Why It Matters
The lawsuit challenges whether a powerful labor union can use ballot initiatives as leverage to force industry-wide unionization agreements.
What Happened
The California Primary Care Association and five community health clinics filed a civil racketeering suit in federal court on Friday, Sept. 18, 2026. The complaint names SEIU-United Healthcare Workers West (UHW) and its president, Dave Regan, as defendants.
Plaintiffs allege the union used Proposition 44 to coerce community health centers into accepting labor-organizing terms. The suit claims Regan offered to withdraw support for the November ballot measure if the industry agreed to unionize 25,000 workers over five years.
An email from a legislative staff member in January outlined the demand: hold elections for at least 5,000 employees annually. Plaintiffs argue this strategy uses economic pressure and threats to bypass standard bargaining processes.
By the Numbers
25,000 — Number of industry workers UHW sought to unionize through the proposed agreement
$2.37 million — Estimated monthly revenue from dues generated by those new members
90% — Percentage of revenue Proposition 44 requires community clinics to spend on patient services
Over $216 million — Amount UHW has spent on ballot measures targeting hospitals and dialysis providers
Dozens — Number of punitive ballot measures filed by the union against healthcare providers
Zoom Out
The lawsuit describes a broader pattern of union strategy. Plaintiffs state UHW has filed numerous ballot measures intended to harm patients, destroy services, and drive providers out of business. The vast majority of those initiatives were withdrawn after industry concessions.
Proposition 44 would restrict spending at nonprofit community health clinics. CPCA argues the measure would reduce money for essential services and risk clinic closures. Regan denied in July that he asked clinics to support unionization in exchange for dropping the proposition. He stated he sought a relationship prioritizing appropriate funding and restoring healthcare cuts from the “One Big [Beautiful] Bill.”
What’s Next
Voters will decide on Proposition 44 in November. A UHW spokesperson did not immediately respond to requests for comment on the lawsuit.