Paul Nguyen

Proposition 38

Authorizes Bonds for Immunology Medical Research

Authorizes Bonds for Immunology Medical Research. Initiative Statute. Authorizes $8.4 billion in state general obligation bonds for immunology and immunotherapy research (technologies that use the body's immune system to treat disease), with half dedicated to cancer, heart disease, and Alzheimer's disease. Allocates funds equally between (1) a single University of California-affiliated nonprofit medical research institute, and (2) research grants for public or nonprofit universities and institutions. Requires funding recipients to sell technology and drugs derived from research in California for 20% below national average price. Appropriates money from General Fund to repay bonds; General Fund receives 10% of licensing royalties until bonds are repaid. Summary of the Legislative Analyst's estimate of net state and local government fiscal impact: increased state cost of $500 million to $600 million annually for about 20 years to repay the medical research bond. The state could recover part or all of this cost in subsequent decades if the funded research leads to discoveries that generate revenue.

initiative_statute 2026-11-03 CA

Summary

Proposition 38 is an initiative statute placed on the ballot by petition signatures. It allows the state to sell up to $8.4 billion in general obligation bonds and use the money for medical research in immunology and immunotherapy, the fields that study the body's immune system and the treatments that help it fight disease.

The bond money is split in half. One half goes to a single nonprofit medical research institute that the California Department of Public Health selects from institutes meeting criteria listed in the measure, including an affiliation with a University of California campus. The other half goes to other public and nonprofit universities and nonprofit research institutions as competitive research grants awarded by a council drawn from seven UC campuses and 10 to 15 other California institutions.

At least $4.2 billion of the total must go to research on cancer, heart disease and Alzheimer's disease. Recipients must pay the state 10 percent of the revenue they make from selling, licensing or otherwise commercializing discoveries, and that money goes to the General Fund until it has covered the full cost of the bonds, including interest.

Treatments developed from the research and sold in California must generally be priced at least 20 percent below the national average price. No more than 2 percent of the bond money may be spent on state administrative costs. The Legislative Analyst estimates the state would pay $500 million to $600 million a year from the General Fund for about 20 years to repay the bond, and says the state could recover part or all of that cost in later decades if the research produces revenue.S1S2S3S7S13

What a yes or no vote means

Yes means

A yes vote means the state could borrow $8.4 billion by selling general obligation bonds to support medical research in immunology and immunotherapy conducted by California research institutes and universities.S1S4S13S14

No means

A no vote means the state could not borrow $8.4 billion to support medical research in immunology and immunotherapy conducted by California research institutes and universities. The programs and grant funding this measure would create would not be established.S4S13S14

