California Limit Compensation of Healthcare Executives Initiative (2026)

California Limit Compensation of Healthcare Executives Initiative
Election date November 3, 2026
Topic Business regulations and Healthcare governance
Status Cleared for signature gathering
Type Initiated state statute	Origin Citizens

The California Limit Compensation of Healthcare Executives Initiative (#25-0009) may appear on the ballot in California as an initiated state statute on November 3, 2026.

The initiative would create a fair compensation limit for CEOs, executives, administrators, and managers of healthcare corporations. The fair compensation limit would begin at $450,000 and increase annually by 3.5% or by the yearly cost-of-living increase. Under the initiative, compensation would include salaries, bonuses, and some benefits.

Measure design

See also: Text of measure

Click on the following sections for summaries of the different provisions of the ballot measure.

Expand All

Compensation limit

The initiative would establish a $450,000 limit on compensation for executives and managers of private hospitals, private physician groups, and public hospitals owned by special districts. The initiative would exclude county-operated hospitals and physician groups with fewer than 25 employees. The limit would also apply to executives operating under contracts or subcontracts that are not formally employees of the organization. not apply to medical professionals providing medical services, research, patient care, or other non-managerial, non-executive, and non-administrative services.

The limit would be adjusted annually by either 3.5% or the year-over-year rate of change in the U.S. Consumer Price Index for Urban Wage Earners and Clerical Workers (U.S. CPI-W), whichever is lower. The limit would apply to total annual compensation and include wages, salary, paid time off, bonuses, incentive payments, cash payments, fair market value of loans, cash value of housing, company cars, use of corporate aircraft, scholarships, fellowships, cash value of dependent care or adoption assistance, cash value of stock options or awards, and severance payments. It would not include organization contributions for the cost of health or disability insurance or health reimbursement and savings accounts.

Reporting requirements

The initiative would require nonprofit corporations that own or operate hospitals or medical entities to report within nine months of the close of their fiscal years to the California Attorney General the names, positions, and compensation (wage and nonwage) for persons performing executive, managerial, or administrative work that received total compensation greater than the $450,000 limit. The initiative would authorize the attorney general to assess fees on the reports to cover the administrative costs of enforcing the law.

Enforcement and penalties

The initiative would authorize any state taxpayer to sue for a violation of the compensation limit. The initiative would require taxpayers to notify the attorney general of their violation and intent to sue. If the attorney general brings a civil action against the same violation within 60 days of receiving notice, the taxpayer would be prohibited from seeking further legal action against the violation.

For nonprofit organizations that do not comply with the compensation limit, the state would be authorized to use the following penalties:

• revoke their tax-exempt status,
• appoint a governing board member for a specified time, or
• impose a maximum fine of $100,000-$200,000 per violation.

The attorney general would be authorized to impose a fine per violation on for-profit organizations or individuals that do not comply with the compensation limit. The maximum fines would vary between $100,000 and $200,000 and depend on the intentionality of violating the limit and the number of repeated violations.

Text of measure

Ballot title

The ballot title is as follows:

“

Limits compensation for health care executives, managers, and administrators. Initiative statute.

”

Petition summary

The summary provided for inclusion on signature petition sheets is as follows:

“

Prohibits certain hospitals and medical entities from paying executives, managers, and administrators more than $450,000 in total annual compensation (salary, paid time off, bonuses, stock options, company vehicle, etc.) or severance payments; compensation limit increases up to 3.5% annually based on Consumer Price Index. Requires annual reporting of all executives, managers, and administrators receiving compensation or severance packages exceeding limit. Authorizes enforcement by Attorney General or taxpayer litigation. Penalties for violations include fines, revocation of tax-exempt status, and appointment of Attorney General representative to board of directors of nonprofit corporations.

”

Full text

The full text of the initiative can be read here.

Support

Service Employees International Union – United Healthcare Workers led the campaign in support of the initiative.

