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California · November 3, 2026 general election · Statewide ballot measure

Proposition 44: what your vote means

Spending requirement for community health clinics. On every California ballot. Official sources checked October 21, 2026.

Proposition 44 · Initiative statute

Spending requirement for community health clinics

Official ballot title (quoted exactly)

REQUIRES COMMUNITY HEALTH CLINICS SPEND 90% OF REVENUE ON PROGRAM SERVICES. INITIATIVE STATUTE.

As printed in the Official Voter Information Guide, California Secretary of State (title prepared by the Attorney General).

A YES vote means:

Private nonprofit community health clinics (Federally Qualified Health Centers) would have to spend at least 90% of their revenue each year on program services, or pay a penalty to the state.

A NO vote means:

This new spending requirement would not go into effect.

What it would change

  • Who is affected: nonprofit Federally Qualified Health Centers that serve medically underserved areas and their patients.
  • Enforcement: clinics that fall short of the minimum would pay a penalty to the state.
  • Taxes and fees: state enforcement costs would be covered by fees.
  • Fiscal impact (Legislative Analyst): increased state costs in the low tens of millions of dollars a year, covered by fees; other uncertain costs possible.

Official arguments, summarized

Short neutral summaries of the arguments printed in the official voters’ pamphlet. The committees that wrote them are responsible for their content. Read the full text at the link below.

Argument for

Supporters say the rule would hold clinics and their executives accountable and direct more clinic revenue to patient care.

Argument against

Opponents say the requirement could force clinics to close and reduce patient services.

Arguments and rebuttals, Proposition 44, Official Voter Information Guide

Who supports it and who opposes it

These lists come from official campaign filings (registered committees) and public endorsements, each linked to its source. They are not complete, and SaveYourState does not endorse anyone listed. Lists checked October 30, 2026.

Who supports it

Not yet compiled

Who opposes it

Official sources

SaveYourState is independent and nonpartisan, not a government site, and does not take positions on ballot measures. This explainer describes effects only, using the official ballot title, explanatory statement, full text, and fiscal impact statement. If anything here differs from those documents, the official documents control.