This story has been updated to reflect comment received from union officials.

More than 75,000 union workers serving Kaiser Permanente patients in a half-dozen states may go on strike this week, after contract negotiations between their coalition and Kaiser reached an impasse. Georgia has Kaiser Permanente locations, but is not one of the states that would strike.

Kaiser Permanente is a nonprofit health system with its own health insurance. It claims 39 hospitals, 622 medical offices and 12.7 million patient-members in states scattered across the nation, heavily anchored on the west coast. If no agreement is reached between the union and the health system, a three-day strike could begin Wednesday for Kaiser facilities in California, Oregon, Colorado, Virginia, Washington state and the District of Columbia.

In Georgia, Kaiser serves more than 300,000 patients around Atlanta and Athens with more than 600 doctors in addition to other workers. Georgia’s 3,250 Kaiser Permanente employees are not part of the union coalition in the contract battle. A majority of Kaiser’s Georgia employees are represented by a different union: the Alliance of Health Care Unions UFCW local union 1996.

Because the strike involves a different union, Georgia will not be part of the strike, officials for Kaiser and the union in Georgia said.

If Kaiser Permanente workers in other states go on strike, Kaiser Permanente in Georgia does not plan to send its own employees out of state to fill those gaps elsewhere “at this time,” said the Kaiser spokesman, Kevin McClelland. Asked if that could change, McClelland said he couldn’t speculate.

A representative of the Georgia union, Ralph Porras, said the union didn’t have a position on lending workers to the striking hospitals, but that it wouldn’t work because Georgia is suffering the same staff shortage.

“We wouldn’t have any workers to lend out,” said Porras, who is executive assistant to the union local’s president.

Health systems nationwide have faced an exodus of burnt-out health care workers from the pandemic, and demands for better pay amid inflation.

The coalition of unions girding for the strike, the Coalition of Kaiser Permanente Unions, said it would be the largest health care strike in history.

The problem comes as health care prices nationwide have been rising faster than inflation for years, compounded by recent record inflation. In other health systems, that frequently results in contract battles between insurance companies and hospital systems. It has even resulted thousands of insurance policyholders suddenly losing in-network access to an entire health system nearby because the insurance company and the health system broke their contract.

The Coalition of Kaiser Permanente Unions said they were making progress with Kaiser on several issues. But they seemed to be at a standstill with Kaiser on the size of pay raises and on whether locations where Kaiser Permanente expands should also become part of the union, along with other issues.

Protesters for the union workers in Los Angeles were photographed carrying signs that read “I can’t afford to live where I work.”