Unionizing UnitedHealthcare

The largest NLRB union election win in February was at the primary care group Optum Care, a subsidiary of UnitedHealthcare. The vertical integration of health care has brought frustrating consequences for health workers, who are now organizing in response.

Hundreds of 1199SEIU health care workers staged a rally and

Hundreds of 1199SEIU health care workers stage a rally and march in New York on March 29, 2023. (Lev Radin / Pacific Press / LightRocket via Getty Images)


There were 122 National Labor Relations Board representation elections run in February 2025, and ten involved units of 250 or more eligible voters. Those ten elections, however, involved 74 percent of all eligible voters that month.

The highest-profile election was the loss at the Amazon Fulfillment Center in Garner, North Carolina, which my colleague Jonathan Rosenblum covers well here. Jonathan and I offer some more in-depth thoughts on what recent news in the world of Amazon organizing means in a recent article in these pages, but in brief: it’s going to be very difficult to make much headway with this company with traditional site-by-site organizing methods. Amazon is too big and too flexible for such organizing, and the company is only going to come to the table if the flow of goods through their dynamic distributional system is disrupted, which requires multisite coordination and a laser focus on the pain points in their facility network.

National Labor Relations Board elections of 250+ eligible voters tallied in February 2025.

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