Planned Parenthood Mar Monte, as seen in 2022. Workers announced plans to form a union, citing an urgent need to protect access to healthcare amid Medicaid cuts.
Samantha Laurey/The Chronicle
Planned Parenthood Mar Monte workers announced plans Monday to form a union, citing what they said was an urgent need to protect access to healthcare amid the Trump administration’s cuts to Medicaid.
Mar Monte, the largest Planned Parenthood affiliate in the country, last year swiftly closed five clinics across Northern California and the Central Coast — including three in the Bay Area — after President Donald Trump signed a bill into law that eliminated federal Medicaid funding for any type of medical care provided by organizations that perform abortions. With further cuts to Medicaid, known as Medi-Cal in California, on the horizon and ongoing funding uncertainty, Mar Monte workers say they’re worried about the stability of healthcare access for their patients.
“I want to be involved and I want an opportunity to protect staff, protect frontline workers and protect healthcare access,” said Ryah Issa, a registered nurse who splits her time between multiple Bay Area clinics. “I think it’s just important to be here and advocate during this time of upheaval from the Trump administration.”
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Mar Monte workers, who started organization efforts two years ago, said they have filed their request to be recognized as a union and are holding an election that runs May 11-19. Mar Monte leadership can then voluntarily accept the results, should a majority of workers support the union.
Issa stepped away from Planned Parenthood to further her medical education and was at school when news broke of the sudden clinic closures in the summer of 2025. Since returning to work, she’s seen how care has had to shift: fewer services and longer wait times.
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Last year, Mar Monte also started winding down services in family medicine, behavioral health and prenatal care because it could no longer get the costs reimbursed by federally funded health insurance.
“Beside the initial shock of the closures, patients are now having to travel substantially longer distances just to get regular care, STI screenings, pap smears, breast exams,” said Isabel Arezu Elias, a physician assistant at a clinic in Sacramento.
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About 80% of Mar Monte’s patients are on Medi-Cal. Ten million people are expected to lose their health insurance because of nearly $1 trillion in Medicaid cuts over the next decade in the One Big Beautiful Bill Act, according to the nonpartisan Congressional Budget Office. Mar Monte operates 30 clinics serving 300,000 patients in the Bay Area, Central Valley, Central California coast and Nevada.
The provision of the law freezing Planned Parenthood out of Medicaid reimbursements lasts for one year. Whether funding returns will depend on whether Congress acts before July 2026.
Gov. Gavin Newsom signed a bill this year to provide a one-time $90 million emergency infusion to the organization, but that doesn’t solve its long-term funding challenges.
In March, Mar Monte clinics began launching new services in Northern California, including Botox injections and hangover-helper IV drips, to bolster revenue under the Trump cuts. The clinics’ leaders see it as a way for patients seeking cosmetic and other elective treatments to help fund the organization’s core mission to provide affordable and free healthcare to low-income families.
“Planned Parenthood is often seen as a family planning center, but we provide wrap-around health care to low-income communities, including communities of color, which rely on us for ongoing care,” Selene Sotoa, a patient care coordinator at the Mar Monte Woodland clinic, said in a statement.
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Sotoa said union representation would secure workers’ voices in decisions over staffing and resources under threat by the cuts. Planned Parenthood workers at affiliates in Oregon, Maine, Minnesota, Chicago, Washington, D.C., and other parts of California, have already formed unions in response to the Trump administration and the changes they have prompted in their clinics’ staffing, pay and workplace conditions.
“Healthcare workers across the country are facing increased financial pressures, a lot of uncertainty and strain on safety nets,” Arezu Elias said. “Forming our union now helps us as workers, helps us be part of the decisions being made in this landscape and protects our co-workers, our communities, our patients and the care that we provide.”
The new union drive already has support from one of the state’s most celebrated labor leaders: Dolores Huerta.
“Healthcare workers organizing today are carrying forward a long struggle to protect reproductive care facing serious attacks: from efforts to defund Planned Parenthood to broader attempts to weaken essential public health services,” Huerta said in a statement. “When workers stand together, they are not only improving their working conditions, they are defending access to care, dignity, and health for the communities.”