How it works

  1. What kind of measure this is: Proposition 38 is a citizen-initiated state statute submitted to the voters under Section 8 of Article II of the California Constitution. The Institute of Governmental Studies reports that the initiative was filed with the Attorney General and cleared for signature gathering on January 2, 2026, that proponents needed 546,651 valid signatures to qualify it, and that the Secretary of State announced on June 23, 2026 that the campaign had collected enough signatures to place it on the November 2026 ballot.S7S13
  2. Where the law goes: the measure adds Division 110.5, commencing with Section 130350, to the Health and Safety Code. Chapter 1 of that division is the California Immunology and Immunotherapy Medical Research Act, which sets up the research program, and Chapter 2 is the California Immunology and Immunotherapy Bond Act of 2026, which authorizes the bonds. The act as a whole is known and may be cited as the California Immunology Research and Cures Initiative.S7
  3. The bond: bonds in the total amount of eight billion four hundred million dollars ($8,400,000,000), not counting any refunding bonds, may be issued and sold. The bonds are a valid and binding obligation of the State of California, the full faith and credit of the state is pledged for timely payment of principal and interest, and repayment comes from the General Fund. The Legislative Analyst notes that a general obligation bond is typically repaid from the General Fund, which is the account the state uses to pay for most public services including education, health care and prisons.S2S3S7
  4. How the money is divided: after payment of other authorized amounts, 50 percent of the bond proceeds are disbursed to a single nonprofit medical research institute for the purpose of conducting or directing health science research in immunology and immunotherapy, and 50 percent are disbursed to the public and nonprofit universities and other nonprofit research institutions represented on the council. The second half must be awarded as individual grants for specific research projects through an application process, and the measure states the money shall not be in the nature of uniform block grants. Grants may go only to California-based public and nonprofit universities and nonprofit medical research institutions, and the purposes section states that no funds may be awarded to for-profit organizations or pharmaceutical companies.S2S7
  5. The cancer, heart disease and Alzheimer's set-aside: the Legislative Analyst says the measure requires that at least $4.2 billion of the bond funds be used for immunology research on cancer, heart disease and Alzheimer's disease. The text breaks that down, requiring not less than $2,100,000,000 of the institute's half and not less than $2,100,000,000 of the grant half to be spent on research into the prevention, treatment and cure of those three diseases.S2S3S7
  6. Choosing the institute: the California Department of Public Health selects the single nonprofit medical research institute and must enter into a funding agreement with it within 90 days of the effective date of the chapter. The institute must meet all of these criteria: it is a medical research institute exempt from federal income taxation under Section 501(c)(3) of the Internal Revenue Code, was in existence as of January 1, 2025, and was founded for the primary purpose of and specializes specifically in immunology and immunotherapy research; it has an affiliation agreement, entered into not later than January 1, 2025, with a University of California campus that has a graduate training program in immunology and immunotherapy, a public health care system of one or more hospitals that conducts its own clinical trials of new experimental drugs and therapies, and a campus health care system with more than 35,000 inpatient admissions and 3,500,000 outpatient visits a year; it is governed by a board required by its bylaws, adopted not later than January 1, 2025, and by the affiliation agreement, to include multiple senior-level representatives of that UC campus or its public health care system; as of January 1, 2026 it owns or leases a site of not less than 200,000 square feet intended to house its research activities; it agrees to conduct collaborative research with other qualified nonprofit California medical research centers, including multi-institutional clinical trials; it has identified sources of funding of not less than $250,000,000 in philanthropic donations or fundraising commitments; and it has secured financial commitments of not less than $50,000,000 to support a rapid vaccine development program and not less than $50,000,000 to support a microbiome research program.S7S13
  7. If no institute qualifies: the department shall modify the criteria to permit the identification of a nonprofit medical research institute eligible for funding under the chapter, the modification must be the minimum amount necessary to identify an eligible institute and must further the purposes of the chapter, and the department must select and enter into a funding agreement within 90 days of adopting the modified criteria. The department must review the agreement every five years to check compliance, and a substantial failure to comply can be grounds for termination if the failure substantially and materially frustrates the purposes of the chapter, after notice and a reasonable opportunity to remedy. CalMatters describes this fallback in the same terms.S7S11
