Article
Where things stand
About 31,000 nurses and other clinicians represented by UNAC/UHCP began an open-ended strike against Kaiser Permanente on Jan. 26. The group includes registered nurses, pharmacists, nurse anesthetists, nurse practitioners, midwives, physician assistants and therapists working at more than two dozen hospitals and hundreds of clinics in California and Hawaii. Their contract expired Sept. 30.
On Feb. 9, more than 3,000 pharmacy and lab workers represented by UFCW locals in Southern California joined with a separate but coordinated walkout. National talks have stalled, and Kaiser has moved unresolved issues to local bargaining tables.
A big offer that has not closed the gap
Kaiser says its proposal would raise pay by roughly 30% over the life of the contract when step increases are included, and calls it the strongest compensation package in its national bargaining history. The union says the core problem is chronic understaffing and workload. Local reporting describes the financial gap as a union ask of about $3 billion for wages and staffing against a Kaiser proposal of about $1 billion.
Kaiser has kept hospitals and emergency departments open using physicians, managers, contingency workers and staff from other regions. Some outpatient pharmacies and labs have closed or cut hours, and some nonurgent procedures have been rescheduled or shifted to virtual visits.
Lessons for leaders elsewhere
Most systems will never face a strike of this scale, but the dynamics are familiar.
- Staffing is the bargaining issue. When unions frame a dispute around workload, wage offers alone may not resolve it. Leaders need credible data on staffing levels, vacancy rates and overtime that they are willing to share and defend.
- Open-ended strikes change the math. A fixed-length strike can be absorbed with replacement agency staff. An indefinite one forces decisions about which services to scale back, how long contingency labor contracts run and how to protect elective revenue.
- Multiple unions can coordinate. Contract calendars that line up across bargaining units raise the risk of compounding disruption. Know when every agreement in your system expires.
- Bargaining structure matters. Shifts between national and local tables can become a dispute of their own, adding to unfair labor practice claims.
Questions for the board
Ask management for a labor risk map: every contract, expiration date and open issue, plus a strike contingency plan that has been tested within the last year. Ask how the system’s staffing data compares with what front-line workers report, and where a gap exists, what is being done to close it before the next negotiation.
Archive entry for Feb 14, 2026, added Nov. 11, 2026.