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Hospitals and counties balk at proposed bill to pay healthcare workers $25/hr

UC Davis Medical Center.
Rich Pedroncelli
AP Photo
UC Davis Medical Center.

Ultrasound technologist Georgette Bradford considers herself blessed.

After 19 years with Kaiser Permanente, she’s not struggling to get by, or considering leaving the field for a more lucrative role at a less risky workplace. She says that sets her apart from many of her coworkers at Kaiser, and fellow members of the SEIU California union.

“We have members that work in the hospital but may have to live in their cars,” Bradford said. “We have members that work in the hospital and have to have two or three jobs to make ends meet.”

Thousands of people who work in health care settings across the state make California’s minimum wage, $15.50 per hour.

Bradford said she’s seen medical assistants, food service workers and patient care technicians leaving the hospital for other roles, with no one hired to take their places. She linked the dwindling number of workers to longer wait times for patients and further burnout for a workforce already battered by the COVID-19 pandemic.

Bradford is one of many unionized workers who are rallying in support of California Senate Bill 525, which would raise the minimum wage for people who work in health care facilities or as home health aides to 25 dollars per hour.

Some hospitals and counties are against the bill, arguing that they need financial support, not a wage mandate. Meanwhile, one senator is trying to preserve as much patient care as possible as the bill progresses through the Assembly.

A workforce in need of support

In her work leading a budget subcommittee overseeing labor in the state, state Senator Maria Elena Durazo kept hearing one thing: The state doesn’t have enough healthcare workers.

In the height of the pandemic, Durazo was disappointed that full time healthcare workers — who include anyone who works at a health care facility — could be making as little as $32,240 a year, if they were paid California minimum wage.

“To say that it's OK to make $32,000 a year is unacceptable or should be unacceptable. Moving that to $50,000 a year is much more along the lines of what it takes to survive,” she said.

That’s what inspired her legislation, SB 525, which would raise the minimum wage for health care workers — like nursing and medical assistants, care aides, administrative workers and some janitorial staff — to $25 per hour.

A UC Berkeley study published in April found that this move could affect at least 469,000 workers in the state, raising their pay by over $5.74, on average. These workers tend to be women of color — 70% of those affected would be people of color, and 75% would be women — and people who are the primary wage earners for their households.

Durazo said she’s not aiming to provide the solutions for all the issues in the healthcare field.

“There is a very specific need. We need to attract and retain workers in the healthcare industry, and we're short by many tens of thousands,” she said.

Small hospitals and counties say its the wrong time

For months, California hospitals have been sounding the alarm that they’re in trouble. In January, Madera Community Hospital closed, and an April 2023 study commissioned by the California Hospital Association found that one in five hospitals in the state are at risk of closure.

The study attributes the situation to strain caused by the pandemic, rising expenses and an extended workforce shortage.

Sarah Bridge is senior legislative advocate for the Association of California Health Care Districts, which represents government entities, called districts, that provide healthcare to people living in a specific region. There are 76 in the state, and they include 33 publicly-owned hospitals. Bridge says even if the bill is implemented gradually, over time, the health districts won’t be able to afford it.

“These are sort of unprecedented costs in a year where we have pretty consistently maintained that we need additional funding ourselves just to maintain current operations," she said.

One health care district, Kaweah Health in Visalia, laid off at least 130 people earlier this year. The CEO said the cost-cutting move was necessary in part due to low reimbursement rates for providing care to MediCal and MediCare patients. Bridge said the state hasn’t responded productively to calls from healthcare providers to better those rates.

“For our districts, [the mandate] will lead to closures because if you can't afford to meet the mandate, you will have to make decisions of services to cut,” she said. “I'm not saying all district hospitals or clinics or skilled nursing facilities will close, but some of them will because they're already on the brink.”

In response to pleas from health care leaders, in May, Governor Gavin Newsom passed the Distressed Hospital Loan Program, which made available $150 million to be loaned out to nonprofit and publicly-funded hospitals in crisis.

However, hospitals and health districts are not alone in opposing the bill — some counties are also against it. Counties provide health care of their own, and in April, a coalition of county associations voiced their displeasure with the bill in a letter to the Senate Labor Chair, Dave Cortese.

In the letter, they alleged the bill “is not sustainable for county government and undermines the local collective bargaining process.”

Senator Durazo said many of the concerns of health care providers were echoed by her colleagues in the Senate. Now, in the Assembly, she added that she has her work cut out for her, balancing the needs of both workers and some employers on the brink.

Durazo says she’s especially considering concessions for distressed hospitals and clinics and a phased implementation of the policy.

“We do care about those hospitals, whether they're in the urban areas or in a rural area,” she said. “We care about everyone having access. So that will be a very important conversation to carry on.”

I’m interested in how health care policy impacts Sacramento and California, who gets access to care and the issues facing health care providers. It’s no secret that health care in the United States is complicated. My hope is to shed light on stories of people trying to get care and the experiences of those providing treatment.
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