers University.

“It’s clearly the case that Kaiser, by any metric, is taking in a lot of money,” Givan said. “It has very highly paid executives and the leaders of Kaiser are making choices about where to invest their money. And these frontline workers feel that a little bit more should be on the frontline and not elsewhere.”

Jacobsen, who’s a member of the union’s bargaining team, said the company’s negotiating behavior felt like “an investment bank that poses as a health care organization.”

“For them to say that they can’t afford to pay us fair wages? I think we know where the greed is,” she said on the picket line on Monday. “It’s not out here on the line. It’s way up there in the corporate office.”

National negotiations that started in May were paused by Kaiser last month, after executives said the union threatened to release damning information about the company. The union then published a report on Kaiser’s financials, including linking the employer’s investments to Geo Group and CoreCivic, private prison companies that also run many immigration detention centers. Kaiser slammed the findings as a “collection of misrepresentation of facts.”

Over the weekend, Kaiser and the union met for negotiations, but workers said they weren’t productive and the strike will continue. The employer said it’s onboarding nurses, clinicians and other staff to work during the walkout, and reassigning some employees to work at strike locations.

KQED’s Katie DeBenedetti contributed to this report.