Editorial: This ballot measure aims to regulate community clinics, but it could gut them

California’s community-based health centers and clinics provide comprehensive primary care in underserved communities regardless of a patient’s ability to pay. They serve expectant mothers, elders living with chronic diseases and young children in need of routine dental care in communities that have few affordable options for access to care. 

Of the 5.8 million Californians served by community health centers and clinics in 2024, nearly two-thirds of them are Latino — a community that is disproportionately uninsured and more likely to rely on a clinic than a private doctor. Community clinics were created to overcome the steep barriers that keep Latino patients from care, including language, transportation and fear of immigration enforcement.

In Latino communities, these clinics are the foundation of a public health infrastructure that took decades to build. One that works precisely because it was designed to reach our community using healthcare navigators and promotoras and built around language access and cultural competency. 

Our labor leaders know that, but a recent ballot measure backed by Service Employees International Union–United Healthcare Workers West (SEIU-UHW) would put that infrastructure at risk.

The argument from SEIU is that community health clinics, despite being nonprofit organizations,  spend too much on executive compensation and non-essential services. The overall objective behind the measure is to regulate where the majority of the funds go: direct patient care.

We all want more resources to benefit local clinics. But the measure could be far more detrimental and can lead to many clinics closing their doors, further limiting healthcare access for our communities.

The “Clinic Funding Accountability and Transparency Act” would require 90% of community clinic funding to go to program service expenses, but uses IRS definitions that do not include critical supportive services such as translation, transportation and community outreach, all services that make care accessible to our communities. The Attorney General would have the final say in defining what qualified. Clinics that do not meet the standards would be penalized and fined, with funds allocated to clinical worker training and recruitment. 

The California Primary Care Association, which represents more than 2,300 community health clinics, estimates that penalty fees alone would drain $1.7 billion from clinics, pushing two-thirds into the red and forcing them to shut down their operations.

The California Legislature reviewed this proposal earlier this year and killed it. SEIU-UHW then gathered signatures to earn a place for it in the November ballot — an all too common escalation tactic that will place a healthcare policy decision with cascading impacts before the voters. 

At a moment when our safety net needs strengthening — as social programs suffer severe cuts under the H.R.1 bill — this measure would tear major holes in it.

Accountability in healthcare spending is a shared value, but this measure puts community-centered healthcare at risk, particularly for Latino and immigrant communities. 

The CDC and decades of peer-reviewed research confirm that community health workers and promotoras are effective in managing chronic disease and increasing preventive care among Latino populations. 

California’s labor movement has always stood for workers and the communities they call home. The workers SEIU-UHW represents are patients in these very clinics. Their health is a labor issue.

In the face of federal disinvestment, clinic closures and the ongoing assault on immigrant communities, community clinics remain essential. We cannot afford a ballot measure that takes an ax to the essential infrastructure that makes care reachable for Latino and immigrant communities. California’s leaders must stand with the communities they represent.