  8. The grant council: the department coordinates and supports an Advisory and Accountability Research Council. A seven-member executive committee is made up of one representative appointed by the chancellor of each of the UC campuses at Berkeley, Davis, Irvine, Los Angeles, Riverside, San Diego and San Francisco. The executive committee, by majority vote, appoints 10 to 15 additional members from California nonprofit universities other than the University of California, and from California nonprofit academic and research institutions that are not part of the University of California, in both cases with demonstrated success and leadership in immunology and immunotherapy research. Every member must be a physician, scientist or researcher with demonstrated experience in those fields. Members serve four-year terms, serve without compensation and may be reimbursed for travel and necessary expenses. The representative appointed from the University of California, Los Angeles serves as the first chairperson of the council.S2S7
  9. How grants are chosen: the council sets selection criteria and research priorities based on the scientific merits of a proposal, the applicant's experience in conducting methodologically sound medical research, the potential benefits to the health and well-being of the population and other criteria it determines, and it must give the highest priority to projects with the greatest potential for yielding the most immediate, accessible and affordable therapies and to those that seek to enhance patient access to immunotherapy treatments. The council may create scientific peer review panels of immunology and immunotherapy experts, and a panel expert is disqualified from reviewing a proposal if the expert has a collaborative or commercial relationship with the applicant. The council accepts or rejects applications from the institutions represented on the council, and it confers with the selected institute when making final funding decisions.S7
  10. Terms attached to the grants: research and development funded under an agreement must be conducted under established standards of open scientific exchange, peer review and public oversight. Each grant recipient must purchase goods and services from California suppliers to the extent reasonably possible, in a good faith effort to achieve a goal of more than 50 percent of those purchases from California suppliers. Each recipient must offer the selected institute the opportunity to substantially participate in and collaborate on the funded research, and must offer the University of California, Los Angeles the opportunity to substantially participate in and collaborate on any clinical trials conducted as part of the research. Recipients must submit to and cooperate with audits, and indirect costs are limited to 20 percent of a research grant, except that the limit may be raised by the amount of matching funds the grantee provides above 20 percent.S2S7
  11. Money back to the state: any recipient of research funds must pay the State of California an amount equal to 10 percent of all revenues it derives from the sale, licensing or any other commercialization or monetization of intellectual property rights that arise from research funded under the chapter, calculated without regard to whether the research was funded wholly or only in part by the bond. Payments are due within 30 days of receipt and are deposited into the General Fund until the cumulative amount equals the total cost to the state of the bonds, including interest, as determined by the California Immunology and Immunotherapy Finance Committee. After that point, additional revenue is deposited into the California Immunology and Immunotherapy Medical Research Fund and spent consistent with the chapter's purposes. The purpose section describes this arrangement as making the measure effectively a loan program. Licensing agreements must require royalties of not less than 10 percent of gross revenues, and the department may approve a lower rate case by case but may not approve a rate below 5 percent. A joint venture or other business arrangement must return not less than 25 percent of gross profits to the recipient.S2S7
  12. The California price discount: as a condition of funding, any recipient that licenses or sells a technology or drug developed through funded research must agree that the licensing or sale to make it available to California patients, hospitals or insurance companies, including through a government-funded health care program, requires a price at least 20 percent below the national average price calculated by excluding California. During the first 12 months of commercial sales, California purchasers may not be charged more than the price charged in any other part of the United States. By one year after the first commercial sale, data from the first nine months of sales are used to calculate a national average cost, and after that the California price must be at least 20 percent below that calculated average, recalculated annually. The purpose section states this requirement is intended to ensure that Californians benefit directly from their public investment. The Legislative Analyst describes the provision as requiring that any treatment developed through funded research and sold in California generally be offered at a 20 percent discount.S2S7
  13. Accountability and audits: not more than 2 percent of all moneys disbursed may be expended for the administrative costs of the department, the council, the oversight committee and the Controller. The purpose section states that 98 percent of all funds must be spent on costs related to medical research and development of cures, and it lists rigorous conflict of interest rules, public disclosure of all spending and independent financial audits. The institute must issue an annual public report on its activities and research accomplishments and must commission an independent financial audit each year from a certified public accounting firm, provided to the Controller. The Controller reviews the audit, holds a public meeting with notice and a formal public comment period and issues an annual public report. The council must commission independent audits of its own activities and of 10 percent of grantees chosen at random, also reviewed by the Controller in the same way. A six-member Citizens' Financial Accountability Oversight Committee reviews the audits and the financial practices of the institute and the council, issues an annual report with recommendations and holds public meetings. The Controller or the Controller's designee chairs it, and the State Auditor, the Treasurer, the President pro Tempore of the Senate, the Speaker of the Assembly and the chairperson of the council each appoint one public member.S2S7
