A new health care provider is coming to Monterey County. That’s great news or terrible news, depending on who you ask.

Sara Rubin here, reminding myself to call the doctor for an annual wellness exam—something my memory prompts me to do every January, maybe in the spirit of New Year’s resolutions, even though I cannot remember when I’m actually due to visit. 

Beyond the personal reminders, our team at the Weekly has been checking in with local health care providers in recent weeks for updates in the field as we prepared our annual Health & Fitness issue, which comes out tomorrow, Jan. 25. One of the stories we’ve been following up on, and that has been in the hopper for at least two years, has to do with a health care provider (and insurer) that is not currently local: Kaiser Permanente. 

Kaiser serves millions of patients in eight states, plus Washington, D.C. The health care giant operates 39 hospitals, 737 medical offices and employs nearly 223,800 people in technical and clerical roles, plus nearly 24,000 physicians and over 68,000 nurses. In 2022, its operating revenue was $95.4 billion. 

And as early as 2025, Kaiser will open a clinic in Salinas, with eyes on a second location on the Monterey Peninsula, possibly in Marina. 

This is a news story we’ve been working to confirm since our team first heard in 2021 about Kaiser entering the Monterey County market. Finally, thanks to the California Public Records Act, I discovered that Kaiser applied for a building permit from the City of Salinas in September, and got the green light on Dec. 20 for an old Babies ‘R’ Us on North Davis Road. (You can read more in the news section in tomorrow’s paper; in a statement provided yesterday, Kaiser finally confirmed its intent to operate in Monterey County.) 

For many Monterey County residents, this is fantastic news. Labor leaders and unions have long been wanting more competition in the local health care marketplace. The thinking goes that with another provider/insurer, costs will be forced down. Staff writer Pam Marino reported in October on local workers appearing at the newly formed Office of Health Care Affordability Board in Sacramento, created in 2022 by the California Legislature, to share stories of laughably high costs of care. Many of those same labor organizations are now urging local authorities to expedite Kaiser’s arrival in Monterey County. That push includes, for example, a campaign from the Monterey Bay Teachers Association urging members to sign a letter to Natividad asking the hospital to accept Kaiser insurance, with 349 signatures and counting.

Existing local medical providers are not enthusiastic about Kaiser’s arrival in Monterey County. When approached to ask if they’d accept Kaiser insurance, each local hospital said no. 

A big part of what has them worried is not the spirit of competition, but the totally broken system of health insurance. In effect, private insurance—plans like Anthem, Aetna, Blue Shield—pay much better than government insurance, specifically Medicare or Medi-Cal. The math for existing local providers essentially requires private insurance companies to subsidize the cost of caring for government-insured patients. If Kaiser siphons off too many privately insured patients, leaving a higher proportion of Medi-Cal patients behind to seek care in other systems—well, those systems (Salinas Valley Health, Montage, Natividad) could face a big numbers problem.

Love it or hate it, Kaiser’s Salinas location is now in progress. Based on regulatory approvals required from the California Department of Insurance and California Department of Managed Health Care, the earliest that could happen is early 2025. 

It’s then that we will really start to see what Kaiser’s presence here actually means for Monterey County patients and providers, and we’ll be closely watching.

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