California voters reject Proposition 44 to limit community clinics' spending

California voters decisively rejected Proposition 44, a measure that would have mandated community health clinics to allocate at least 90% of their annual revenue to patient care or face state fines, LAist reported.

With 81.7% of voters opposing the proposition, the measure failed as anticipated by prior polling, including a Public Policy Institute of California survey showing only 25% support among likely voters, according to CalMatters.

The defeat marks another loss for the Service Employees International Union-United Healthcare Workers West, which sponsored the measure and had previously seen three similar measures rejected in 2018, 2020, and 2022.

Opposition was led by the California Primary Care Association and other healthcare industry groups, who outspent the union by a 2-to-1 margin. The association emphasized protecting comprehensive patient and community care as a priority.

A nonpartisan Legislative Analyst’s Office report noted clinics currently spend about 80% of their revenue on patient services, below the proposed 90% threshold.

The outcome maintains the current spending flexibility for community health clinics in California, including those serving the Los Angeles area.