  14. Transparency and ethics rules the text sets: the measure states that the institute is not a public agency for any purpose under state law, including the California Public Records Act, the open meeting requirements of Article 9 of Chapter 1 of Part 1 of Division 3 of Title 2 of the Government Code, and the Political Reform Act of 1974. The Political Reform Act of 1974 applies to the council except as provided in the section. Under those exceptions, a council member may not make, participate in making or attempt to use their official position to influence a decision to approve or award a grant or contract to their own employer, but a member may participate in a decision to approve or award a grant or contract to an entity in the same field as their employer, and may participate in a decision on research involving a disease from which the member or a family member suffers. Service on the council by a member of the faculty or administration of the University of California, or by a representative or employee of a nonprofit academic or research institution, is not by itself treated as incompatible or in conflict with their other duties. Section 1090 of the Government Code does not apply to council grants or contracts unless the grant or contract directly relates to services provided by a member or an entity the member represents, or financially benefits them, and the member fails to recuse.S7
  15. Startup loan from the General Fund: the measure appropriates $100,000,000 from the General Fund as a source of a startup loan or loans to the institute for the costs of initial implementation and support of its research program, with the department determining the timing and amounts of those loans up to that aggregate. Any loan must be repaid to the General Fund within 12 months, or if not repaid within 12 months, as soon thereafter as is practicable as determined by the Treasurer, from the proceeds of bonds sold under the bond act.S7
  16. How the law can be changed later: the act may be amended by a statute that is passed by a two-thirds vote of the members of each house of the Legislature and signed by the Governor, provided the amendment furthers the purposes of the act. No such statute may amend the provisions of the act regarding the allocation and disbursement of bond proceeds or the purposes for which bond proceeds may be expended. The act is severable and is to be liberally construed.S7
  17. Earlier California medical research bonds: the Legislative Analyst notes that beyond company and government funding, California voters have approved two ballot measures, Proposition 71 in 2004 and Proposition 14 in 2020, giving the state authority to issue general obligation bonds for specified medical research, and that together those measures allowed the state to issue $8.5 billion in bonds for stem cell research. The League of Women Voters of California Education Fund states that Proposition 71 authorized $3 billion and Proposition 14 an additional $5.5 billion, and that those measures funded research through competitive grant programs.S2S3S12
  18. Who is behind it and what the criteria point to: CalMatters reports that Proposition 38 is written in a way that very likely excludes all but one institute in the state, the California Institute for Immunology and Immunotherapy, and that a UCLA spokesperson confirmed that among all nonprofit entities affiliated with the school only the California Institute for Immunology and Immunotherapy could satisfy the requirements of the proposition. CalMatters reports that the institute first became a nonprofit in 2022, that its co-founder Gary K. Michelson has given it at least $120 million since then and is its board chair, and that Michelson and the Michelson Center for Public Policy he founded donated at least $8.2 million to the campaign supporting the measure. The campaign's spokesperson told CalMatters that the language is not uniquely tailored to that institute and that the criteria were designed to ensure the selected institute is prepared to accelerate research immediately. The Los Angeles Times reports the campaign spokesperson said lots of institutions would qualify for funds under the measure, while adding that it is very likely the California Institute for Immunology and Immunotherapy will qualify for half of the funds under the current criteria, and that institutions such as Stanford, Scripps Research, USC and Cedars Sinai are likely to qualify for the other half.S11S15
  19. Nonpartisan description of what it would do: CalMatters describes Proposition 38 as a bond of $8.4 billion largely to fund research into fighting cancer, heart disease and Alzheimer's plus other diseases treatable through immunotherapies, with half the money going to a research institute affiliated with the University of California and the other half distributed to select public universities and nonprofits, drugs created through the research discounted 20 percent for Californians, 10 percent of any revenue from the drugs going back to the state's General Fund, and philanthropist and medical inventor Gary Michelson having put the measure on the ballot.S10

