The issue of affordability has reignited a long-simmering battle between California’s medical industry and one of its largest health worker unions.
SEIU-United Healthcare Workers West, with approximately 120,000 members, has put forward two ballot initiatives to cap the pay of medical executives and require community clinics to spend the vast bulk of their revenues on patient care.
The California Hospital Association has responded with its own ballot proposal that would make it tougher for unions to spend money on future political initiatives by requiring a union’s rank-and-file membership to approve any spending of at least $1 million on statewide measures or $100,000 on local ones.
The competing measures, which have drawn enough verified signatures to qualify for the November ballot, come at a time when the rising cost of healthcare is emerging as a top voter concern.
The Service Employees International Union affiliate has seized upon affordability angst to resurrect failed proposals to cap healthcare executive compensation.
Mikey Vaughn, a certified nursing assistant at Cedars-Sinai Medical Center, said that the Los Angeles hospital, despite its reputation as the go-to place for the rich and famous, often lacks supplies and staffing that he and his colleagues need to do their jobs.
But that’s not how hospital officials see it. Cedars-Sinai spokesperson Duke Helfand said if the measure passed, the hospital would be unable to recruit and retain physicians, nurses, and specialists, dramatically impairing its ability to provide healthcare.
The union wants to cap compensation at $450,000 a year for senior hospital and medical group executives, as well as other administrative and managerial staff. SEIU-UHW does not have an estimate of the amount the initiative would claw back from pay packages that exceed the limit. And the initiative does not stipulate how dollars diverted from payroll must be spent.
The union has dubbed the proposal the “Health Care Executive Compensation Act of 2026.” A coalition of medical industry heavyweights opposing it — hospitals, physicians, and clinics, among others — has rebranded it the “Health Care Endangerment Act.”
Carmela Coyle, CEO of the hospital association, called the measure a cynical political ploy.
And Glenn Melnick, a healthcare economist at the University of Southern California, said that even if the initiative were fully implemented, he doubts it would reduce patients’ healthcare costs.
The second SEIU-UHW ballot initiative, on community clinics, is already in court. The California Primary Care Association, which represents clinics, filed a federal lawsuit in April seeking to invalidate it before it reaches the November ballot.
Looming Medicaid Cuts Supercharge California’s Latest Labor-Industry Fight
One of California’s largest healthcare unions is sponsoring two initiatives that would regulate community clinics and cap executive and managerial pay at hospitals and physician groups. In the most recent eruption of a long-standing feud, the measures have drawn fierce opposition from a wide swath of the medical industry.
By Bernard J. Wolfson June 10, 2026 KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.This kffhealthnews.org/health-industry/the-week-in-brief-california-dueling-ballot-initiatives-union-hospital-association/">article kffhealthnews.org">KFF Health News and is republished here under a creativecommons.org/licenses/by-nc-nd/4.0/">Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
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