California voters face Proposition 44 on the November 3, 2026 ballot, an SEIU-UHW-backed initiative statute requiring nonprofit federally qualified health centers to allocate at least 90 percent of annual revenue to mission-related patient services rather than administration or overhead, with penalties for shortfalls and Attorney General oversight of reporting. Clinic associations and providers have mounted opposition through lawsuits challenging qualification and studies projecting substantial penalties or closures for facilities that fail the threshold under current operations. Signature collection succeeded with over one million submissions earlier this year, yet organized resistance from primary care groups and questions over implementation have shaped trader views that rejection remains the more probable outcome ahead of the general election.