Fiscal impact

The Legislative Analyst's summary of the estimate of net state and local government fiscal impact is an increased state cost of $500 million to $600 million annually for about 20 years to repay the medical research bond, with the state able to recover part or all of this cost in subsequent decades if the funded research leads to discoveries that generate revenue.

The analysis explains that the state General Fund cost to repay the bond would be $500 million to $600 million a year for about 20 years, that the annual cost would be about one-quarter of 1 percent (0.25 percent) of the state's total General Fund budget, and that because the state pays interest on what it borrows, the total cost of the bond would be about 10 percent more, after adjusting for inflation, than if the state paid up front with money it already has.

On possible revenue, the analysis says the state could receive revenue from research funded by the measure, that the amount is uncertain but could be significant, that it would depend on how many research projects lead to marketable treatments and how much money any given treatment generates, and that the timing of those revenues and how long it would take to offset the state's bond cost is uncertain but could take decades.

On indirect effects, the analysis says the measure likely would have some indirect fiscal effects, particularly on costs for state health programs such as Medi-Cal, because if the funded research leads to new medical treatments the average cost of patient care could either increase or decrease, so the overall effect on program costs is uncertain.

One point on the repayment period: the official analysis printed in the voter guide and published by the Legislative Analyst's Office states about 20 years, while the argument against the measure submitted by Robert M Kaplan, Ph.D. states that taxpayers would be committed to roughly $500 million in annual debt payments for the next 25 years, and CalMatters also reports a 25 year figure; those are the measure's opponents and a news report rather than the official estimate.

The measure also appropriates $100,000,000 from the General Fund as a startup loan to the institute, to be repaid within 12 months or as soon as practicable after that from bond proceeds.S1S2S3S5S6S7S11

Who benefits and who pays

Who benefits

  • The single selected research institute: it receives half of the bond proceeds, described by the Legislative Analyst as about half of the $8.4 billion, to conduct or direct immunology and immunotherapy research, plus a $100,000,000 startup loan from the General Fund that is repaid from bond proceeds. The institute must meet the criteria in the measure, issue an annual public report and commission an independent financial audit each year.S2S7
  • Other California public and nonprofit universities and nonprofit research institutions: they receive the other half of the bond proceeds as competitive research grants, and their representatives sit on the council that sets research priorities and selects grant recipients. The measure restricts eligibility to California-based public and nonprofit institutions and states that no funds are awarded to for-profit organizations or pharmaceutical companies. CalMatters reports that the three UC campuses excluded from the council are Merced, Santa Barbara and Santa Cruz.S2S7S11
  • Californians who need treatments in the future, if the research produces them: the measure requires that a technology or drug developed through funded research and sold or licensed in California be made available to California patients, hospitals and insurance companies at a price at least 20 percent below the national average price calculated by excluding California. This is a rule about future products, so the benefit depends on research that has not yet produced a treatment.S2S7
  • California suppliers and the state's life sciences labor market: each grant recipient must make a good faith effort to buy more than 50 percent of its goods and services from California suppliers, and the purpose section states the measure is intended to expand California's biotechnology industry, create good-paying jobs, generate economic output and stimulate new sources of revenue through grant funding, intellectual property licensing and private sector investment.S7
  • Supporters' claims about who benefits: the argument in favor says the measure funds research that could lead to treatments and cures for cancer, heart disease, Alzheimer's, Parkinson's disease, ALS and other illnesses, that at least half of all funds are dedicated to cancer, heart disease and Alzheimer's research, that it creates a stable funding source while federal medical research funding is being cut, that it will create tens of thousands of good-paying jobs, that the 20 percent discount lowers health care costs for Californians, and that the measure is designed to pay for itself with no net cost to the state or taxpayers. These are the supporters' claims as printed in the voter guide and on the campaign website.S5S6S14
  • Organizations and people listed in support: the voter guide summary page lists the Michael J. Fox Foundation, Alzheimer's Los Angeles, the Kidney Cancer Association and the American Nurses Association of California as supporters. The argument in favor is signed by Susan Disney Lord, board chair of Alzheimer's Los Angeles, Eugene P. Brandon, Ph.D., of the ALS Association board of trustees, and Dr. Brian Shuch, M.D., of the Kidney Cancer Association board, and it also lists the American Nurses Association of California, Blood Cancer United, the California Colorectal Cancer Coalition, the Liver Coalition, the National Multiple Sclerosis Society and the Parkinson Association of Northern California. CalMatters and the Institute of Governmental Studies add the American Association of Immunologists, the California Democratic Party, City of Hope and the Michelson Center for Public Policy. The Los Angeles Times adds the Alzheimer's Association, the California Black Health Network, Source LGBTQ+ Center and the Parkinson Association of Northern California, and the LAist voter guide adds the California Black Health Network.S4S5S10S13S14S15

