For a more in depth discussion of Proposition 8, and the ten other initiatives on the ballot this November you can watch the forum in its entirety on YouTube or read the full analyses here. And keep your eyes peeled on The CAP⋅impact Podcast’s feed on Apple Podcasts, Stitcher Radio, or wherever you get your podcasts from for analysis of this year’s ballot initiatives in your headphones coming next week.

Proposition 8: Fair Pricing for Dialysis Act

Current Law

  • California Health and Safety Code regulates chronic dialysis clinics (CDCs)
  • Current law does not limit the revenue of chronic dialysis clinics providing kidney dialysis treatment.

Proposed Law

  • Limit chronic dialysis clinics revenue and require clinics to issue refunds for revenue above 115 percent of the costs of direct patient care service and health care quality improvements.
  • Assess penalties if clinics fail to maintain information or timely submit a report required, report inaccurate or incomplete amounts or percentages, or fail to timely issue a full rebate.
  • Require clinics to submit annual reports to the California Department of Public Health (CDPH). These reports shall include the number of dialysis treatments provided, the amount allowable costs, the amount of owner/operator’s revenue car, the amount by which revenues exceed the cap, and the amount of rebates paid.
  • Prohibit clinics from refusing to treat patient based on source of payment for care.

Policy Considerations


Yes on Proposition 8 No on Proposition 8
  • Lower costs of dialysis treatment.
  • Improve patient care by incentivizing clinics to spend more of direct patient care services.
  • Ensure clean dialysis centers because clinics would spend more on health care quality improvements.
  • Require corporations to refund excessive profits that aren’t spent on improving patient care.
  • Clinics will operate at a loss because reimbursement rates are too low.
  • Clinics will be forced to close.
  • Patients will be forced to seek treatment at more expensive hospital emergency rooms due to closures of clinics.
  • Definition of “allowable” costs excludes critical staff and necessary services to operate a dialysis clinic.
  • Presents constitutional issues, giving rise to a post-election challenge.

Analysis of Proposition 8 provided by John Ponce and Anupe Litt.