(The Hill) — The Coalition of Kaiser Permanente Unions, which represents over 85,000 health care workers in seven states and the District of Columbia, said Sunday it did not reach an agreement with the organization ahead of the contract’s expiration, setting the stage for the possibility of the largest health care strike in U.S. history late this week.

Hours before workers’ contracts were set to expire after 11:59 p.m. PT on Saturday, the coalition said it remains far apart from nonprofit Kaiser Permanente on important issues like across-the-board pay increases, retiree medical plans and protections against subcontracting and outsourcing. 

“Kaiser continues to bargain in bad faith over these issues and, so far, there is no light at the end of the tunnel,” the coalition said in a statement Saturday night. 

In a statement to The Hill, the coalition said health care workers are ready to sit down with Kaiser Permanente executives when they are “ready to bargain in good faith.”

The coalition’s national bargaining team submitted a 10-day notice to Kaiser Permanente executives on Sept. 22, calling for strikes to begin Wednesday at 6 a.m. if they do not come to an agreement by then. 

More than 75,000 health care workers across California, Oregon, Washington, Colorado, Virginia and D.C. are expected to be involved in the strikes, which would make it the largest health care worker strike in U.S. history. Hundreds of leaders were recently trained on how to run picket lines ahead of the strike, which could last until 6 a.m. on Oct. 7, the coalition said. 

Kaiser Permanente is the largest nonprofit health care provider in the U.S. It reported profits topping $3 billion in the first six months of 2023.

In a statement shared with The Hill, Kaiser said it continues to “make progress on key issues” and has reached tentative agreements with the coalition on issues including travel for continuing education, the use of temporary workers such as traveling nurses, tracking of staffing vacancies and dispute resolution. 

The non-profit noted contract expirations do not necessarily mean a strike will occur, and said it is “optimistic” they will reach an agreement ahead of Wednesday.

Kaiser and the coalition last negotiated a contract in 2019, a year before health care workers were put onto the front lines of the pandemic and forced to work through worsening conditions. 

The coalition is also asking Kaiser to address staff concerns over unsafe staffing levels and unfair labor practices.

In a May survey of 33,000 health care workers by the Service Employees International Union-United Healthcare Workers West, around two-thirds said they witnessed delays in or denial of care due to understaffing.

Kaiser told The Hill it has hired more than 50,000 front-line employees in the last two years, including more than 9,800 workers represented by the coalition. In April, the nonprofit said it agreed with the coalition to a goal of hiring 10,000 new people for coalition-represented jobs by the end of 2023. The nonprofit said it expects to reach that goal by the end of October. 

Regarding wages, the nonprofit claims it “leads total compensation” in every market it operates in, and its proposals would ensure it keeps that status. Kaiser said its current offer to the coalition includes across-the-board wage increases and a proposed $21 minimum wage in Washington, Oregon, Colorado, Virginia, Maryland, D.C. and Hawaii starting in 2024 and a $23 minimum wage starting in 2024 in California. 

Operations at Kaiser are expected to continue as normal Sunday regardless of the contract’s status, and its hospitals and emergency rooms will remain open regardless of the strike, Kaiser said.

The nonprofit also said it has “contingency plans” to ensure patients can still receive care for the duration of the strike.