Arguments

• Service Employees International Union – United Healthcare Workers: "At a time when healthcare facilities across the country are facing massive federal budget cuts that threaten critical programs like Medicaid, healthcare workers say it’s more important than ever that every healthcare dollar be invested in providing quality patient care, not in multimillion-dollar executive pay packages. The initiative seeks to address the growing gap between excessive healthcare executive salaries and the realities faced by frontline workers and patients."

Opposition

Ballotpedia has not located a campaign in opposition to the ballot measure. You can share campaign information or arguments, along with source links for this information, with us at editor@ballotpedia.org.

Opponents

Organizations

• California Hospital Association

Arguments

• Carmela Coyle, president and CEO of the California Hospital Association: "Late last week, California’s largest health care union filed paperwork with the Office of the Attorney General to add a ballot measure to next year’s election that would cap compensation packages for hospital and medical group leaders at $450,000. These measures couldn’t have come at a more precarious time for health care in California. Following the largest cut to health care in our nation’s history, this is a moment when the state should be doing all it can to recruit and retain thoughtful, mission-driven leaders who can develop innovative ways to preserve access to vital health services for patients. Instead, this proposal will only make it difficult — if not impossible — to do so."

Background

SEIU-UHW West hospital compensation limit ballot initiatives

In 2014, SEIU-UHW West proposed the Charitable Hospital Executive Compensation Act. It was an initiated state statute that would have:

• prohibited nonprofit hospitals, hospital groups, hospital-affiliated medical foundations, and physicians' groups from paying annual compensation (salary, benefits, paid time off, bonuses, stock options, etc.) or providing severance packages to executives, managers, and administrators in an amount exceeding the salary and expense allowance of the President of the United States;
• required annual public disclosure of the 10 highest-paid executives and the five largest severance packages;
• authorized the state attorney general to monitor and enforce the initiative's provisions;
• provided penalties for violation of the initiative's provisions, including fines, revocation of a hospital's tax-exempt status, and the appointment of a representative of the state's attorney general to a hospital's board of directors.

The SEIU-UHW and the California Hospital Association (CHA), which opposed the initiative, negotiated a deal that led to the union withdrawing both the ballot initiative and a second initiative related to hospital pricing.

A similar measure was proposed again in 2016 in California. They withdrew it ahead of the signature deadline in May 2016.

Similar initiatives were also filed by the union in Oregon in 2014 and in Arizona in 2016. Neither submitted signatures by the respective deadlines.

Hospitals by ownership type in California

The Kaiser Family Foundation (KFF) reported that California had a total of 353 hospitals in the state in 2023. The chart below shows the breakdown by type.

Path to the ballot

See also: Laws governing the initiative process in California

An initiated state statute is a citizen-initiated ballot measure that amends state statute. There are 21 states that allow citizens to initiate state statutes, including 14 that provide for direct initiatives and nine (9) that provide for indirect initiatives (two provide for both). An indirect initiated state statute goes to the legislature after a successful signature drive. The legislatures in these states have the option of approving the initiative itself, rather than the initiative appearing on the ballot.

In California, the number of signatures required for an initiated state statute is equal to 5% of the votes cast in the last gubernatorial election. A simple majority vote is required for voter approval. The requirements to get initiated state statutes certified for the 2026 ballot:

• Signatures: 546,651 valid signatures are required.
• Deadline: The deadline for signature verification is June 25, 2026. However, the secretary of state suggested deadlines for turning in signatures of January 12, 2026, for initiatives needing a full check of signatures and April 17, 2026, for initiatives needing a random sample of signatures verified.

Initiative #25-0009

• July 15, 2025: Shelbi N. Augustus and Jonathan Everhart filed the initiative with the California Attorney General's Office.
• August 1, 2025: The Attorney General's Office published the initiative, issued it a serial number, and placed it under official review.
• October 8, 2025: The initiative was cleared for signature gathering.
• November 12, 2025: The secretary of state reported the campaign had collected at least 25% of signatures required.

See also

2026 measures

• 2026 ballot measures
• Business regulations on the ballot

California

• California ballot measures
• California ballot measure laws

News and analysis

• Ballot measure lawsuits
• Ballot measure readability
• Ballot measure polls

External links

• #25-0009 Full Text

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