Who pays

  • The state General Fund and the taxpayers who fill it: the Legislative Analyst estimates the state would pay $500 million to $600 million a year from the General Fund for about 20 years to repay the bond, which is about 0.25 percent of the state's total General Fund budget, and the analysis notes the total cost would be about 10 percent more, after inflation, than paying up front with money the state already has. The bonds are general obligation bonds of the state with the full faith and credit of the state pledged for repayment, and the text requires an annual sum to be collected each year in the same manner as other state revenue to pay the principal and interest coming due.S1S2S3S7
  • No new tax, fee or assessment: the measure creates a bond repaid from existing state revenue rather than a new charge on households or businesses, and it does not raise the personal income tax, the sales tax or a property tax. The cost falls on the state budget, which the measure's opponents describe as a claim on the General Fund that is needed for health, higher education and social programs.S2S3S16
  • Patients, if funded research changes the cost of care, in the Legislative Analyst's own framing: the analysis says if the funded research leads to new medical treatments, the average cost of patient care could either increase or decrease, and as a result the overall effect on state health program costs is uncertain.S2S3
  • Critics' concerns about cost and risk, which are claims rather than official findings: the argument against the measure, submitted by Robert M Kaplan, Ph.D. and signed by him as a senior scholar at the Stanford University School of Medicine's Clinical Excellence Research Center, says the claim that the measure will pay for itself is speculative, that California faces a continuing structural budget deficit, that the measure would commit taxpayers to roughly $500 million in annual debt payments for the next 25 years, and that this long-term obligation would reduce the state's fiscal flexibility to respond to changing priorities. The campaign against the measure adds that the debt is certain while the revenue is not, that the state should not borrow billions for research that may never produce treatments, and it cites the 2004 stem cell research program, which it says returned only about $16 million in royalties. These are the opponents' claims as printed in the voter guide and on their campaign website.S5S6S16
  • Critics' concerns about transparency, also claims: the opposition campaign argues that despite promises of accountability, the selected institute would not be treated as a public agency under key California transparency and ethics laws, including the Public Records Act and open meeting requirements, and that the measure's decision makers would be exempt from the Political Reform Act, so they would not need to file a Statement of Economic Interest. The text states that the institute is not a public agency for purposes of specified laws and that the Political Reform Act applies to the council except as provided in the measure.S7S16

Support and opposition

Supporters

Total raised: $64,215,472

As of: October 6, 2026

Organizations

  • Michael J. Fox Foundation for Parkinson's Research
  • Alzheimer's Association
  • Alzheimer's Los Angeles
  • ALS Association
  • American Nurses Association of California
  • Kidney Cancer Association
  • National Multiple Sclerosis Society
  • Prostate Cancer Foundation
  • Blood Cancer United
  • California Colorectal Cancer Coalition
  • Liver Coalition
  • Melanoma Research Alliance
  • Parkinson Association of Northern California
  • American Association of Immunologists
  • City of Hope
  • California Black Health Network
  • Source LGBTQ+ Center
  • Michelson Center for Public Policy
  • California Democratic Party
  • Susan Disney Lord, Board Chair, Alzheimer's Los Angeles
  • Eugene P. Brandon, Ph.D., Board of Trustees, ALS Association
  • Dr. Brian Shuch, M.D., Board of Directors Member, Kidney Cancer Association

Top funders

  • Gary K. Michelson $40,000,000 Individual, California; donor to committee 1485847 as reported on the Fair Political Practices Commission top 10 contributors list
  • Michelson Center for Public Policy, Inc. – Yes on 38 (Nonprofit 501(c)(4)) $21,200,000 Committee 1494727, listed with top donor Gary K. Michelson and noted as aggregating with the Michelson Center for Public Policy; donor to committee 1485847
  • Gary K. Michelson $10,000,000 Individual, California; the sole top contributor reported for committee 1494727
  • Meyer Luskin $5,000,000 Individual, California; donor to committee 1485847
  • California Democratic Party $15,595 Political party committee; donor to committee 1485847, listed with top donors Kalshi, Inc. and the committee Yes on 50, the Election Rigging Response Act

