The affordability issue has reignited a long-simmering battle between California's medical industry and one of its largest health care worker unions.
SEIU-United Healthcare Workers West, with about 120,000 members, has filed two ballot initiatives to cap medical executive pay and require community clinics to spend most of their revenue on patient care.
The California Hospital Association has responded with its own ballot proposal that would make it harder for unions to spend money on future policy initiatives by requiring rank-and-file union members to approve any spending of at least $1 million on state-level measures or $100,000 on local measures.
The competing measures, which have garnered enough verified signatures to qualify for the November ballot, come at a time when the rising cost of health care is emerging as a top voter concern.
The Service Employees International Union affiliate has seized on angst over affordability to resurrect failed proposals to cap health care executive pay.
Mikey Vaughn, a certified nursing assistant at Cedars-Sinai Medical Center, said the Los Angeles hospital, despite its reputation as the go-to place for the rich and famous, often lacks the supplies and staff he and his colleagues need to do their jobs.
But that's not how hospital officials see it. Cedars-Sinai spokesman Duke Helfand said if the measure was approved, the hospital would be unable to recruit and retain doctors, nurses and specialists, which would drastically impact its ability to provide medical care.
The union wants to limit compensation to $450,000 a year for top executives at hospitals and medical groups, as well as other administrative and management staff. SEIU-UHW does not have an estimate for the amount the initiative would recover from salary packages that exceed the limit. And the initiative does not stipulate how the dollars diverted from the payroll should be spent.
The union has called the proposal the “Healthcare Executive Compensation Act of 2026.” A coalition of medical industry heavyweights who oppose it (hospitals, doctors and clinics, among others) have renamed it the “Healthcare Hazards Act.”
Carmela Coyle, executive director of the hospital association, called the move a cynical political ploy.
And Glenn Melnick, a health economist at the University of Southern California, said that even if the initiative were fully implemented, he doubts it would reduce patients' health care costs.
SEIU-UHW's second ballot initiative, on community clinics, is already in court. The California Primary Care Association, which represents the clinics, filed a federal lawsuit in April seeking to invalidate it before it comes to the November vote.
One of California's largest health care unions is sponsoring two initiatives that would regulate community clinics and cap salaries for executives and managers at hospitals and physician groups. In the latest flare-up of a long-running dispute, the measures have drawn fierce opposition from a wide swath of the medical industry.
