The Brief

California’s billionaires are not the only ones fighting back against the state’s largest health workers union this election season. Now the clinics are too.

The California Primary Care Association, which represents more than 2,300 community health clinics, and Open Door Community Health Centers filed a lawsuit Thursday to stop Service Employees International Union-United Healthcare Workers West from placing an initiative on the November ballot that would dictate how clinics spend money.

The clinic measure is less prominent than the billionaire-backed fight against a wealth tax, but recently came closer to appearing before voters.

The clinic’s lawsuit, which was filed in the U.S. District Court for the Northern District of California, argues that the union’s ballot measure would interfere with federal laws and regulations that place strict spending requirements on nonprofit health clinics that serve low-income patients.

Joey Cachuela, general counsel for the clinic association said in a statement the initiative threatens patient care. “We are filing this preelection challenge and need the courts to act to prevent this drastic measure from ever going to the ballot. Patient lives are at risk,” Cachuela said.

A spokesperson for the healthcare workers union did not immediately respond to a request for comment.

Dr. Elizabeth Sophy, far right, who is a part of Father Joe’s Villages Street Health Team, examines Devlin Chambers at an encampment in downtown San Diego on March 22, 2024. Chambers, 60, said he has a pinched nerve in his back.

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Kristian Carreon

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CalMatters

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Earlier this month, union members turned in more than 1 million signatures to qualify the “Clinic Funding Accountability and Transparency Act” for the ballot. The union collected nearly double the number of signatures required to place the proposal before voters.

Under California’s election rules, proposals that gather enough signatures qualify for the ballot after the Secretary of State’s office verifies their validity.

The union proposal would require federally qualified health centers to spend 90% of revenue on services that fulfill the stated mission to “provide primary and preventive care to low-income and underserved populations.” It would also punish clinics that do not adhere to this spending formula and place the money in a state-operated account that could later be used for worker training and staffing programs.

“It is the intent of this initiative to create a reasonable minimum standard of mission-directed

spending … to ensure clinic patient service delivery and workforce stability is prioritized over management and overhead spending,” the initiative states.

Union leaders and members argue that clinics spend too much money on executive pay and administrative overhead and too little on patients. They also contend that some clinics spend only half of their revenue on direct patient care, an allegation that clinics call misleading.

“We have one message for our clinics: Put patients first. It’s time for an end to wasteful spending. It’s time to make sure clinics are putting their money in patient care and not CEO-pay,” said Brisa Barrera, a medical assistant from Santa Rosa Community Health during an April rally to celebrate delivering the signatures.

The clinic association, however, argues that the initiative would illegally force hundreds of community health centers to close by stripping nearly $2 billion from health systems.

Tory Starr, chief executive of Open Door Community Health Centers, which operates clinics in Humboldt and Del Norte counties, said the measure would be “devastating” to the organization’s rural patients and would result in layoffs, reduced services and closures.

A nearly identical version of the ballot initiative failed to pass in the state Legislature earlier this year.

The initiative is one of three measures the union has submitted to the ballot. Another aims to limit health care executive pay at $450,000, and SEIU-UHW is also backing the “billionaire’s tax” that has drawn ire from both Democrats and Republicans.

Supported by the California Health Care Foundation (CHCF), which works to ensure that people have access to the care they need, when they need it, at a price they can afford. Visit www.chcf.org to learn more.

This article was originally published on CalMatters and was republished under the Creative Commons Attribution-NonCommercial-NoDerivatives license.

Progressive Jane Kim, one of two Democratic candidates for California insurance commissioner, is betting that voters are as hungry for change as those who powered Zohran Mamdani into New York City's mayor's office and Abdul El-Sayed into Michigan's U.S. Senate race after the Democratic Party endorsed her rival, state Sen. Ben Allen.

How it plays out could rest on how engaged voters will be about an elected position they may not know much about; how much weight disillusioned voters give to the state party's endorsement; and how much they respond to ads and mailers that they’ll be bombarded with ahead of the November election.

