Prop. 35 threatens to do more harm than good for children, families, seniors who rely on Medi-Cal 

Measure risks billions in budget cuts to Medi-Cal, other vital services for struggling Californians 

[SACRAMENTO, Calif.] Sept. 5, 2024 – Advocates for health care, democracy, communities of color, children and seniors today announced unified opposition to Proposition 35 on the November ballot. The California Pan Ethnic Health Network (CPEHN), The Children’s Partnership, the California Alliance of Retired Americans (CARA), Courage California, and the League of Women Voters of California emphasized the need to strengthen and invest in California’s Medi-Cal program while expressing strong opposition to the way Prop. 35 is written, which advocates say threatens to do more harm than good for communities who count on Medi-Cal.

“As advocates for communities of color who are disproportionately harmed by health inequities, CPEHN must warn voters against Prop. 35. While we strongly support boosting access to health care providers serving our communities, Prop. 35 throws away the hard work communities have done to make health care more equitable,” said Kiran Savage-Sangwan, Executive Director of CPEHN. “Care for people served by Medi-Cal now could be cut by billions of dollars, and California’s progress in expanding health care to all would be stalled or reversed. We say vote NO.” 

Prop. 35 rolls back investments in community health workers, community behavioral health, services that support seniors with Alzheimer’s, and funding to ensure children ages 0-5 don’t lose Medi-Cal coverage at the most critical time for brain development. 

“Instead of increasing Medi-Cal access, Prop. 35 severely jeopardizes funding for the care communities need by limiting funding sources for the program,” said Mayra E. Alvarez, President of The Children’s Partnership. “There is no question that California pays far too little to providers participating in Medi-Cal. However, we oppose Prop. 35 because of its restriction on how the MCO tax revenue funds can be used, the caps on the tax, and who the decision makers are in making those determinations. We can’t go backward on health care equity. Vote NO on 35.”

“The League of Women Voters of California urges a ‘NO’ vote on Prop 35 because it limits the legislature’s flexibility to make budgetary decisions and adjust priorities based on emerging and essential needs,” said Stephanie Doute, Executive Director of the League of Women Voters of California.  

California relies on managed care organization (MCO) taxes to fund Medi-Cal, California’s Medicaid health care insurance program for children, families, seniors and people with disabilities with low incomes. The revenues from the tax are matched by the federal government to bring billions of dollars into this vital health care program. However, Prop. 35 puts these funds at risk because it caps taxes on commercial plans, reducing revenue, and likely won’t be approved under future federal standards. This would mean losing funding for the program while locking in spending for a select group of health care providers.  

"Courage California fights for an equitable California, powered by our people, which is why we must oppose Prop 35,” said Irene Kao, Executive Director of Courage California. “Prop 35 not only shrinks funding needed to expand health care access and improve care to disadvantaged communities, but it denies Californians critical opportunities to advocate for their community’s needs. We urge Californians to make clear that we will not shrink access to care in our communities and vote NO on Prop 35.”

“Through my Chairpersonship in Senate Budget Subcommittee #3 on Health and Human services, we worked to ensure the community providers, who don’t have high-paid lobbyists, had a voice in the budget process. By listening to those with boots on the ground, the legislature developed a plan to equitably address many Medi-Cal concerns over the next few years,” said State Senator Caroline Menjivar. “Prop. 35 excludes community priorities and only prioritizes larger providers, while taking away necessary flexibility in how Medi-Cal dollars are spent.”

The state’s Department of Finance says Prop. 35 would cost the state general fund $12 billion over the next three years. A budget hole of this size would likely force cuts not only to health care but to other critical safety net programs that keep vulnerable Californians healthy, like housing and food support. An analysis from the California Budget and Policy Center says “such cuts would likely harm Californians with low incomes most” and “raise health equity concerns, as they would disproportionately impact people of color, children, older adults, and people with disabilities.” 

“Prop. 35 passage rolls back funding for community-based services to older adults and adults with conditions that make them at risk of needing institutional care. Beyond that, it would cut funding for living facilities that provide essential services to severely disabled seniors,” said Ramón Castellblanch, the Vice President of the California Alliance of Retired Americans. “These and other programs relied upon by many seniors are already severely underfunded; Prop. 35 would exacerbate this situation and we urge a NO vote.”

Prop. 35 prioritizes health care funding for special interests over communities’ health care needs. One-third of Medi-Cal enrollees get their care from community health centers, but only 10 cents from each dollar under Prop. 35 would fund these clinics. Funding for public hospitals, which care for a disproportionate share of Medi-Cal patients, is arbitrarily capped under Prop. 35. Meanwhile, private ambulance providers, like those that funded the initiative, won’t face such caps. 

The San Jose Mercury News editorial board decried Prop. 35 as “another example of special-interest, ballot-box budgeting that limits the discretion of lawmakers and reduces flexibility to respond to fiscal crises.” The board went on to say, “Voters should reject it.”

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About the California Pan Ethnic Health Network
The California Pan Ethnic Health Network brings together and mobilizes communities of color to advocate for public policies that advance health equity and improve health outcomes in our communities. Learn more at cpehn.org.

About The Children’s Partnership
The Children’s Partnership (TCP) is a California-based children’s policy and advocacy organization committed to advancing child health equity through public policy, research and community engagement. TCP envisions a California where all children—regardless of their race, ethnicity or place of birth—have the resources and opportunities they need to grow up healthy and thrive. Learn more at childrenspartnership.org.

About the California Alliance of Retirement Americans
The California Alliance for Retired Americans (CARA) is a statewide nonprofit organization that unites retired workers and community groups to win social and economic justice, full civil rights, and a better, more secure future for ourselves, our families, and future generations. CARA is the official state affiliate of the Alliance for Retired Americans. Learn more at californiaalliance.org.

About the League of Women Voters of California 
The League of Women Voters of California is a nonpartisan, grassroots organization working to protect and expand voting rights, build grassroots power in our communities, drive policy change on the biggest challenges facing our state, and ensure everyone is represented in our democracy. Learn more at lwvc.org.

About Courage California  Courage California unites and equips Californians to hold leaders accountable and take courageous action for change. Learn more at couragecalifornia.org.