2026 California Ballot: Proposition 44

Proposition 44: Requires community clinics, which serve low-income patients, to spend 90% of their annual revenue on patient care. Clinics that don't spend the 90% will be penalized by the State.

According to CalMatters:

• This proposition would direct the attorney general to provide guidance on what type of spending qualifies as patient care.
• The measure was put on the ballot by Service Employees International Union-United Healthcare Workers West.
• Opposers say the measure could cost clinics more than $1.7 billion in noncompliance fees in the first year.

FISCAL IMPACT: Increased state costs in the low tens of millions of dollars per year, covered by fees. 

"Yes" Vote: Low-income patient clinics would have to spend at least 90% of their revenue each year on providing health care services, or else face financial penalties by the State.

"No" Vote: No spending requirements would be placed on certain community clinics.

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