Kim, a former member of the San Francisco Board of Supervisors, is squaring off against Allen to become the regulator of the state’s massive insurance market. Kim wants to establish state-run natural disaster insurance for all and expand low-cost auto insurance to all California drivers, in line with well-known progressive ideas like Medicare for All. Allen wants to stabilize and improve the private insurance market after years of availability and affordability problems largely driven by increased wildfire risk and massive, deadly wildfires.

Kim’s message has struck a chord with many Californians: She got the most votes, more than 27%, among the 11 candidates on the ballot in the June primary. Allen came in second with more than 19%.

“(Kim and Allen are) a microcosm of the fracture going on in the Democratic Party across the country,” said Shauhin Talesh, a law professor at UC Irvine whose expertise includes insurance and consumer protection. “They both think insurance companies should be regulated. The question: How aggressively should California intervene and what role should the government claim?”

Allen recently secured the California Democratic Party’s endorsement, which Talesh said wasn’t surprising because the senator is seen as a more “traditional” candidate.

Kim, whose accomplishments include securing free community college for San Francisco residents and the state’s first $15 minimum wage, was the director of the California Working Families Party, a party within the Democratic umbrella that supports progressive policies including raising the minimum wage. She is backed by U.S. Sen. Bernie Sanders, on whose presidential campaign she worked in 2020.

“Is this going to become another situation where people are speaking with their votes (and going against the establishment)?” Talesh asked. “At what point does Democratic Party recognize it?”

But Kim isn’t just lacking the state party’s endorsement. The insurance industry is, not surprisingly, leery of her plans to have the state play a greater role in insurance. So are some consumer advocacy groups such as Consumer Watchdog, whose founder wrote the ballot initiative that became the state’s insurance law.

Jamie Court, president of the group, warned that a state-run natural disaster insurance fund — which Kim says would be funded by portions of premiums policyholders pay to their insurance companies — would require tens of billions of dollars to start, which he said could be wiped out by one catastrophic fire.

Kim has said that while her proposal would require further study, her critics fail to address that there needs to be more discussion and “public engagement to reform the system.”

“I don’t think just allowing the insurance industry to raise rates is the solution,” she told CalMatters in an interview. “People will lose their homes or go uninsured. And that will wreck the economy.”

Allen told CalMatters that his opponent’s proposal “is effectively a massive subsidy for those who are rich” because their homes will cost more to replace after a fire.

Maurice Mitchell, national director of the Working Families Party, said Kim’s message is resonating with Californians because of “a populist wave, not a progressive wave” nationwide.

He noted that primary results showed Kim did well in historically conservative areas such as the Inland Empire and the Central Valley, as well as in Los Angeles County — which includes Allen’s district.

Considering those results, Jorge Contreras, California director of the Working Families Party, called the state Democratic Party’s endorsement of Allen “out of touch.”

Some delegates for Kim complained their votes did not seem to be counted; Kim called for a recount.

“The votes were counted,” said Robin Swanson, spokesperson for the party. “And recounted. The result was the same.”

Insurance Commissioner candidate Ben Allen delivers remarks during the California Democratic Party convention at Moscone Center in San Francisco on Feb. 21, 2026.

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Yalonda M. James

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San Francisco Chronicle via AP

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Contreras noted that the next day, the California Labor Federation endorsed Kim.

Not everyone buys the "moderate" label being pinned on Allen — including at least one of his own supporters.

“Ben is a progressive by any standard,” said RL Miller, former chair of the California Democratic Party’s Environmental Caucus who also runs a political action committee, Climate Hawks. The group doesn’t endorse in California races, but Miller said she personally endorsed Allen.

“He’s stood with us and authored landmark climate bills over the years,” Miller said, adding that the “tribal nature of Democratic politics these days” might be the reason Allen is being seen as the more moderate candidate.

Allen has a strong track record on the environment, including his work on Proposition 4, the $10 billion bond measure approved by voters in 2024, which includes funding for wildfire prevention. He also authored the law that decreases the use of single-use plastics.

