The Minnesota Nurses Association (MNA) announced Tuesday that contracts had been ratified for roughly 15,000 nurses across major hospital systems in the Twin Cities and the Duluth-Superior region. The agreement covers nurses employed by Allina Health, Children’s Minnesota, Fairview, and Health Partners in the Twin Cities, and by Essentia Health and Aspirus Health’s St. Luke’s Hospital in the northeast of the state.
The contract ratification follows more than four months of closed-door talks between the MNA and hospital administrators. Nurses in the Twin Cities have been working without a contract since May 31. The MNA announced the tentative agreement with Twin Cities hospitals on July 3, days after Duluth-area nurses voted overwhelmingly to authorize a strike. The next day, the union called off the Duluth strike and quickly moved to finalize a second agreement.
Meanwhile, a separate strike by more than 500 Advanced Practice Providers (APPs) at Essentia Health hospitals in northeastern Minnesota and western Wisconsin remains ongoing. The APPs are nurse practitioners, midwives, physician assistants, and clinical nurse specialists. They joined the MNA last year and are now being isolated on the picket line by the union
The MNA bureaucracy worked to fragment and dissipate the growing anger among healthcare workers across the state. At no point were nurses across the different systems and job classifications unified in a common fight. The bureaucracy's actions were aimed not at strengthening the struggle, but at limiting its political and economic impact.
Nurses had been prepared to fight. The strike votes were driven by years of chronic understaffing, stagnant pay, and unbearable working conditions. Yet the new contracts address none of the underlying problems. In the Twin Cities, nurses will receive a nominal 10 percent raise over three years. Nurses in Duluth and Superior are being given just 9.75 percent over the same period—well below the cumulative inflation rate since 2021, and entirely inadequate in light of present inflation.
Meanwhile, staffing remains in crisis. Nurses regularly report patient ratios of 6 to 8 per shift, double what was standard a decade ago. Some hospitals have been forced to repurpose storage areas, waiting rooms, and even garages to house patients. A certified nursing assistant told the World Socialist Web Site that last-minute shift cancellations have become routine, making it impossible to plan work-life schedules or ensure patient safety.
These unbearable conditions are a product of a healthcare system gutted by the profit motive and by years of bipartisan austerity. The vacancy rate for nursing positions in Minnesota quadrupled during the pandemic and now sits at 11 percent. An investigation by local news station WCCO found 19 hospitals throughout the state have slashed or relocated services since 2022.
The situation in Minnesota is linked to the cuts to Medicaid and public health funding championed by the Trump administration and endorsed in practice by the Democrats. Earlier this month, Trump signed into law the so-called “One Big Beautiful Bill Act,” which includes over $860 billion in Medicaid cuts over ten years. The bill immediately strips coverage from more than 11 million people nationwide by imposing new work requirements and funding caps. In Minnesota, more than 1.2 million residents—approximately 20 percent of the state—are currently enrolled in Medicaid. Reimbursement from public insurance accounts for more than half of hospital revenue in Minnesota. The impact of these cuts will be devastating.
Far from opposing these attacks, the MNA works to subordinate nurses to the very political establishment responsible for these cuts. It promotes toothless appeals to Democratic Party politicians, who are just as committed as the Republicans to austerity.
In its statements about the contracts, the MNA hailed “our victories at the Capitol” and called on members to “hold corporate healthcare accountable”—through petitions, legislation, and dialogue. This is a deliberate political trap. The MNA's real function is to suppress mass opposition among healthcare workers while channeling it into safe, pro-corporate outlets.
The stakes of this betrayal are made clear by the fate of the striking APPs. These frontline caregivers were used as political cover by the union, who talked the strike up as a bold new front in organized labor, then hung out to dry. Two weeks into their strike, there is no end in sight. Essentia management has taken a hard line, relying on scabs and floating workers while the MNA keeps the APPs isolated and nurses are told to celebrate their so-called victory.
The union has even refused to defend its own staff. Tania Singh, an MNA organizer and longtime healthcare worker, was fired by the union in June after she spoke out on social media in defense of the people of Gaza and criticized the Israeli genocide. Her case, like the contract betrayal, exposes the union’s political alignment not with workers, but with the Democratic Party and the interests of American imperialism.
There is no way forward as long as the MNA bureaucracy retains control. Nurses and healthcare workers must draw the lessons of this experience: they can only advance their interests through the formation of independent, democratically controlled rank-and-file committees. These committees must link nurses, APPs, CNAs, and other hospital workers together across roles and regions, and coordinate action on the widest possible scale—including a fight for full staffing, massive wage increases, and full public funding of healthcare.
Such a struggle must be part of a broader political offensive by the working class against war, austerity, and the capitalist system. The fight for safe staffing and decent pay is inseparable from the fight against the billionaires who have looted public healthcare and plunged millions into misery. Minnesota’s billionaires alone have seen their wealth surge by 25 percent since 2020. Meanwhile, both parties pour trillions into war, repression, and tax cuts for the rich.
The way forward lies not through more appeals to the Democratic Party, but through the building of a political movement of the working class—against both corporate parties and for socialism. Nurses must take the lead.