Skip to main content

A New Healthcare Ballot Proposition in 2024

As of May 31, 2024, there are 13 statewide initiatives qualified for the ballot in the upcoming general election this November―and that number is expected to increase prior to the June 27 qualification deadline. 

One important healthcare initiative that will likely appear on the ballot in November is the Protect Access to Healthcare Initiative. In late April, proponents of the measure collected over 800,000 signatures in support of the initiative, almost 250,000 more signatures than the required 546,651 signatures needed for qualification.¹ 

Filed by California Medical Association (CMA) and the Coalition to Protect Access to Care, this ballot initiative would permanently establish the tax on managed care organizations and would require the Department of Health Care Services (DHCS) to structure the permanently authorized tax according to the most recent version of the tax renewed in 2023. The department would be authorized to modify the tax to receive federal approval. The tax is a charge on the number of enrollees in organizations that deliver healthcare primarily to Medi-Cal participants.² 

After last year’s passage of AB 119, the Budget Committee’s bill to reestablish a version of the Managed Care Organization (MCO) tax through December 2026, members of the healthcare community are aiming to make this state fund revenue permanent via the ballot measure process. 

AB 119 generates new state funds that can be used to match federal funds and bring additional dollars to expand the state’s Medicaid program, Medi-Cal.   

Over the past few years, more Californians have qualified for Medi-Cal coverage due to the governor’s changing requirements on eligibility. But coverage does not equal access. 

Historically, Medi-Cal has been greatly underfunded. Securing funding through statutory mandate and implementing previous Medi-Cal reimbursement increases for certain providers may create a path for a more robust program. In turn, this might ultimately lead to a long-term increase in patient access to care.   

Gabriela Villanueva is CAP’s Government and  External Affairs Analyst. Questions or comments  related to this article should be directed to

¹Ballotpedia. California 2024 ballot propositions; California 2024 Elections. Accessed May 10, 2024.

²Ballotpedia. California Managed Care Organization Tax Authorization Initiative (2024). Accessed May 13, 2024.…