Proposition 23: Dialysis clinics initiative

The prop impacts 600 kidney dialysis centers in the state

Proposition 23

Ekaterina Pechenkina

Prop 23 would require a physician on-site at dialysis clinics in California. Graphic by Ekaterina Pechenkina

Ekaterina Pechenkina, Staff Writer

The gist

In California, there are 600 kidney dialysis centers that accommodate 80,000 patients a month. These clinics stay open long hours, even on weekends. Proposition 23 requires at least one physician on-site. Dialysis centers would have to provide the same care for all patients, whether they use private insurance or Medi-Cal. It also requires dialysis centers to report data to the state and federal government.

The fiscal impact of this ballot measure is that it would result in increased costs by low tens of millions of dollars annually on local and state levels.

Supporters say it will improve staffing by requiring a physician on-site, stops discrimination based on patients’ form of payment, requires reporting infections and therefore improves hygiene in clinics.

Opponents argue it threatens many community dialysis centers to close, increases health care costs and increases physician shortage.

What the media is saying

Endorsement: No on Prop.23: Union power play puts dialysis patients at risk, The San Diego Union-Tribune (article)

The complete list of L.A. Times’ endorsements in the November 2020 election (article)

Prop 23 Asks: Should Dialysis Clinics Always Have A Physician On Site? KQED Bay Curious (podcast)


• California Democratic Party
• California Labor Federation


• DaVita, Inc.
• Fresenius Medical Care
• American Nurses Association\California
• California Medical Association
• California State Conference NAACP
• Dialysis Patient Citizens, American Academy of Nephrology (PAs)

For more information about Prop 23, go to