Allen’s votes have also been more aligned with some of the same groups now supporting Kim, including the California Labor Federation. The senator’s record has generally not aligned with business interests, according to CalMatters’ Digital Democracy database.

Though both candidates have pledged not to take money from the insurance industry, Contreras said it’s important to follow the money in this race.

Business groups spent $1.5 million to oppose Kim’s primary campaign, mostly from JOBSPAC, a coalition of employers sponsored by the California Chamber of Commerce, according to Digital Democracy.

Meanwhile, Contreras said “Ben Allen has taken crypto money, which came in big for him at the end.” Campaign finance records show billionaire Chris Larsen, co-founder of crypto company Ripple, in May gave $1 million to the PAC sponsored by California Environmental Voters, the biggest outside spender supporting Allen’s campaign.

Contreras said billionaires are going to spend a lot of money supporting moderates this election cycle: “Why? Because they want the status quo. Jane is now going to be the bogeyman.”

Jane Kim speaks to supporters during an election night party at El Rio in San Francisco on June 2, 2026.

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Beth LaBerge

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KQED

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The biggest contributors to Kim’s campaign are the California Working Families Party and the California Teachers Association, which gave about $365,000 and $150,000 each, respectively.

The main difference between this battle and other contests going on elsewhere is that many voters don’t know exactly what the insurance commissioner does, said Kevin Liao, a Democratic political consultant who briefly worked on Allen’s campaign before leaving to work on Tom Steyer’s gubernatorial campaign during the primary.

That could mean that voters will rely on shortcuts such as Sanders’ endorsement of Kim, or the California Democrats’ endorsement of Allen. The race could come down to whose brand will convince voters, he said.

“We’re at a moment when voters, certainly the base of the Democratic Party, are fed up with the party establishment,” Liao said.

But not all candidates with more progressive ideas have found success: In California, the progressive Steyer failed to advance to the general election. Recently, David Crowley, a moderate Democrat, beat Francesca Hong, a democratic socialist, in the Democratic primary for Wisconsin governor by less than a percentage point.

This article was originally published on CalMatters and was republished under the Creative Commons Attribution-NonCommercial-NoDerivatives license.

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Regular reports out of immigrant detention facilities, some as recent as last month, indicate a pattern of complaints: bad water, untrained staff and slow response times to acute and chronic medical conditions.

Despite those complaints — echoed by disability rights groups, a federal judge and the California Justice Department — Immigration and Customs Enforcement detention facilities have received high marks on their own internal scorecards.

An analysis by the Project on Government Oversight found that, under the Trump administration, the number of ICE detention facilities with the agency’s highest inspection grade, “superior,” has tripled since 2024. That coincided, the analysis found, with weakened detention standards and fewer inspections.

Those “superior” ratings have coincided with a rise in deaths in immigration detention custody — 2025 was the deadliest year in ICE custody since 2004.

Four people have died at the Adelanto ICE Processing Center since August 2025, according to the Project on Government Oversight, the most of any facility in the country during that span.

The ratings come from ICE’s Office of Detention Oversight, which also grades the facilities for “deficiencies,” or violations of ICE detention standards. Those failures are important: If a facility fails twice in a row, it can lose federal funding.

“Despite this provision — or perhaps because of it — detention facilities rarely received failing grades from inspectors between fiscal years 2022 and 2026,” the Project on Government Oversight investigators wrote.

ICE detention facilities are holding a record number of people, at least 65,000 on July 11. But even with that skyrocketing custody population, ICE has also found fewer violations among its facilities.

The analysis found that the number of violations at ICE facilities dropped by 68% between 2022 and 2025.

The Project on Government Oversight, which describes itself as a nonpartisan investigative nonprofit, said in its report that ICE did not respond to multiple interview attempts. The nonprofit released its findings this morning and CalMatters is seeking comment from ICE.

When news media organizations reach out to for-profit prison companies that run these detention centers, like GEO Group and CoreCivic, about complaints, they often point to these federal detention standards as a counterpoint to specific allegations.

This article was originally published on CalMatters and was republished under the Creative Commons Attribution-NonCommercial-NoDerivatives license.