Know Before You Vote: Propositions 43, 44, 45
By Engage Tuolumne
Published: October 2, 2026
Last updated: October 1, 2026
Your Guide to California’s November 3 Ballot Propositions
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This is the fifth in a series of articles on the 14 propositions appearing on the November 3 ballot. The entire series is under the Election Watch tab
Proposition 43: Limits Voters’ Ability to Raise Revenue for Local Government Services. Legislative Constitutional Amendment
What it does
- Currently, local governments generally need two-thirds voter approval to impose, extend, or increase special taxes—taxes dedicated to a specific purpose. However, this two-thirds requirement does not currently apply to special taxes proposed through voter signature gathering.
- Proposition 43 would change that by increasing the approval threshold for voter-proposed local special taxes from a simple majority (over 50%) to two-thirds.
- The change would apply to voter-proposed local special-tax measures approved beginning January 1, 2027.
What it doesn’t do
- It would not allow voter-proposed special taxes to continue passing with a simple majority.
- It would not create a new, more flexible path for local voters to approve funding for services such as law enforcement, fire protection, roads, and other local priorities.
- The Legislative Analyst’s Office says the measure could result in lower local government tax revenues in the future, although the actual impact would depend on future decisions by voters and local governments.
Arguments in favor
- Makes it harder for local officials and special interests to raise taxes by restoring a two-thirds vote requirement for voter-proposed local special taxes.
- Closes what supporters describe as loopholes in Proposition 13 that allow certain local tax increases to pass without the two-thirds threshold.
- Protects taxpayers by applying the two-thirds requirement to local special taxes, including certain sales, property, utility, and other taxes.
- Prevents special taxes from passing with a simple majority during lower-turnout elections.
A YES vote means voter-proposed local special taxes would need approval from two-thirds (66.67%) of voters to take effect.
Arguments against
- The measure could make it harder for communities to raise revenue needed for local services.
- A higher threshold could make it easier for well-funded interests to block tax measures supported by a majority of voters.
- The measure would not directly lower existing local taxes, but would raise the number of votes needed for certain voter-proposed tax measures to pass.
A NO vote means certain voter-proposed local special taxes could continue to be approved by a simple majority.
Who supports it
- California Taxpayers Association
- Family Business Association of California
- California Hispanic Chambers of Commerce
- Howard Jarvis Taxpayers Association
- California Small Business Association
Who opposes it
- Xavier Becerra, former United States Secretary of Health and Human Services
- Democratic Party of California
- California Democratic Socialists of America
- Evolve California
- League of Women Voters of California
- California Labor Federation
- League of California Cities
- California Federation of Teachers
- California Special Districts Association
- California State Association Counties
Proposition 44: Requires Community Health Clinics to Spend 90% of Revenue on Program Services. Initiative Statute.
What it does
- Requires nonprofit Federally Qualified Health Centers (community clinics that provide primary care to medically underserved communities) to spend at least 90% of their revenue on “program services” that advance their charitable purpose, including but not limited to direct patient services.
- Gives the Attorney General authority to issue guidance explaining which expenses qualify as “program services.”
- Allows monetary penalties to potentially be refunded if a clinic becomes compliant within five years.
- Allows criminal charges for submitting false reports or intentionally manipulating spending calculations to meet the 90% requirement.
What it doesn’t do
- Does not allow community clinics to spend more than 10% of their revenue on expenses that may not qualify as “program services,” including certain administrative costs.
- Does not specifically provide additional funding to strengthen the healthcare workforce, recruit and retain employees, expand services, or invest in the infrastructure needed to deliver modern healthcare.
- Does not directly address the financial stability of community clinics, which could affect their ability to maintain or expand care.
- Does not establish a specific cap on CEO salaries.
Arguments in favor
- Gives the Attorney General authority to clearly define which expenses qualify as program services.
- Helps redirect what supporters consider excessive overhead and executive spending toward patient care and other healthcare services.
- Generally limits spending outside qualifying program services to the remaining 10% of revenue.
- Requires clinics that fall below the 90% threshold to pay a penalty, while allowing that penalty to potentially be refunded if the clinic becomes compliant within five years.
A YES vote means affected community health clinics would be required to spend at least 90% of their revenue on healthcare and other qualifying program services.
Arguments against
- Penalizes clinics for spending money on important services and investments, including staffing, transportation, telemedicine, employee training, medical technology, and infrastructure such as mammography, CT, and X-ray equipment. They also point to expenses involved in building new clinics or expanding existing locations, as well as building rent and leases.
