The union for thousands of nurses and other health care workers at Kaiser Permanente in Maryland, Virginia and Washington, D.C., is poised to strike if they can’t reach an agreement with management over staffing and pay.

So far, workers in the mid-Atlantic region have opted not to walk the picket line with other Kaiser unions around the country, who began three-day work stoppages this week on the West Coast and in Colorado, as well as a one-day strike ending Thursday morning in Virginia and Washington, D.C.

Union officials said if all union workers end up participating in future actions, it could be the largest health care strike in U.S. history.

The workers in the mid-Atlantic region represent just a small percentage of the California-based Kaiser’s 85,000 workforce. But Kaiser has been expanding in Baltimore and the state in recent years, and if workers walked off the job it could present delays for enrollees in its health plans.

The Maryland workers are part of OPEIU Local 2, which is among a coalition of Kaiser unions around the country that have authorized strikes. Negotiations over a new contract began in April and broke down as the contract got closer to expiring at the end of September. Union officials say the dispute centers on understaffing, which drives burnout and threatens patient care.

“Kaiser used to hold itself out as the best place to get care and the best place to work, but it is now failing at both. Kaiser can and must do better,” said Linda Bridges, president of OPEIU Local 2, in a statement on Oct. 2 when the strike was authorized.

“We are demanding Kaiser bargain in good faith, stop violating the law and address the healthcare staffing crisis,” she said.

Kaiser acts as both insurer and health care provider, operating its own medical centers that have been expanding in the Baltimore area and the Washington suburbs. The nonprofit provider normally scores high on patient satisfaction surveys, though in this region, unlike in other states, Kaiser doesn’t operate hospitals.

Nearly 58,500 people enrolled in Kaiser plans through Maryland’s health exchange this year, putting Kaiser well behind the dominant carrier, CareFirst BlueCross BlueShield, but ahead of the number who chose plans from Aetna and UnitedHealthcare. More people are enrolled in Kaiser plans through their employers.

A statement Thursday from Kaiser said despite a marathon bargaining effort, no settlement was reached in time to avert the strikes in different states. But the statement said there have been some tentative agreements that address union priorities.

They include across-the-board wage increases in all markets over the next four years, an updated performance plan that includes worker payouts, minimum wages of $23 an hour in California and $21 an hour elsewhere, improved health and retirement benefits, tuition assistance and training programs.

“We remain committed to reaching a new agreement that continues to provide our employees with market-leading wages, excellent benefits, generous retirement income plans and valuable professional development opportunities,” the statement said.

The statement acknowledged challenges during the past three years related to the coronavirus pandemic and said, “Our employees are now operating in a new cultural, labor and post-pandemic environment that we are all working hard to understand.”

The company pledged to reconvene bargaining soon and find “workable solutions” that balance employee needs and costs for beneficiaries.

The strife comes at a time when other health care workers and those from other industries have been joining unions and seeking better benefits.

Nurses at Ascension Saint Agnes Hospital in Baltimore filed for union representation with National Nurses United in late July. The union would represent about 600 registered nurses at the hospital.

Those organizing the effort have recently charged hospital management with violating labor law and not respecting their right to organize, and they have filed an unfair labor practice charge with the National Labor Relations Board.

Hospital officials say they have been following the law.

meredith@thebaltimorebanner.com