Tens of thousands of Kaiser Permanente healthcare workers across the U.S. West Coast initiated a large-scale strike, marking one of the most significant labor actions in the nation’s healthcare history. The walkout, which began on Tuesday, October 4, 2023, and was initially slated to last three days, involved over 75,000 workers and impacted hundreds of facilities in multiple states, including California, Colorado, Oregon, Virginia, Washington, and Washington D.C..
Core Issues: Staffing, Pay, and Patient Care
The primary drivers behind this historic strike were demands for safe staffing levels, fair wages, and enhanced protections for patient care. Union officials cited chronic understaffing, exacerbated by the COVID-19 pandemic, as leading to burnout among healthcare professionals and compromising the quality of care patients receive. Workers pointed to long wait times for appointments and in emergency rooms, as well as increased workloads, as direct consequences of insufficient staffing.
Union leaders argued that Kaiser Permanente, a major nonprofit hospital network and managed-care organization, had generated significant profits – reportedly $3 billion in the first half of 2023 – while neglecting the needs of its frontline workforce and patients. The workers were seeking substantial wage increases, with demands for a minimum wage of $25 per hour in California and $23 per hour in other states, alongside annual pay raises over a four-year contract.
Key Players and Union Involvement
The Coalition of Kaiser Permanente Unions, representing a diverse range of healthcare professionals including nurses, lab technicians, pharmacists, social workers, and support staff, spearheaded the strike. Prominent unions within the coalition include the Service Employees International Union (SEIU) and the National Union of Healthcare Workers (NUHW). The strike was characterized as the largest healthcare worker strike in U.S. history, involving up to 85,000 members in some reports following the initial walkout.
Kaiser Permanente, while acknowledging the dispute, described the strike as “unnecessary and disruptive”. The organization maintained its commitment to reaching an agreement that balanced fair compensation with high-quality, affordable care, and stated it had plans to maintain operations with minimal disruption by utilizing temporary workers.
Background and Context
Negotiations for a new contract had been ongoing since April 2023, with contract expirations looming in early October. The unions accused Kaiser executives of bargaining in bad faith, highlighting instances where negotiation sessions allegedly broke down or Kaiser representatives were unwilling to engage fully. This labor dispute occurred amidst a broader trend of increased union activity and worker militancy across various industries in the United States.
Resolution and Tentative Agreement
Following the initial three-day strike from October 4-6, 2023, Kaiser Permanente and the unions resumed negotiations. A tentative agreement was reached on Friday, October 13, 2023. This agreement, which was later ratified by over 85,000 Kaiser Permanente workers with a 98.5% approval margin, brought an end to the immediate strike action.
The ratified four-year contract, effective from October 1, 2023, to September 30, 2027, included a commitment to a minimum wage of $25 per hour in California and $23 per hour in other states, along with a 21% wage increase over the contract’s term. The agreement also included provisions for subcontracting and outsourcing protections and investments in the healthcare workforce.
While this major strike was resolved, labor actions continued in other sectors of Kaiser Permanente, such as the prolonged mental health workers’ strike in Southern California, which involved members of the NUHW and eventually reached a tentative agreement in May 2025 after a 196-day strike. This overall period underscored the ongoing labor tensions within the healthcare industry, particularly concerning fair compensation, adequate staffing, and the preservation of quality patient care in a post-pandemic landscape.
