What is Proposition 44
Proposition 44 is a California ballot initiative on the November 3, 2026 ballot. It would require certain private nonprofit safety-net clinics, including affected Federally Qualified Health Centers, to spend at least 90% of their annual revenue on qualifying healthcare services. The California Attorney General would determine which expenses qualify, and clinics that fall below the requirement could face financial penalties.
What Proposition 44 Would Actually Do
Clinics already spend most of their revenue on patient care. But a rigid 90% mandate leaves little room for the things that keep quality care running: facilities, technology, staffing infrastructure, and the administrative work required to serve Medi-Cal and uninsured patients well.
Get the Facts
- $1.7 billion in first-year cuts to community clinics
- Threatens care for children, working families, seniors and veterans
- Penalizes clinics for investing in essential staff and patient services
- Puts politicians between patients and their healthcare providers
The real risk: clinics that can’t meet the spending formula may be forced to cut services — or close altogether — reducing access exactly where communities depend on it most.
