The nurses union endorsed Mamdani shortly after his Democratic primary win in June.
Hospital representatives insist the union’s demands would cost them billions of dollars over the next three years, which they cannot afford due to massive health care cuts in President Donald Trump’s One Big Beautiful Bill Act. The federal tax-and-spending law will cost New York hospitals billions of dollars annually due to funding cuts and increases in uncompensated care for newly uninsured patients, according to industry lobbyists.
“I welcome the opportunity to sit down with Mayor Mamdani to discuss in detail the financial condition of New York’s hospitals, including the severe federal cuts they’re facing,” Kenneth Raske, president of the Greater New York Hospital Association, said in a statement.
Hospital negotiators have invoked Trump’s megalaw as they rebuff the union’s demands, arguing they can only afford increases of about $4,500 annually to nurses’ total compensation, which includes health benefits.
But the union’s populist arguments have gained momentum since some of the same nurses went on strike in 2023. With Mamdani’s upset victory in last year’s mayoral race, affordability became the word of the year.
“New York’s private healthcare CEOs pocket millions in salaries while our nurses on the frontlines are overworked and underpaid,” Rep. Alexandria Ocasio-Cortez, whose district includes multiple Montefiore hospitals, wrote in a social media post last week. “Our communities and nurses deserve better.”
That dichotomy was underscored Monday during a union press conference down the block from the construction site of a new medical tower for New York-Presbyterian. At an estimated $1.2 billion, the 16-story complex is one of the most expensive hospital projects in New York City in recent years, according to Crain’s New York.
The three health systems have already spent over $100 million to prepare for a strike by hiring temporary nurses, according to the Greater New York Hospital Association. A Mount Sinai spokesperson said the health system has so far brought in 1,400 of them. In a report this week to bondholders, New York-Presbyterian reported spending $60 million on preparations.
The New York-Presbyterian and Mount Sinai health systems are each sitting on billions of dollars in net assets, while Montefiore has hundreds of millions of dollars in net assets that can technically be used as leaders see fit, according to their most recent financial disclosures.
“If these hospitals have money to hire scabs, then they’ve got money and resources to address the needs of these nurses,” state Attorney General Letitia James said during the press conference.
Mamdani’s predecessor took a comparatively milquetoast approach when nurses at some of the same hospitals went on strike in 2023. Then-Mayor Eric Adams called himself a “strong supporter of our nurses” and urged hospitals to “do what’s right to ensure these nurses get the just compensation that they deserve” in two radio interviews. But unlike Mamdani, he refrained from directly criticizing the hospitals involved.
That was then — when the Covid-19 pandemic and its images of overwhelmed hospitals were still a relatively recent memory. The current strike is unfolding as millions of Americans stand to lose low-cost health insurance due to Trump’s Medicaid cuts and congressional Republicans’ decision not to extend enhanced subsidies for Affordable Care Act plans.
Affordable health insurance coverage has been a key sticking point in the contract talks, with hospital negotiators pushing for cost-sharing increases and cuts to the nurses’ prescription drug benefits to reduce costs. The union’s benefits fund covers nearly 18,000 members and 22,000 dependents; that does not include Montefiore nurses, who are covered by the health system’s plan.
Spokespeople for Montefiore, Mount Sinai and New York-Presbyterian said the union’s demands are “extreme” and “reckless” in the face of “the challenging realities of today’s health care environment.” New York-Presbyterian laid off 2 percent of its workforce last year, or about 1,000 employees, due to “current macroeconomic realities.”
The three health systems have not publicly shared their own estimates of the impact of the cuts, which will roll out over the three-year term of the nurses’ eventual agreements. The Greater New York Hospital Association is working on a regional analysis of the cuts’ impact, but a spokesperson said it is not yet complete.
Union leaders argue the hospitals are cherrypicking numbers to make their demands look unreasonable. Mount Sinai, for example, has said its nurses earn $162,000 on average and would take home an average of $250,000 by the third year of the contract under the union’s latest proposal. The current base pay for a nurse at Mount Sinai Hospital starts at just under $122,000 and increases based on title and years of experience, according to the union’s recently expired contract.
NYSNA Executive Director Pat Kane said the cost of the nurses’ demands is driven in part by their own employers. Hospital services are the leading driver of health care spending nationally due to the high price of care, and New York-Presbyterian and Montefiore hospitals are among the most expensive in New York City, data shows.
“They’re complaining about the cost of this health care plan when a lot of that money that they pay for the plan goes right back in their coffers,” Kane said. “It’s ridiculous.”
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