Allina went rogue, according to the nurses’ union. It is dead-set on canceling a set of four sweetheart, union-fought health care plans that currently serve the vast majority of its 5,000 nurses, and transferring everyone to one of three corporate plans that come with higher out-of-pocket maximums and deductibles. Under Allina’s corporate health care plans, nurses and their families would have to switch to Allina doctors or face paying $12,000 out of pocket before their coverage even kicks in.

That means the nurse battling cancer would likely have to drop the oncologist who has cared for her since day one of her diagnosis, and the nurse with children who have grown up seeing an out-of-network pediatrician will all of a sudden have to transfer them to a new one who is unfamiliar with their medical histories. Metro-wide, about 10,000 nurses and their dependents may have to change providers.

On the other hand, Allina would save $10 million.

Allina nurses have been arduously negotiating since February to keep their union health care plans. They have other issues that they want to discuss with their bosses at Allina, like increasing staff to achieve a better patient-to-nurse ratio and reducing physical attacks on nurses. Allina has made health care the sticking point of negotiations, however, and has declined to discuss the union’s other proposals unless it gives in.

The nurses’ current contract expired Tuesday at midnight. Allina’s representatives left the negotiating table Tuesday afternoon without compromising with the union. The Minnesota Nurses Association will now have to take Allina’s proposal to slash health benefits to its members at Abbott, United, Unity, and Mercy hospitals for a vote on whether to accept or reject the changes – and in the case of the latter, whether to authorize a strike.

That vote will take place on June 6. If nurses vote to band together and fight for their health care plans, Allina will be notified of strike plans so that it can make plans for keeping the hospitals up and running or transferring patients. Ultimately, 5,000 registered nurses could picket in mid-June as Allina hires scabs with temporary licenses to stick patients with needles, empty bedpans, take x-rays, and explain complex medications.

Union-busting hiring agencies like HealthSource are already recruiting nurses for “what could be the biggest strike of 2016” in the nation. These temporary workers are being offered about $75 an hour, with a guarantee of about 60 hours – or a week and a half.

Angie Becchetti, 31, has been an Abbott nurse going on eight years. She’s the mother of two children, a one-year-old and a four-year-old. Her family currently sees doctors outside of the Allina network who have served them well through Becchetti’s difficult deliveries and the kids’ broken bones. With her union plan, giving birth cost her a copay. If she were forced to switch to Allina’s plan, it would cost her $7,000 to $12,000 more to have a child, she says.

“Absolutely we would go on strike,” Becchetti says. “We’re fighting for respect for everyone in this profession and the ones who haven’t started this profession yet. We’re prepared to start this journey into the unknown. Nurses have vocalized that they’re willing to go to the end for their patients and themselves and their families. What you’re asking to take away from us, a lot of nurses would leave their current jobs.”

Hypothetically, a strike could last a long time. Back in 1984, Minnesota nurses picketed for 38 days in one of the largest nurses’ strikes in American history. In 2001, Fairview nurses went on strike for three weeks. Most recently in 2010, nurses executed a one-day strike to fight for safe staffing.

Every time, the temporary nurses have struggled to keep the hospitals running smoothly, says Bernadine Engeldorf, a United psychiatric nurse with 38 years of experience.

“I’ve heard all sorts of stories from colleagues, pharmacists, nurses’ assistants, that the replacement workers appeared to be inexperienced, had difficulty managing the patient care at the time,” Engeldorf says. “There were some nurses who went to work and found IV drugs hanging [in people] that shouldn’t have been hanging.”

Two years ago, Engeldorf had a total hip replacement. It cost her $150 for inpatient surgery on both sides under her union plan. The surgeries were worth $48,000. She says she’s never considered how much she would have to pay if she had been enrolled in Allina’s health plans at the time, but the deductible would have been much higher.

“[Allina’s] pretty insistent that the only way they can come to an agreement is if we transition to their healthcare,” Engeldorf says of the failed negotiations. “They haven’t been willing to talk about staffing and workplace violence. That’s very disappointing.”

In a statement, Allina spokesman David Kanihan wrote that the company wants to bring nurses to the same level of care as non-contract employees and doctors at Allina.

“Currently, MNA-represented nurses at Allina have their own separate health insurance plans. These plans have outdated designs and are, consequently, very expensive,” according to Kanihan. “We want to find a way to transition the nurses to the same health insurance offerings that everyone else in Allina has.”

Under the company’s proposal, nurses would not be forced into high-deductible plans, Kanihan wrote. One company plan offers free preventative care, primary care visits for $10, and $27 specialty visits.

Nurses would just have to switch to the Allina network.

Patients have more power to affect their nurses’ working conditions than they may think, Becchetti says.

“I think patients need to vocalize when their call lights aren’t answered on time, or when they sat there in pain because their nurse was understaffed and didn’t have the help they should have had,” she says. “They need to bring their concerns forward because it ultimately is them who are affected at the bedside and that’s what we’re trying to bring forward to our employer.”