- Gives the State Attorney General—an elected official who may not have healthcare experience—significant authority over which types of healthcare-related spending qualify under the measure.
- Adds another layer of requirements to community health clinics that are already subject to extensive federal and state regulations, spending requirements, audits, and reporting.
A NO vote means affected clinics would not be required to spend at least 90% of their revenue on healthcare and other qualifying program services.
Who supports it
- California League of United Latin American Citizens
- NAACP California/Hawaii State Conference
- California Taxpayers Association
- Environmental Policy Innovation Center
- Committee to Build an Affordable California
- American Clean Power—California
Who opposes it
- American Academy of Pediatrics, California
- California School Nurses Organization
- California Medical Association
- California Primary Care Association
- American College of Obstetricians & Gynecologists, District IX
- Planned Parenthood Affiliates of California
- National Association of Social Workers, California Chapter
- American College of Emergency Physicians, California
- California Academy of Family Physicians
- California Democratic PartyOne name/organization per line
Proposition 45: Modifies Environmental Review for Certain Projects. Initiative Statute.
What it does
- Amends the California Environmental Quality Act (CEQA) to speed up environmental review for certain types of projects, including many housing, transportation, water, healthcare, wildfire prevention, education, internet access, and clean-energy projects.
- Sets specific deadlines for public agencies to complete environmental reviews and take required actions.
- Creates an expedited environmental-review process that limits some of the current requirements for agencies to consider different feasible alternatives for reducing a project’s environmental impacts.
- Establishes deadlines for filing and resolving lawsuits challenging project approvals.
- Requires agencies and project applicants to consult about the project only with California Native American tribes that are formally recognized by the federal government.
- Limits the amount of time agencies can accept comments from the public and other government agencies about a project.
- Allows courts to stop only the portion of a project affected by a CEQA violation while the agency works to correct the problem.
What it doesn’t do
- Does not completely exempt covered projects from environmental review. Eligible projects would still be reviewed under CEQA, but through modified procedures and tighter deadlines.
- Does not automatically approve a project. Cities and counties would continue to have the authority to approve or deny projects.
- Does not require developers to build any particular project. It creates an optional expedited process for eligible applicants, who could choose either the new procedures or the existing process.
- Does not guarantee that housing, electricity, water, or other costs will decrease.
- Does not eliminate all environmental laws or regulations.
- Does not prevent people or organizations from challenging projects in court.
Arguments in favor
- Speeds up development while maintaining important environmental protections.
- Helps address California’s high cost of living by making it faster and potentially less expensive to build essential projects, including water-supply and water-quality projects, hospitals and healthcare facilities, wildfire-prevention projects, schools and classrooms, roads, bridges and public transit, clean-energy projects, and electric-grid infrastructure.
- Requires agencies to identify the information they need when an application is submitted and establish clearer, more binding timelines.
- Sets deadlines for courts to resolve CEQA challenges and limit what courts can consider in certain cases.
A YES vote means Eligible projects would have access to a faster environmental-review process and a streamlined process for resolving court challenges instead of following the existing CEQA process.
Arguments against
- Opponents argue that Proposition 45 would weaken California’s environmental review law, which is intended to protect communities and the environment from potentially harmful development. They argue that:
- The long-term financial effects are uncertain. Faster construction could lower project costs, but projects that cause environmental harm could create additional costs for governments and communities.
- The measure could reduce the tools available to public agencies to identify and address potential environmental and community impacts.
- Changes to the review and litigation process could lead to more costly disputes and make it more difficult for agencies to enforce CEQA requirements.
- Some long-term costs of inadequate planning could ultimately fall on public agencies and taxpayers.
A NO vote means Proposition 45 would not become law, and the current CEQA environmental-review and court-challenge procedures would remain in place.
Who supports it
- California League of United Latin American Citizens
- NAACP California/Hawaii State Conference
- California Taxpayers Association
- Environmental Policy Innovation Center
- Committee to Build an Affordable California
- American Clean Power—California
Who opposes it
- National Wildlife Federation
- California Communities Against Toxics
- California Environmental Voters
- California Environmental Justice Alliance
- California Nurses for Environmental Health & Justice
- Clean Water Action
- Coalition for Clean Air
- Physicians for Social Responsibility—Los Angeles
- People Over Polluters
- Sierra Club of California
Sources
- California General Election November 3, 2026: Official voter Information Guide, California Secretary of State.
- 2026 Voter Guide: Propositions, CalMatters.
- California 2026 Ballot Propositions, Ballotpedia.