By El Popular News Editorial
From clinics along Arvin and Lamont to community health centers here in Bakersfield, families across Kern County rely on a safety net built specifically for communities like ours. Independent analysts warn that Proposition 44 would hit rural and Central Valley clinics the hardest—places where the nearest alternative is often a long drive away. This publication recommends voting NO this November.
At first glance, Proposition 44 sounds reasonable: it requires nonprofit community clinics to allocate at least 90 percent of their revenue to direct patient care. In practice, this is far more complicated and costly for the clinics our friends and family actually rely on.
Let’s start with what the measure does and doesn’t include. Nurse managers and medical leaders don’t count. Translation services don’t count. Staff who help a family enroll in Medi-Cal, and drivers who take a patient to an appointment they otherwise couldn’t make, don’t count either. Even the cost of building a new clinic or expanding an existing one is excluded from the 90 percent. A community clinic here doesn’t run on exam rooms alone, and a rule that excludes the staff and services that keep a clinic running doesn’t protect patients. It just makes the goal harder to achieve.
Independent research confirms this. Health economists at the Berkeley Research Group found that the measure will divert $1.7 billion from community health centers and clinics statewide, and that nearly two-thirds of all health centers and clinics would end up operating at a loss. California’s own nonpartisan Legislative Analyst puts it bluntly: clinics could close. That same office estimates the measure would raise statewide health care costs by more than $1 billion, largely because patients clinics can no longer treat will end up in much more expensive emergency rooms.
The measure also leaves the decision of which expenses qualify in the hands of the state Attorney General, not a doctor, not a clinic administrator, not the community. Clinics that fail to meet the target pay a fine. This is money taken directly from healthcare to cover a penalty.
The clinics earned the community’s trust by serving people according to their needs. Sierra Vista Clinic opened in 1971 specifically to serve migrant farmworkers in Kern and Fresno counties, and today it serves nearly 200,000 people a year. By federal law, these clinics are already required to have a majority of their board members be patients, and they are held accountable annually to rigorous state and federal audits. This level of outreach and accountability exists because a clinic can invest what is necessary to reach out to people, not just to treat them when they arrive.
Those who support Proposition 44 argue that anticipated federal health care cuts are the reason to act now. That reasoning is misguided. Clinics are already preparing for less federal support, and the more than 1.6 million Californian children who rely on them, including students at school health centers, do not need an additional state penalty.
The opposition includes a broad coalition of those who actually run and operate these clinics: the California Primary Care Association, the California Medical Association, the California Hospital Association, and the California Academy of Family Physicians, along with clinic systems like AltaMed Health Services and Family Health Centers of San Diego. They understand better than anyone what a 90 percent mandate means, in practice, for a patient in the doctor’s office.
This publication recommends voting NO on Proposition 44.