Proposition 23, a labor-backed initiative, is a new version of a similar measure that voters turned down last year.
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Prop. 23 requires a physician or nurse-practitioner at dialysis clinics. Infection rates would need to be reported to the government. State approval would be needed for clinic closure or service reduction.
It also says all patients regardless of income should be treated, including those depending on Medi-Cal and Medicare who are primarily older or low-income patients.
RELATED: Everything you need to know about the measures on California's November 2020 ballot
Opponents say the doctor requirement increases costs and would force many community clinics to close.
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Proponents say it ensures improvements at all clinics.
Kidney dialysis is a $3 billion-a-year California industry with 80,000 patients who depend on it for their lives.
Dialysis clinics are a highly charged topic. California patients can wait 5 to 10 years for a kidney transplant with a 35% chance of living on dialysis until one is available.