COVID-19 California Nurses

Registered nurse Verlin Frazier stands for a photo in front of a patient board in the empty COVID-19 ICU at Providence Mission Hospital in Mission Viejo, Calif., Tuesday, April 6, 2021.

(The Center Square) – A union representing more than 100,000 healthcare workers is planning to make a push in the upcoming legislative session to establish a healthcare minimum wage at the state level, arguing higher wages are needed to increase retention among healthcare workers.  

The Service Employees International Union-United Healthcare Workers West wants legislation creating a statewide minimum wage in the health care sector by the end of next year. The move comes after the union supported two ballot measures to set a healthcare minimum wage of $25 for certain workers in two Southern California cities this election season.  

Inglewood voters look to have approved Measure HC, a measure that would raise the minimum wage to $25 for certain workers at private hospitals and dialysis clinics. The latest updated vote tally showed 54% approved the measure compared to 46% who voted against it. The measure does not apply to workers who do the same jobs at public hospitals.

Voters in Duarte, another Southern California 35 miles from Inglewood, are on pace to reject a similar measure. The latest update shows 63% of voters oppose Measure J, which would raise the minimum wage to $25 for clinicians, nurses, maintenance workers, janitors, technicians and food service workers at covered healthcare facilities there.

The two measures represent the first of what could be a battle at the ballot box in coming years between healthcare unions and hospital associations. Three more cities – Los Angeles, Long Beach and Downey – will see a similar initiative in 2024.

Supporters of the initiatives argue a healthcare minimum wage is needed to address staffing shortages in the health care workforce and increase retention.

Union members met with lawmakers in August to discuss a potential push for a health care minimum wage at the state level, Gabriel Montoya, an EMT at Kaiser Downey and a union-wide executive committee member with SEIU-UHW, told The Center Square. The union attempted to push for an end-of-session deal in August to establish a health care minimum wage by coordinating with the hospital industry, but the deal fell through

“We have seen the largest net loss of health care workers in California than we've ever seen before following and during this pandemic,” Montoya said. “We've seen California hemorrhaging healthcare workers, and we think this is one of the ways to stop that hemorrhaging.”

Union members acknowledge that the push for a statewide ballot initiative or legislative measure likely won’t come without opposition from the California Hospital Association and others in the hospital industry.

Both Measure HC and Measure J were opposed by the hospital industry, including the Hospital Association of Southern California. Groups in opposition claimed the measures would result in "unequal pay" for workers with the same jobs who work in public hospitals. The “No on HC” campaign was specifically concerned that the measure excludes the majority of healthcare workers in Inglewood.

George Greene, president and CEO of the Hospital Association of Southern California, said in a statement that hospitals “support fair wages for health care workers,” but criticized both measures.

“Measure J and Measure HC were deeply-flawed, unequal and unfair measures – picking winners and losers among health care workers while excluding workers at the vast majority of healthcare facilities in each city,” Greene said.

“We support continued conversations at the state or regional level to determine the most appropriate and equitable approaches to addressing worker compensation,” he added.

Opponents of Measure HC also claimed the initiative would raise health care costs and increase insurance premiums for families. Union representatives, however, say ordinances at the local level are written to target the profits of hospital systems and prevent them from raising premiums. 

“These hospital systems are raising premiums while they're still paying their workers just above minimum wage, and many of them are making billions of dollars while doing it,” Montoya said. “We believe that a lot of these hospital systems are in a perfect place to be able to afford to pay these workers without raising premiums on the patients.”

The SEIU-UHW made a push to advance a $25 minimum wage ordinance in 10 California cities, and while not all the cities ended up adopting the ordinance, an analysis commissioned by the California Hospital Association estimated the ordinances would result in increased costs of more than $392 million per year at covered facilities across all 10 cities – a nearly 7% increase.

The analysis also noted that if the ordinances had been enacted in all 10 cities, it would increase the cost of providing care at covered facilities. The report estimates 26% of covered facilities in the 10 cities are already experiencing low margins, “making it difficult to absorb a 2% increase in costs.” As a result, covered facilities could look to private insurers to increase payments, which could mean patient’s premiums or out-of-pocket costs are increased, according to the analysis. 

“In general, increased taxes raise the cost of doing business and depending on the market conditions, some if not all of the increased costs are passed on to consumers. I would think since there are few substitutes for hospital care, that these higher costs will show up as higher prices and higher premiums later,” Glenn Melnick, a professor at the USC School of Public Administration and Blue Cross of California Chair in Health Care Finance, told The Center Square in an email. 

Union members say their goal at the end of the coming legislative session is to have a healthcare minimum wage in place in California and hope to work with lawmakers to pass the measure through the legislative process, according to Montoya.

Staff Reporter

Madison Hirneisen is a staff reporter covering Virginia and Maryland for The Center Square. Madison previously covered California for The Center Square out of Los Angeles, but recently relocated to the DC area. Her reporting has appeared in several community newspapers and The Washington Times.