Sonia Bracey, a medical assistant, has worked for Kaiser Permanente for twenty-five years. When she first got a job at the health care giant, which serves 12 million patients across the country, she was proud to be associated with the company, recruiting friends and family members to work there.

Now, as Kaiser negotiates a new contract to cover some 50,000 workers at locations spanning from California to Hawaii to Georgia, Bracey doesn’t feel the way she used to.

“When I clock out, the first thing I do is remove my badge,” she says.

The company has offered the Alliance of Health Care Unions, a coalition of twenty-one locals, just 1 percent annual raises, as well as a two-tier wage structure. In Kaiser’s proposal, new hires at almost every job classification beginning in January 2023 would receive wages between 26 percent and 39 percent lower than existing wages.

But the company has $44.5 billion in reserves, and continues to be profitable: In 2020, it made more than $2 billion in operating profits. Indeed, the company returned $500 million in CARES Act funds it received during the pandemic.

“They claim that we are heroes because we kept their doors open throughout the pandemic and followed all the guidelines to ensure safety measures were in place for the patients as well as the employees,” says Bracey, who is a member of United Steelworkers (USW) Local 7600, which represents 7,400 health-care workers at seventy-two locations across California. “So, for them to offer a 1 percent raise is unacceptable. It’s disrespectful.”

“A 1 percent raise is not okay,” says Norberto Gomez, vice president of Local 7600 and a mobility technician who has worked at Kaiser for twenty-three years. “We are the ones taking patients to the morgue, to the freezer trailers on the dock. We are the ones who helped Kaiser through this. A 1 percent raise is a slap in the face to all of our workers. COVID touched everybody, whether you’re a dietary person or a transportation person or a licensed vocational nurse or a receptionist.”

As for the two-tier wage structure, Kaiser workers, like many others across the United States right now, believe that accepting such a concession would cause irreparable harm to morale at the workplace, pitting workers against one another while also leaving those on the higher wage scale vulnerable in the future. In the context of a health care facility, the consequences of such a division would be immense.

“Working on the floor, you build a bond with the patients, with the doctor that you work with, and with your coworkers,” says Bracey. “Everybody learns each other’s strengths and weaknesses, and so if something happens, we know who we can call on.” Were some workers to make significantly lower wages than their peers, that balance would be upended.

“If somebody comes in and they’re making $12 an hour and know you started at $25, when you ask for help, conflict might arise,” explains Bracey. “Instead of knowing that my coworker has my back if I need help, that coworker might say, ‘That’s not my problem.’ Morale will decrease. It’s going to tear down everything on the floor that we have built as coworkers.”

Kaiser backed down from a two-tier proposal in 2019 when some 80,000 workers threatened to strike. However, it succeeded in a similar wage proposal in 1986, outlasting workers who struck for more than a month.

While Kaiser cites competitive pressures as the reason wage cuts are needed, workers say that they are already paid too little. Bracey lives in Victorville, California, in the Inland Empire, and her wages are significantly lower than those of people doing identical work at Kaiser’s Los Angeles and Orange County facilities.

Local 7600 says the wage disparities are particularly hard to countenance given that 72 percent of its membership are people of color. While Kaiser pays regional wage scales for professional jobs like registered nurse or pharmacist, it is Local 7600’s members in auxiliary positions who are subject to a wage gap. According to the union, Kaiser’s anesthesia techs in the Inland Empire and Kern County are paid 39 percent below their peers in Los Angeles and Orange County, EKG technicians are paid 29 percent below, and emergency room technicians 33 percent below.

The wage disparity is so extreme that work has become an off-limits topic of conversation between Bracey and her cousin, who works at one of Kaiser’s Los Angeles locations.

“We don’t talk about work because it pisses me off,” says Bracey of the wage disparity.

Contract negotiations between Kaiser and the Alliance have been ongoing since April, and the unions are pushing for 4 percent annual increases, no two-tier, and contract language to ensure safe staffing levels.

Staffing in health care facilities was an issue before the pandemic, but COVID-19 only exacerbated the problem.

“People are working seven days a week,” says Bracey. “I have coworkers who have worked twenty-one to thirty days straight to accommodate Kaiser’s needs because they refuse to backfill positions.”

“Already budgeted jobs are not being backfilled appropriately,” says Gomez. Rather than filling existing positions from which workers have left, Kaiser is leaning on short-term registry or contingent employees to fill the gap. “Had they backfilled positions appropriately to begin with, they probably wouldn’t have been in the position where they have to bring in these other workers.”

Given the distance between the two sides, local after local within the alliance has taken strike authorization votes in the past few weeks, with members voting overwhelmingly in favor of authorizing a strike. Just this week, United Food & Commercial Workers (UFCW) Local 1996, which represents 2,450 health care and technical Kaiser staff in Georgia, returned one such vote, with 96 percent of ballots cast in support of a strike.

“We are all in lockstep with each other,” says Gomez of the Alliance of Health Care Unions. “For our local’s issue around wage justice, the disparity in wages, we have all the support in the world from our sister and brother unions. We’re all on the same page and fighting for the same thing.”

Should Kaiser’s workers decide to strike, they are required to give the company a ten-day notice. That notice could come any day now.