Unions representing more than 85,000 healthcare workers have held pickets at 50 facilities across California, Washington, Oregon and Colorado amid new contract negotiations as their current union contracts are set to expire on 30 September.

The negotiations at Kaiser Permanente are the third largest set of contract negotiations in the US in 2023, behind the 340,000 workers at UPS who will be voting on a tentative agreement this month that was reached days before planned strike action, and 150,000 autoworkers at Ford, General Motors and Stellantis whose contracts are set to expire on 14 September.

The Coalition of Kaiser Permanente Unions represents workers in seven states and Washington DC. The coalition said that in a recent bargaining session, Kaiser Permanente claimed workers at the non-profit “make too much money” while the CEO is paid a salary of $16m a year.

Workers fighting for a new contract have criticized Kaiser Permanente over chronic understaffing, high workloads that worsened during the Covid-19 pandemic and lagging wages as the cost of living and inflation has risen substantially in recent years.

Trayvonne Ross, a senior food service worker at Zion medical center in San Diego, California, for three years, claimed his department was understaffed and had trouble retaining workers due to low pay and the high cost of living in the area.

He said the understaffing affects patients who aren’t able to receive their meals on time, often having to wait for hours while Ross and his co-workers have to do the work of two to three people to try to keep up.

“I’m struggling,” said Ross, who is applying for the Supplemental Nutrition Assistance Program, the federal food assistance program, for his family.

“Currently, I live in just a one-bedroom apartment with me, my wife and three kids just to be able to live close to where I work,” said Ross. “I know that Kaiser is making a whole lot of money and I think it’s just very sad that not only me, but some of my co-workers, are having to ask for government assistance just so we can keep up.”

Kaiser Permanente is one of the largest healthcare providers in the US, serving 12.7 million members in California, Washington, Oregon, Georgia, Hawaii, Washington DC, Maryland and Virginia.

The non-profit reported a profit for the first quarter of 2023 of $1.2bn after reporting losses in 2022. Over the past five years, Kaiser Permanente has reported over $21bn in profit, while paying 49 corporate executives at least $1m each annually.

Megan Mayes, a patient access representative at Kaiser Permanente in Portland, Oregon, for 17 years, said when Covid-19 hit, she and many of her co-workers were putting in 60 to 70 hours a week to help keep up with the high demand.

Despite those extra hours, she said, the high cost of living and inflation have made it difficult for Mayes and her family to make ends meet financially.

“I have three kids. The grocery bills are a lot. We don’t go out to eat, we meal prep, and it’s still not sustainable. My husband is a journeyman carpenter, has a union, works full-time and has worked overtime since the pandemic as well and we’re always operating in a deficit every single month,” said Mayes. “Kaiser Permanente then telling me that I’m overpaid? And what does that look like for bargaining when we’re saying well, we’re very clearly not and here’s the numbers that support it.”

Mayes said that even with new job openings, the company can’t get enough applicants because the pay is lagging and no longer competitive. The union is asking for a $ 25-an-hour wage floor for all positions.

“We used to have applicants lined up for blocks to get training just to be at Kaiser Permanente and I’ve never seen this ever in my 17 years here where we can’t even get one single applicant for a job,” she said. “Kaiser used to be the best, they were always the gold standard, and they’re not any more. We’re all asking Kaiser to do the right thing, invest in your employees, invest in the people who have stuck with you for years, through a global pandemic. It’s time to start taking care of your employees.”

In a statement Kaiser Permanente provided the company said it had filled 6,500 coalition jobs this year as part of plans to hire 10,000 new workers and claimed average staff turnover is 8.5% compared with 21.4% for the healthcare industry as a whole.

In a separate statement, a Kaiser Permanente spokesperson dismissed picketing as an attempt by the unions to gain leverage in bargaining and disputed the union’s complaints about wages. The statement added: “Our priority is to reach an agreement that ensures we can continue to provide market-competitive pay and outstanding benefits. We are confident we’ll be able to reach an agreement that strengthens our position as a best place to work and ensures that the high-quality care our members expect from us remains affordable and easy to access.”