The union representing 31,000 Kaiser Permanente nurses and health care professionals across California and Hawaii, the United Nurses Associations of California/Union of Health Care Professionals, on Thursday issued a 10-day notice to strike, with walkouts possible from San Jose to San Diego and Honolulu starting Jan. 26.
Safe staffing, wages, and stalled contract negotiations are at the center of the dispute, following the expiration of the union’s contract and an unresolved unfair labor practice charge.
The strike could impact care at dozens of hospitals and hundreds of clinics, making it one of the largest potential health care labor actions of the year in the U.S. Kaiser Permanente is the largest health care system in the Bay Area.
Picket lines are planned at nearly 20 Kaiser hospitals and 200 clinics.
In December, Kaiser Permanente said it paused bargaining with the Alliance of Health Care Unions “following a union leader’s actions that have compromised the national bargaining process and undermined both parties’ ability to continue good faith bargaining.”
On Jan. 15, Kaiser Permanente responded by proposing a solution to move forward with contract negotiations, which if successful, could avert a strike.
United Nurses of California represents a wide range of licensed and specialized health care professionals, including registered nurses, nurse practitioners, nurse anesthetists, pharmacists, physician assistants, midwives, therapists, dietitians, and speech-language pathologists.
The union is part of the Alliance of Health Care Unions, a coalition that negotiates a national contract on behalf of 23 local unions covering Kaiser facilities from Hawaii to Washington, D.C.
Most United Nurses members work in California, where approximately one in four residents receives care through Kaiser Permanente. In Hawaii, Kaiser serves about 272,000 health plan members.
The strike notice follows the release of a new report by the union examining Kaiser Permanente’s financial practices. According to the union, the report highlights billions of dollars in financial reserves and investments at Kaiser, while frontline workers and patients continue to experience chronic understaffing and delayed access to care.
Union leaders argue that Kaiser, which operates as a nonprofit, has continued to pursue expansion projects nationwide while claiming it cannot afford staffing improvements or wage increases at existing facilities.
The union’s report, “Profits Over Patients,” describes worsening safety risks, staff burnout, and longer waits for appointments and services at Kaiser even as health plan premium rates continue to rise. These conditions persist alongside $7.9 billion in net income across the first three quarters of 2025 and a $66 billion dollar surplus for Kaiser, levels outside analysts have described as extraordinary for a nonprofit health care system.
In addition to patient care concerns, the report examines Kaiser’s investment activity, which it said include ties to private prisons, ICE detention centers, fracking, predatory lending and other ventures that the union claims conflict with Kaiser’s health care mission and raise ethical questions for a nonprofit.
“Kaiser says it’s a nonprofit focused on people. But our patients and our members are living something else: not enough staff, too much work, delayed care, and preventable breakdowns,” said Charmaine S. Morales, RN, president of United Nurses of California. “Kaiser isn’t strapped for resources. It’s making choices — and those choices are hurting people. It’s time for accountability.”
Contract negotiations between the union and Kaiser expired on September 30. The two sides previously experienced a five-day work stoppage in October 2025. Since then, negotiations have reportedly stalled, with no bargaining sessions held for over a month.
In December, the union filed an unfair labor practice charge with the National Labor Relations Board, alleging Kaiser attempted to bypass the agreed-upon national bargaining process and interfered with good-faith negotiations that had been ongoing since May 2025.
Under federal law, health care unions must provide at least 10 days’ notice before initiating a strike. This requirement is intended to allow hospitals time to prepare and maintain continuity of patient care.
Union leaders say the notice is both a legal obligation and an opportunity for Kaiser to return to the bargaining table before a strike begins.
UNAC/UHCP has identified several key issues driving the strike authorization:
- Safe staffing: Workers report that ongoing shortages and increasing workloads are contributing to care delays, increased risk of errors, and widespread burnout across clinical roles.
- Wages and economic security: The union says Kaiser’s wage proposals do not keep pace with rising costs of housing, food, and health care, contributing to retention challenges.
- Retirement security: Many health care professionals represented by the union do not have pensions, raising concerns about long-term financial stability after physically demanding careers.
“We’re not going on strike to make noise,” Morales said in a press release. “We’re authorizing a strike to win staffing that protects patients, win workload standards that stop moral injury, and win the respect and dignity Kaiser has denied for far too long.”
Morales added that the union believes the situation could be resolved if Kaiser returns to the negotiating table. “Kaiser can end this whenever they choose by coming back to the table and bargaining in good faith,” she said.
Union leaders say the goal remains reaching an agreement, not prolonging labor action.
