According to the suit, misleading ballot label and title and summary “falsely suggest that state law currently does not require any medical professional to be on-site during dialysis treatments” and serves as a prejudicial argument in favor of Prop 23.

SACRAMENTO – The No on Prop 23 campaign today filed a lawsuit against Attorney General Xavier Becerra asking the court to correct the false, misleading and prejudicial ballot label and title and summary he wrote for Proposition 23. The ballot label and title and summary are used in the Official Voter Guide distributed to every California voter.

Elections Code Section 9051 subsection (c) specifically states that, “In providing the ballot title and summary, the Attorney General shall give a true and impartial statement of the purpose of the measure in such language that the ballot title and summary shall neither be an argument, nor likely to create prejudice, for or against the proposed measure.”

The suit alleges that the ballot label and title and summary– which read “REQUIRES ON-SITE MEDICAL PROFESSIONAL” — creates the false impression that dialysis clinics today have no medical professionals on site. According to the lawsuit:

“Words matter. They create impressions for the reader.Giving voters the false impression that there are no medical professionals on-site at dialysis clinics serves as a de facto argument in favor of Proposition 23.

In reality, every dialysis clinic is required by law to have a medical director (a licensed physician) on staff along with other medical professionals such as a full-time registered nurse, certified patient care technicians, licensed social workers and licensed dieticians. All are critical to providing care to patients. The physician on site mandated by Prop 23 is an administrative position and would not supplant the role of a patient’s own individual nephrologist who prescribes and oversees all of his/her patient’s treatments. And, dialysis treatments are administered by specially-trained dialysis nurses and patient care technicians.

“Without intervention from the courts, the current Prop 23 ballot title and summary misleads voters into thinking Prop 23 is needed to require medical professionals on site at dialysis clinics,” said DeWayne Cox, a patient who has been on dialysis for ten years and lives in Los Angeles. “That title is prejudicial and that premise is false. If Prop 23 passes, clinics will be forced to cutback services or close, jeopardizing access to life-saving dialysis treatments for tens of thousands of patients like me. As a patient advocate, I’m strongly opposed to Prop 23 because patients like me will be put at serious risk by this dangerous proposition.” 

The Memorandum of Points and Authorities filed by No on Prop 23 can be found here.

The petition filed by No on Prop 23 can be found here.


Nearly 100 groups oppose Prop 23, including the California Medical Association, American Nurses Association\California, and many others because it would jeopardize the lives of dialysis patients by forcing hundreds of dialysis clinics to cut back services or shut down completely – making it more difficult for dialysis patients to access their life-saving treatments.

Furthermore, this dangerous and costly dialysis measure would make the state’s current doctor shortage and emergency room overcrowding even worse, while unnecessarily increasing health care costs for taxpayers and consumers by hundreds of millions of dollars every year. All of this, in the midst of a global pandemic, threatens to put a strain on necessary health care resources across California.

There are approximately 80,000 dialysis patients in California with failed kidneys who need machines to clean their blood and remove toxins from their bodies. Patients must receive dialysis treatment three times a week for four hours at a time to stay alive. Access to consistent dialysis treatments is so important that just one missed treatment increases patients’ risk of death by 30%.

Prop 23 is sponsored by the United Healthcare Workers West (UHW) union – the same organization that abused California’s initiative process two years ago by bankrolling Proposition 8 on the 2018 ballot. Prop 8 would have also caused dialysis clinics throughout California to cut back services or shut down, dangerously threatening dialysis patients’ lives. That’s why every daily newspaper in California opposed Prop 8 and voters overwhelmingly rejected it by 20 points. Now, this special interest group is at it again with a different attempt, but the same outcome, that would put dialysis patients lives at risk.

While unions have the right to try to unionize workers, it’s not right to abuse the initiative system and use vulnerable patients as political pawns – especially now in the face of a public health crisis.

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