Proposition 44 will be on the midterm ballot in California on Nov. 2. The measure proposes the creation of the Clinic Funding Accountability and Transparency Act, which would require Federally Qualified Health Centers (FQHCs) to spend at least 90 percent of their revenue on mission-directed goals.
If passed, this proposition would negatively affect UC students’ access to healthcare and career advancement opportunities.
Proposition 44 puts strict spending regulations on FQHCs and imposes heavy fines if those spending regulations are not met. It specifically requires that 90% of a clinic’s revenue be spent on IRS Form 990, Part 3, Line 4e. Clinics would only be able to use 10% of their funds for necessities that are not included in this part of the tax form, including translation assistance, insurance enrollment services, specialized technology and telehealth services.
Currently, FQHCs would face up to $1.7 billion in fines within the first year of Proposition 44’s requirements. As a result, many health centers would close. Community health centers are required to provide care regardless of a patient’s insurance status. Without them, thousands of patients on Medi-Cal plans would struggle to find adequate care.
UC Irvine students would likely be impacted even more than the average Californian. The nearest clinic to UCI, the Exer Urgent Care at UTC, is an FQHC enrolled in the Coalition of OC Community Health Care Centers (Coalition OC). If it were to go out of business, students without UC SHIP insurance would not have an urgent care within walking distance. According to Erick Delgado, the Program Manager of Health Systems Transformation at Coalition OC, this problem is common in the region.
“Orange County doesn’t have a county hospital system,” he said. “What that means is that there will be no one to pick up the slack where the safety net falls.”
The closure of FQHCs would also impact the UC medical institutions. A study completed by the Berkeley Research Group and the California Primary Care Association concluded that UC clinics could face unmanageable demand as Californians relocate to new clinics. The change could reduce student access to clinics and drive up the costs of UC operations.
Proposition 44 would also have drastic ramifications for UCI’s public health department. While the text of Proposition 44 criticizes clinics’ recruitment and retention of healthcare workers, Delgado argues that those very programs will be negatively impacted by new spending requirements.
“On employment, a lot of advancement would be gone. The careers themselves would probably be gone,” he said. “So much of the population health work would also be lost — so much of that deep knowledge that we have about how populations work, about the kinds of needs that they have, about the kind of care that is necessary for us to develop and treat them better.”
Despite attending a highly ranked Public Health program, clinic closures would reduce local access to networking opportunities and places to gain practical experience. This would put UCI students at a disadvantage compared to students in other regions and states.
To preserve accessible healthcare for ourselves and for our community, it is imperative that we vote no on Proposition 44.
Editor’s Note: Editorials should not be interpreted to reflect the opinion, thoughts or beliefs of any individual New University editor, staff member or affiliate.
