Kaiser put labor inside its AI decisions, then filed 147 back-office cuts
The first comprehensive AI agreement between a major US healthcare employer and its unions gives 62,000 workers a standing role in how AI is chosen, designed and taught. Seven days before MIT Sloan published the playbook, Kaiser filed notice cutting 147 back-office jobs.
Vincent Jiangthree-minute read
The playbook and the cuts landed seven days apart
Seven days before MIT Sloan published the first full account of the 2025 agreement between Kaiser Permanente and the Alliance of Health Care Unions, covering 62,000 nurses, technicians and support workers, Kaiser filed notice to cut 147 business and administrative jobs across 16 California locations, effective 20 November. 1 3 The account, by MIT Sloan's Kochan and Kelly with San Francisco State's Minster, calls it the first comprehensive agreement by a major US healthcare employer to put worker input into every stage of AI decision-making, from identifying problems to designing tools and training employees. 1
What labor's five seats cost an employer
The machinery is the price. A 10-member AI Task Force, five seats labor and five Kaiser, holds direct decision-making authority over technology investments; more than 3,500 unit-based teams get innovation training; peer advisers coach colleagues through each rollout. 1 Equal seats on a body with that authority mean, in practice, neither side moves without the other. A vendor selling AI into Kaiser now clears a committee where labor holds half the votes. 1
The deal prices process, not headcount
The agreement governs how AI is selected, designed and taught. 1 The filings cut 72 positions at regional administrative offices in San Diego, 22 at Pleasanton's IT campus and 20 at Pasadena's administrative offices, on top of 216 layoffs disclosed in October 2025, primarily IT and food services. 3 4 Nothing in the filings ties the cuts to AI; Kaiser frames them as affordability, with severance and outplacement attached. 3 4 The template prices how AI arrives, not who stays after it lands.
Nearly half the eliminated jobs sit in one San Diego administrative office
Data
| Value | |
|---|---|
| San Diego admin offices | 72 jobs |
| Pleasanton IT campus | 22 jobs |
| Other 11 locations | 21 jobs |
| Pasadena admin offices | 20 jobs |
| Oakland headquarters | 11 jobs |
| Oakland, Harrison St | 1 jobs |
The playbook is spreading
UNITE HERE's version, won in 2018 hotel contracts covering nearly 100,000 workers, requires up to six months' notice before new technology and bargaining before it deploys, with severance and recall when jobs go; coverage has climbed from about a quarter of members in 2019 to roughly two-thirds today. 6 SAG-AFTRA's 2026 deal, ratified by 91.4% of voters, makes producers show "significant additional value" before a synthetic performer replaces an actor, and bars strikes over AI until 2030. 8 The Writers Guild won written notice when scripts are licensed to train commercial AI systems, but no pay. 8 9
What Kaiser got for it
Kaiser paid for its partnership: 21.5% across-the-board raises over four years, about 30% average wage growth, after nearly 11 months of bargaining and two Hawaii strikes. 5 The 147 jobs equal 0.08% of its roughly 180,000 California employees, inside a sector consolidating back-office roles everywhere. 2 3 The UNITE HERE report makes labor's case outright: win the power to shape technology rather than fight a losing battle to stop it. 6
The tell
Watch the task force's first published review of a technology investment. 1 Then watch Wynn Resorts' Encore Boston Harbor, where 1,300 casino workers walked out on 4 September over wages, benefits and minimum hours; no AI clause appears in that fight, on the record. 7
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