SANTA CRUZ, CA – Santa Cruz Community Health (SCCH) is urging voters to reject Proposition 44, warning that the reckless measure would cut $1.7 billion from California community health clinics in its first year, force service reductions and closures, and threaten care for millions of patients, including thousands in Santa Cruz County.

Proposition 44 would impose rigid spending rules that exclude many of the people, systems, and services required to deliver care. Community health centers could be forced to cut services, eliminate jobs, delay essential investments, or close sites.

“Proposition 44 ignores how care is actually delivered,” said Anita Aguirre, Chief Executive Officer of Santa Cruz Community Health. “For safety-net providers like us, the consequences would be devastating — fewer services, fewer care options, and greater barriers for patients who already struggle to get care.”

If approved, Proposition 44 would require community health centers to spend at least 90 percent of annual revenue on a narrow set of “mission-related” expenses. The definition excludes core functions such as health information technology, electronic health records, insurance enrollment, care coordination to specialists and hospitals, interpretation services, workforce development, facility operations, and clinical leadership.

“Care does not begin and end in the exam room,” Aguirre said. “Clinics need trained staff, secure technology, safe facilities, and strong support systems to keep patients healthy.”

SCCH is part of a growing statewide coalition opposing Proposition 44, including patients, doctors, nurses, more than 1,000 community health clinics, and nearly 100 health care and community organizations. SCCH urges voters to learn what is at stake and reject the measure in November.

Locally, the Santa Cruz County Board of Supervisors, the Health Improvement Partnership of Santa Cruz County, and the Santa Cruz County Chamber of Commerce have joined SCCH in opposing Proposition 44.

California’s community health centers are already strained by workforce shortages, rising costs, growing demand, and federal funding reductions. Proposition 44 would remove $1.7 billion in the first year and billions more in future years, pushing clinics toward deep service cuts or closure.

SCCH provides primary care, behavioral health, reproductive health, pediatric care, and chronic disease management to nearly 14,000 patients each year. If community clinics cut services or close, patients will be pushed into hospital emergency rooms for routine care—driving more overcrowding, longer waits, and billions of dollars in higher costs.

“When clinics lose resources, patients lose care,” Aguirre said. “They delay treatment and end up in overcrowded emergency rooms. Those already facing the greatest barriers will be hit first and hardest.”

Proposition 44 would add bureaucracy without adding care. Community health centers already comply with extensive federal and state oversight, including audits, mandatory reporting and public accountability requirements, and are governed by patient-majority boards of directors.

At the same time, new pressures on safety-net clinics like SCCH are coming from the federal level. California is implementing H.R. 1, also known as “The Big, Beautiful Bill” starting with Medi-Cal eligibility restrictions in October 2026, followed by work-reporting requirements and six-month eligibility reviews in 2027. State officials estimate that up to 2 million Medi-Cal members could be affected. As coverage losses drive more uninsured patients to community clinics, Proposition 44 would strip those clinics of resources. Together, H.R. 1 and Proposition 44 could dismantle Santa Cruz County’s health care safety net.

“Santa Cruz County cannot afford to lose its health care safety net,” Aguirre said. “Proposition 44 puts the care our patients and community depend on at direct risk.”

Vote NO on Proposition 44 this November. Visit NoProp44.com to learn more, share the facts, and join the coalition working to protect community health clinics and preserve access to care.

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About Santa Cruz Community Health:

Santa Cruz Community Health (SCCH) is a leading nonprofit Federally Qualified Health Center providing high-quality, comprehensive, and affordable health services. Through the Santa Cruz Women’s Health Center, Santa Cruz Mountain Health Center, and Live Oak Health Center, we welcome the whole family—regardless of language spoken, personal identity, immigration status, or ability to pay.

Founded as the Santa Cruz Women’s Health Center in 1974, SCCH has maintained a 52-year commitment to improving the health of our patients and community while advocating the feminist goals of social, political, and economic equality. Our dedicated team of medical providers, nurses, licensed clinical social workers, medical assistants, and administrative personnel serves over 14,000 patients annually, ensuring access to essential care throughout Santa Cruz County