Time to Stop SEIU-UHW’s Abuse of the Ballot

On November 3, California voters overwhelmingly rejected Proposition 44. The measure, sponsored by SEIU-United Healthcare Workers West, would have dictated how community health clinics spend their revenue. Voters also defeated the union’s Proposition 40 wealth tax. Add SEIU’s three dialysis initiatives that lost by widening margins in 2018, 2020 and 2022, and the union has now lost five statewide ballot measures in just eight years.

But despite this losing record, SEIU-UHW will continue filing new measures in its ongoing effort to gain leverage. Each new measure forces a targeted group to choose between financing an expensive political campaign or giving in to the union’s demands. Health clinics raised $39 million to defeat Proposition 44; dialysis companies raised $111 million to defeat Proposition 8 in 2018, even though the union represented no dialysis clinic workers.

Union president Dave Regan explained the appeal in a 2014 memo: “you end up with what you actually want when you use the ballot.” What the union wants is often unrelated to the text of its measures. In 2014 it withdrew two hospital initiatives after the hospital industry agreed to a jointly lobby the state legislature for more healthcare spending. This June it qualified a cap on health care executive pay and then withdrew it in a trade with the California Hospital Association, which had qualified its own measure designed to give union members more of a say in SEIU-UHW’s ballot measure antics. 

Proposition 44’s target, the California Primary Care Association and five clinics, filed a federal racketeering complaint against the union in September. The complaint alleges that the union qualified 50 state initiatives across the nation over a dozen years and then withdrew almost 85 percent of them.

The complaint also lays out the union’s modus operandi. In January, it says, a legislative staffer relayed the union’s price for dropping what would become Proposition 44: an agreement requiring union elections covering 25,000 clinic employees over five years, which the clinics estimate would bring the union $2.37 million a month in new dues. On June 24, according to the complaint, the union’s chief lobbyist countered: The union would withdraw Proposition 44 if the clinics dropped their opposition to Proposition 40 and turned over the money they had raised to the wealth tax campaign. The clinics refused. The union calls the allegations “categorically false,” and the case is pending in federal court in Sacramento. Separately, an internal investigation commissioned by SEIU California and the national SEIU accused Regan of attempting to “extort” support for Proposition 40.

Union members pay for all of this. SEIU-UHW’s federal financial reports show dues of up to $234 a month and $87 million spent on political activities and lobbying from 2021 through 2025 (final numbers for the expensive campaign year of 2026 will not be available until next Spring). About $25 million of the election spending went to a single signature-gathering firm. Another $13.5 million went to the Fairness Project, a Washington group Regan launched in 2015 to run ballot measures outside California, and an additional $11.5 million went to ballot campaigns in Arizona. Regan’s own pay from the union rose 35 percent between 2021 and 2025, reaching $394,492. No membership vote was required for any of this spending. Nursing assistants and hospital housekeepers have financed years of losing campaigns whose main product is bargaining leverage for union leadership. That is a misuse of their dues.

California law already recognizes the danger of ballot measure extortion, but has not gone far enough to rein it in. California Elections Code section 18621 makes it a crime for a measure proponent to bargain for “any money or thing of value” in exchange for withdrawal. Proponents have withdrawn five qualified initiatives since 2024 without securing any compromise legislation leading to the suspicion that they obtained some sort of quid pro quo. 

Unfortunately, Attorney General Rob Bonta does not appear to have filed any complaints against ballot proponents in light of these withdrawals. At least in the case of SEIU-UHW, this appears to be a failure to enforce election law, since it is clear that SEIU-UHW received “a thing of value” by withdrawing its hospital CEO pay measure.

The Legislature could promote enforcement of Section 18621 by listing examples of “things of value,” such as dropping competing measures or agreeing to recognize a specific union in an employer’s workplace. It should permit withdrawal of a qualified measure only when the Legislature enacts a compromise bill in public view, and it should require proponents to file any related agreement with the Secretary of State. 

State law should also require unions to obtain majority approval from their members before spending dues money on ballot measures. The hospital association qualified an initiative to do that this year, submitting 931,534 signatures, and then traded it away in its deal with SEIU-UHW.

None of these reforms would compromise California’s direct democracy. California adopted the initiative process in 1911 so that citizens could go around a Legislature captured by special interests. It should not serve as a bargaining chip for one of them.