color photograph of an outdoor protest outside a Kaiser Permanente facility. an older Latino man holds a white paper sign with black written text that reads "patients stand w/kaiser workers overcrowded outpatients." in the top left corner, the prism logo is overlaid. from the left side, a yellow text box emerges with white text that reads "Kaiser workers negotiated a deal with few concessions, averting November strike."
Patients join Kaiser Permanente health care employees, as well as union members representing workers, as they walk the picket line in Los Angeles during the second day of their strike on Oct. 5. (Photo by Frederic J. BROWN / AFP) (Photo by FREDERIC J. BROWN/AFP via Getty Images)

Kaiser Permanente and the Coalition of Kaiser Permanente Unions came to a tentative agreement for a four-year contract on Oct. 13, with the proposed agreement raising wages and increasing job training opportunities for Kaiser workers at hundreds of Kaiser facilities across the U.S. 

The deal comes after nearly seven months of bargaining and a three-day strike that took place Oct. 4-7 with more than 75,000 Kaiser employees walking off the job and launching the largest health care strike in U.S. history. The tentative agreement will now go to the 85,000 members of the coalition who will vote for ratification. In the meantime, the coalition has withdrawn a notice for a seven-day November strike that would have taken place if an agreement had not yet been reached. 

“This deal is life-changing for frontline health care workers like me and life-saving for our patients,” said Yvonne Esquivel, a pediatric medical assistant at Kaiser Permanente in Gilroy, California. “Thousands of Kaiser health care workers fought hard for this new agreement, and now we will finally have the resources we need to do the job we love and keep our patients safe.”

The tentative agreement establishes a new minimum wage that will reach $25 an hour in California and $23 an hour in all other states by 2026. It also provides across-the-board wage increases of 21% over four years. The plan increases investment in employees’ professional development and enhances opportunities for employees to receive incentives through the company’s Performance Sharing Plan. The PSP distributes payouts to employees who meet particular labor goals. 

A sticking point in the negotiations had been the company’s practice of outsourcing. The coalition announced that it came to an agreement with Kaiser regarding protective terms around subcontracting and outsourcing that allowed experienced health care workers to stay in their jobs and provide continuity of care for patients. 

Workers called for increased wages and job security provisions as means of improving recruitment and retention of health care staff. Burnout in the health care industry has rapidly escalated since the pandemic, creating a staffing shortage at Kaiser Permanente facilities that regularly results in lengthy wait times for critical appointments and procedures. In a May 2022 survey of 33,000 health care workers by Service Employees International Union-United Healthcare Workers West (SEIU-UHW), 65% of health care workers said they had seen care delayed or denied due to short staffing. Seventy-four percent of workers reported at least sometimes lacking proper time to care for patients. 

The coalition managed to negotiate a contract with few concessions. While it originally asked for across-the-board wage increases of 7% each year in the first two years and 6.25% in the next two years, amounting to wage increases of 26.5% across four years, it agreed to wage increases of 21% over the life of the contract. This is far more than the amount Kaiser proposed before the strike, which would have entailed a 12.5%-16% wage increase depending on the state.

Kaiser and the coalition also had to compromise to address the staffing crisis. Kaiser agreed to increase its education fund by 40% to provide training for the development of current employees and has committed to conducting mass hiring events. The union conceded to a contract provision requiring that during a one-year period following ratification, new hires and people who transfer commit to their position for one year to maintain a stable workforce.

“One thing that really stands out is that [the new agreement] is going to be accelerating the hiring period,” said Megan Mayes, a patient access representative at the Kaiser Westside Hospital in Hillsboro, Oregon, and bargaining team member. “That’s really going to boost getting people in and solving our staffing crisis that we have currently.” 

Department of Labor Acting Secretary Julie Su played a key role in moving the negotiations forward, according to both Kaiser Permanente and the coalition. Su traveled to California to help both sides address sticking negotiating issues.

“When workers have a voice and a seat at the table, it can result in historic gains for workers, their employer, and our country,” Su said. “The president and I congratulate the parties on reaching a mutually beneficial deal that delivers important stability for this critical workforce, for Kaiser Permanente, and for the patients in their collective care.”

The three-day strike showed Kaiser executives and patients the significant impact of even a short work stoppage and put pressure on Kaiser to come to an agreement before November. Workers walked out in California, Colorado, Oregon, Washington, Virginia, and Washington, D.C., resulting in some patients experiencing delays and rescheduled appointments for non-emergency services and elective surgeries. But without the strike, workers said that the new agreement—particularly the safeguarding of protections against outsourcing—would have been impossible.

“Without [the strike], we still would have been at national bargaining and still feeling like management was bargaining in bad faith, which was the current trend for many months,” Mayes said. “I definitely think that this strike changed that, and that is bittersweet. [I am] sad that it had to come to that for us to reach a tentative agreement, but also just so thankful that 75,000 coalition employees came together and knew that we deserved better, our patients deserved better, and that this was important. And it was worth it.”

Workers say that the new agreement not only ensures better conditions for Kaiser employees, but better care for patients. With less understaffing and a more steady workforce recruited and retained through better pay and more efficient hiring processes, patients are less likely to experience lengthy wait times and poor quality of care. 

“I think our patients are just going to experience a whole new Kaiser honestly because it’s been pretty brutal,” Mayes said. “It’s going to be really nice to get back to not having long patient wait times and having the staff so that people can actually get in to see their care providers.”

Sravya Tadepalli is a freelance writer based in Oregon. Her writing has been featured in Arlington Magazine, Teaching Tolerance, the Portland Tribune, Oregon Humanities, and the textbook America Now. Sravya...