What’s Actually in California’s “Attorney Self-Dealing” Initiative: 6 Provisions You Should Know

A proposed constitutional amendment is quietly collecting signatures across California. It’s marketed as protection for car accident victims.

Signature gatherers across California are asking voters to support something called the “Protecting Automobile Accident Victims from Attorney Self-Dealing Act,” Initiative 25-0022. 

What is it?

This initiative would cap attorney fees, with the stated goal of allowing crash victims to keep more of their settlement. It would also ban financial arrangements between lawyers and medical providers that may not serve the client’s best interests.

There are legitimate concerns it aims to address. Some personal injury attorneys have been known to refer clients to out-of-network providers with inflated billing practices or maintain financial relationships with medical providers that may benefit the attorney more than the client. Those practices have drawn warranted criticism. Uber and initiative supporters argue the reforms are necessary to address documented fraud and inflated billing practices that drive up costs for all Californians.

However, the initiative extends beyond those targeted reforms. Buried in 14 pages of proposed constitutional amendments are provisions that would reshape what injured Californians can recover, how they prove their medical treatment was necessary, and whether attorneys will be able to take on certain cases at all.

The campaign, backed primarily by Uber with roughly $12 million invested so far, has already gathered at least 25% of the 874,641 signatures needed for the November 2026 ballot. We covered Uber’s broader lobbying history behind this push in a recent piece.

What follows are six provisions in the initiative’s actual text that most voters will never see on a petition clipboard.

1. Even the State’s Own Summary Calls It What It Is

The proponents named their measure the “Protecting Automobile Accident Victims from Attorney Self-Dealing Act.” But California’s Attorney General, whose office is required to write a neutral title and summary for circulation, titled it differently: “Limits Automobile Accident Victims’ Recovery of Medical Expenses and Fees Their Attorneys May Receive.”

That’s a neutral government office reading the text and describing what it actually does. And what it does, first and foremost, is limit what victims can recover.

2. It’s a Constitutional Amendment, and That’s a Deliberate Choice

This isn’t a proposed statute that the legislature could amend if it causes unintended harm. It would add an entirely new article, Article XXIII, to the California Constitution. If it passes and problems emerge, there’s no legislative fix. You’d need another ballot initiative, another signature drive, and another election to change a single word.

That’s the same structural lock Uber used with Proposition 22 in 2020, which required a seven-eighths legislative supermajority to amend. The current initiative goes a step further: it includes a provision stating that if any competing measure appears on the same ballot, this one automatically overrides it if it gets more votes.

3. The Medical Expense Caps Are the Real Payload

The fee cap gets the headlines. But Section 2 of the initiative is where the math quietly guts victim recoveries. It would cap what victims can recover for unpaid medical expenses at 125% of Medicare reimbursement rates. If there’s no applicable Medicare rate, the fallback is 170% of Medi-Cal rates.

What does that mean? According to Milliman’s 2025 commercial reimbursement benchmarking data, commercial insurers in California pay between 166% and 277% of Medicare rates, depending on the region and the type of service. Nationally, the average is 196%. The American Hospital Association has reported that Medicare reimburses hospitals at roughly 87% of their actual costs.

So this initiative would cap recoverable medical expenses at less than what commercial insurance actually pays and far less than the actual cost of providing care. A victim who needs a $100,000 surgery could be limited to recovering a fraction of that amount, regardless of what the procedure actually costs.

Think of the ripple effect… 

Medical providers who currently treat accident victims on liens, agreeing to wait for payment until the case resolves, would have far less reason to take that risk when the recoverable amount has been slashed. Once providers stop treating on liens, victims must either pay out of pocket or go through insurance with all its delays and coverage limitations. 

Victims who can’t afford upfront care get less treatment. Less treatment means less documentation. Less documentation means weaker claims. Weaker claims mean lower settlements. Insurance companies pay less across the board.

This isn’t speculation. The initiative’s own fiscal analysis from the Legislative Analyst’s Office projects an overall reduction in motor vehicle accident cases being filed and increased state Medi-Cal costs ranging from millions to tens of millions of dollars annually, because victims who can’t recover full medical expenses will fall back on public programs.

4. It Creates a Two-Tier Burden of Proof That Treats Victims as Suspects

Under current California law, if you’re injured in a car accident and seek medical treatment, you need to show that the treatment was reasonably necessary. That’s the standard “preponderance of evidence” test: more likely than not.

The initiative keeps that standard for medical bills that have already been paid. But for unpaid medical bills, which is the exact situation most accident victims face since they’re treated on liens while their case is pending, it imposes a “clear and convincing evidence” standard. That’s the bar typically reserved for fraud cases, punitive damages, and involuntary civil commitment.

Think about what that means in practice. The way most personal injury cases work in California is that victims receive treatment first. Pays from their recovery later. This initiative would subject that entire category of medical care to the kind of scrutiny courts normally apply when someone is accused of deception. It treats unpaid treatment as presumptively suspicious.

5. It Overrides the Collateral Source Rule, a Bedrock of California Injury Law

California’s collateral source rule says a wrongdoer doesn’t get to pay less just because the victim had insurance. The California Supreme Court upheld the rule in Helfend v. Southern California Rapid Transit District (1970), and it exists for a straightforward reason: the person who caused the harm shouldn’t benefit from the victim’s foresight in carrying coverage.

Section 2 of the initiative explicitly states it applies “notwithstanding the collateral source rule.” If you have health insurance and get injured by a negligent driver, the defendant can now point to your coverage to argue that your medical expenses should be valued at what insurance would have paid, not what the care actually cost. Put simply, the person who hit you gets a discount because you were responsible enough to carry health insurance.

6. It Only Targets Car Accidents

The initiative doesn’t touch slip-and-fall cases. It doesn’t affect product liability, workplace injuries, medical malpractice, or any other category of personal injury. It applies exclusively to automobile accidents.

If this were genuinely about protecting victims from unscrupulous lawyers, why wouldn’t it apply to all personal injury cases? Auto accidents are where rideshare companies, auto insurers, and fleet operators spend the most on claims.

The narrow scope raises questions about whether the initiative’s intent is broader consumer protection or relief for industries with the highest exposure to auto accidents.

What This Future Actually Looks Like

Connect the provisions, and the picture comes into focus. Attorneys can’t afford to take complex cases under a 25% fee-and-cost cap. Medical providers stop treating on liens because recoverable amounts are capped below the cost of care. Victims without upfront resources get less treatment. Less treatment produces weaker claims. Weaker claims produce lower settlements, or no settlement at all.

Stanford law professor Nora Freeman Engstrom has warned that fee caps of this kind would effectively lock lower-income plaintiffs out of the courthouse. And this initiative only caps fees for plaintiffs’ attorneys, the lawyers representing injured people. Defense attorneys, including those representing Uber and major insurance carriers, face no fee restrictions whatsoever.

Critics argue that the end result would not be a system that protects victims from bad lawyers, but rather one where victims cannot access legal representation at all.

If someone asks you to sign a petition for the “Protecting Automobile Accident Victims from Attorney Self-Dealing Act,” it is worth asking who funded it and why.

Supporters of the initiative argue it protects victims from inflated billing and self-dealing attorneys. Critics contend the provisions would reduce access to legal representation and limit what injured Californians can actually recover. Voters will ultimately decide which concern carries more weight.