Yes on 40

Why Does The California Primary Care Association Oppose Proposition 40 Funding For California Primary Care?

As massive federal cuts threaten to shutter community health clinics across the state, CPCA leadership inexplicably opposes only funding solution that would save its own members

SACRAMENTO, Calif. — A damning new report commissioned by the California Primary Care Association (CPCA) reveals the grave threat federal healthcare cuts pose to patients and community health centers across the state. It also raises serious questions about why CPCA’s President is actively opposing the only viable funding solution that would fix the looming crisis, and save his own members.

According to CPCA’s findings, an estimated 2.3 million to 3 million Californians are expected to lose access to Medi-Cal in the coming years as a result of HR 1. And as its report makes clear, that would have a devastating impact on the 2,300 community health clinics that CPCA claims to represent:

  • Medi-Cal enrollment declines could result in community health centers losing $1.1 billion to $1.4 billion in revenue.
  • On average, community health center revenue could decline by as much as 89% per patient per year from $1,718 to $191.

“As CPCA’s own findings make clear, without revenue from the billionaire tax, California’s community health centers will almost certainly be forced to close,” said Debru Carthan, Vice President of SEIU-United Healthcare Workers West. “Their findings raise questions about why CPCA’s President is actively opposing the only viable funding solution on the table that would keep community health centers open and save CPCA’s 2,300 members.”

Prop 40, known as the Billionaire Tax, is a one-time emergency 5% tax on the wealth of roughly 250 billionaires. It would generate $100 billion in revenue to keep hospitals and ERs open. It would also save the 2,300 community health centers across the state that CPCA claims to represent.

Despite that, CPCA’s President is actively opposing Prop 40 — seemingly more concerned with playing politics and trying to curry favor in Sacramento than saving his own members and protecting care for millions of California families.

Impact of federal healthcare cuts

  • Hospitals, ERs, and clinics will close. Without revenue from Prop 40, federal healthcare cuts are expected to put an estimated 83 California hospitals and clinics at risk of closure. Cuts and closures have already started, impacting communities from Los Angeles, to Oakland, to Glenn County. The patient care crisis will worsen as patients are forced to wait longer and drive further for medical care.
  • Up to 3.4 million Californians could lose their healthcare coverage under Medicaid, including many seniors, children, veterans, and people with disabilities
  • The state could lose about $20 billion in federal healthcare funding every year — destabilizing the health care system and driving up health care costs for everyone.
  • Insurance premiums for Californians who purchase Affordable Care Act plans could rise as much as 97%, and an estimated 400,000 Californians could be priced out of healthcare altogether.

Impact of food assistance cuts

  • Currently, 5.5 million Californians benefit from food aid. 3.5 million are senior citizens and children.
  • At least 754,000 people could lose their entire monthly benefit, with over 3 million households facing reductions.
  • The estimated funding loss is $2.5 to $4.5 billion annually.
  • The SNAP/Cal-Fresh cuts, if not backfilled by other funding mechanisms, are expected to cost California approximately 400,000 jobs over the next nine years.

About Prop 40, the California Billionaire Tax Act

Trump’s “Big, Ugly Bill” slashed funding for healthcare in California to pay for more billionaire tax breaks. These cuts eliminate healthcare coverage for up to 3.4 million Californians and double health insurance premiums for millions more. Prop 40, the California Billionaire Tax Act, will make billionaires finally pay their fair share in taxes to keep local hospitals and ERs open and healthcare affordable for millions of Californians.

Vote YES on Prop 40 to save lives, tax billionaires.

Original article disclosure

Paid for Paid for by Yes on 40 – Billionaire Tax Now – No on 41 & 42, Sponsored by Service Employees International Union – United Healthcare Workers West. Committee’s Top Funder Service Employees International Union – United Healthcare Workers West

Documented support

The following support is documented in published statements or announcements. An individual’s support does not by itself establish endorsement by their employer or institution.

Debru Carthan

Debru Carthan supports the California billionaire-tax initiative, identified as Proposition 40.

The dated article documents this endorsement or public statement of support. Source article (2026-07-23).

Service Employees International Union – United Healthcare Workers West

Service Employees International Union – United Healthcare Workers West supports the California billionaire-tax initiative, identified as Proposition 40.

The dated article documents this endorsement or public statement of support. Source article (2026-07-23).

Arguments, evidence and sources

Additional context with attribution and source links. It distinguishes published evidence from the campaign’s proposed response and conclusions; it does not rewrite the original article.

Community health center funding risk

Chapman Consulting’s May 2026 report, commissioned by CPCA, estimates $1.1–$1.4 billion in community health center revenue losses from Medi-Cal enrollment declines. It considers both federal H.R. 1 and California budget changes. This financial exposure is the evidence underlying the campaign’s argument for replacement healthcare revenue.

Its separate 89% per-patient illustration models removal of PPS payments for the affected state-only Medi-Cal group, not an 89% reduction in all clinics’ revenue. The study does not endorse Prop 40 or establish that all clinics will close.

Why protecting hospitals is a concrete concern

Public Citizen’s March 2026 assessment identifies 83 California hospitals as financially vulnerable to Medicaid cuts. It provides a specific research basis for the campaign’s argument that replacing lost healthcare funding matters to hospital access.

Vulnerability does not mean that 83 closures have occurred or are certain.

  • The Big Ugly Threat to Safety Net Hospitals — Eileen O’Grady; Public Citizen; 2026-03-31. Identifies 83 financially vulnerable California hospitals using financial and Medicaid-exposure criteria. A risk assessment is not a count of hospitals already closed or a prediction that every identified hospital will close.

A dedicated healthcare, education and food-assistance response

The amended initiative directs 90% of funds available after administrative costs to healthcare and the remaining 10% to education and food assistance together. It is designed to replace threatened services with dedicated revenue rather than a general-purpose tax increase.

Proposed allocation, not a guarantee that every threatened service will be preserved.

  • 2026 Billionaire Tax Act — amended initiative 25-0024A1; 2025-11-24. Primary proposed text. The Attorney General hosts the filing; that is not an endorsement. Sections 4 and 5 govern allocations; proposed Revenue and Taxation Code sections 50301–50303 govern the tax and valuation.

People and institutions behind this support and evidence

Chapman Consulting

Organization / institution. Identity connected to the documented support, authorship, or cited evidence on this page.

Identity: Official source 1

Debru Carthan

Person. Identity connected to the documented support, authorship, or cited evidence on this page.

Affiliation: Service Employees International Union – United Healthcare Workers West.

Eileen O’Grady

Person. Identity connected to the documented support, authorship, or cited evidence on this page.

Affiliation: Public Citizen.

Public Citizen

Organization / institution. Identity connected to the documented support, authorship, or cited evidence on this page.

Identity: Official source 1

Service Employees International Union – United Healthcare Workers West

Organization / institution. Identity connected to the documented support, authorship, or cited evidence on this page.

Also identified as: SEIU-UHW; SEIU United Healthcare Workers West.

Member of: Service Employees International Union.

Identity: Official source 1