Nurses with Children's Minnesota will vote Thursday whether to authorize a strike at the organization's two Twin Cities hospitals amid a contract dispute over health benefits.

The vote would be the first in the 2019 bargaining cycle as nurses negotiate new contracts with the major Twin Cities hospitals, a group that includes the Allina, Children's, Fairview and HealthEast systems, as well as Methodist Hospital in St. Louis Park and North Memorial Medical Center in Robbinsdale.

Union negotiators at Children's say nurses are frustrated over the hospital's cost-shifting, which is making traditional health insurance increasingly expensive and pushing nurses into high-deductible plans with less generous benefits.

"They're pricing us out of the better insurance," said Elaina Hane, a pediatric intensive care nurse and part of the Minnesota Nurses Association negotiating team with Children's.

Technically, the nurses are voting on the most recent contract terms offered by Children's, but it is essentially a strike vote because the union hasn't agreed to several of those terms, including pay raises.

Children's officials said they were surprised and disappointed by the strike vote because the two sides had reached agreements on other contract terms.

"Strike votes normally do not occur until the parties have exhausted their efforts to reach a mutual agreement. We are not at that point," said Katie Penson, Children's senior director of clinical services, critical care.

A "no" vote on the contract would give the Children's nurses the authority to strike, but no dates have been set. Negotiations continue Friday.

Whether the vote could influence talks at other hospitals is unclear. None of the bargaining units have reached agreements over wages, but they have made progress in other areas, including provisions to protect and support nurses who are victims of workplace violence.

A showdown over health coverage evokes memories of 2016, when nurses at Allina hospitals twice went on strike seeking to preserve their insurance benefits, which they argued were necessary given the high rate of injuries on the job.

Hane said Children's nurses, despite caring for minors, are prone to the same pains and strains as other caregivers. "There's a lot of nurses that end up having knees replaced or shoulders fixed," she said.

The nurses' health insurance options are the same offered to other Children's employees, so hospital leaders are reluctant to make changes. The union has asked for a three-year freeze on premium costs.

Penson acknowledged that premiums have risen sharply for the plan with the most generous benefits but said that's because the plan's deductibles and benefit levels have remained the same for years.

"Children's ... still pays the lion's share of costs for this plan and the two other available plans," she said.

Hane said the total cost of insuring a family under that plan has increased 33% over nine years, but the cost to employees has increased 132%, while the cost to the employer has increased only 8%.