Key arguments

  • Supporters say the measure accelerates development of breakthrough treatments and cures for diseases that affect nearly every family, that at least half of all funds are specifically dedicated to cancer, heart disease and Alzheimer's research, and that immunotherapies are already curing cancers such as melanoma, lung cancer and leukemia while research is under way into Parkinson's, heart disease, diabetes and other conditions. These are the supporters' claims as printed in the voter guide argument in favor and on the campaign website.S5S6
  • Supporters say the measure is needed because federal funding cuts and uncertainty are disrupting medical research at nonprofit research institutes and universities and delaying progress toward cures, and that the bond creates a stable source of funding dedicated exclusively to California-based nonprofit universities and research institutes, helping California lead the nation in medical innovation and creating tens of thousands of good-paying jobs. These are the supporters' claims.S5S6
  • Supporters say the measure lowers health care costs because any cure or immunotherapy developed through it must be provided to California patients at a 20 percent discount, and because preventing and curing diseases will reduce long-term health care expenses. These are the supporters' claims and their reasoning.S5S6
  • Supporters say the measure is designed to pay for itself with no net cost to the state or taxpayers, because 10 percent of revenue from the licensing of successful immunotherapies must be returned to California to offset the costs of the bond including interest. These are the supporters' claims. The Legislative Analyst, by contrast, says only that the state could recover part or all of the cost in subsequent decades if the funded research leads to discoveries that generate revenue.S2S5S6
  • Supporters list accountability provisions they say protect taxpayers: a 2 percent cap on state administrative expenses, public disclosure of spending, independent financial audits and a rule that for-profit corporations are not eligible for grant funding. These provisions are also in the text of the measure.S5S6S7
  • Supporters say the measure is supported by doctors, nurses and patient advocates, and the argument lists the ALS Association, Alzheimer's Association, American Nurses Association of California, Blood Cancer United, California Colorectal Cancer Coalition, Liver Coalition, Michael J. Fox Foundation, National Multiple Sclerosis Society and Parkinson Association of Northern California, among others, along with quotes from cancer survivors and researchers. The rebuttal to the argument against adds a quote from an immunotherapy patient who says the treatment left him cancer-free. These are the supporters' statements.S5S6
  • Money reported on the support side: the Secretary of State's contribution totals page for this measure reports two committees formed to support it, with a combined total of $64,215,472 in reported contributions through 10/06/2026. They are MICHELSON CENTER FOR PUBLIC POLICY, INC. – YES ON 38, a nonprofit 501(c)(4) with committee ID 1494727 and $13,000,000 reported, and YES ON 38: CALIFORNIANS FOR LIFE-SAVING IMMUNOLOGY RESEARCH AND CURES, SPONSORED BY THE MICHELSON CENTER FOR PUBLIC POLICY, committee ID 1485847, with $51,215,472 reported. The Fair Political Practices Commission's top 10 contributors list for the November 2026 general election reports $76,215,595.20 in top aggregated contributions in support of this measure, which is the sum of the top contributors it lists for the two committees. The two figures measure different things: the Secretary of State total is the committees' reported contributions through 10/06/2026, while the Commission figure is the total donated by the top contributors that list identifies.S8S9

Opponents

Total raised: $3,782

As of: October 6, 2026

Organizations

  • Robert M Kaplan, Ph.D., Stanford University School of Medicine, Clinical Excellence Research Center
  • David Panush, California Health Policy Strategies
  • League of Women Voters of California
  • Orange County Register Editorial Board
  • Howard Jarvis Taxpayers Association

Key arguments

  • The argument against the measure, signed by Robert M Kaplan, Ph.D., says California recognizes that continued investment in science is essential but this measure is not the way to do it. It says the measure continues the use of ballot initiatives to direct research funding to selected topics, adds another highly focused program on top of existing ones for stem cell research and precision medicine, and that ballot-box science favors the most visible topics rather than the greatest scientific opportunities or public health needs, naming mental illness, kidney disease and eye diseases as conditions getting less attention. These are the opponents' claims.S5S6
  • The argument against says borrowing is an inappropriate way to finance scientific research, that the bonds would obligate taxpayers to $500 million in annual debt payments for about 25 years, that bonds are commonly used for long-lived infrastructure with predictable benefits while discoveries often require decades and many lines of investigation never produce marketable treatments, and that the long-term obligation would reduce the state's fiscal flexibility. It also says the assumption that successful discoveries generate revenue for the state is unrealistic because universities rarely commercialize new therapies on their own and private companies typically invest the far greater resources needed for development, clinical testing, manufacturing and regulatory approval. These are the opponents' claims, and the 25 year repayment period is their figure; the official Legislative Analyst estimate printed in the voter guide states about 20 years.S2S5S6
  • The argument against says the requirement that certain therapies developed with state support be sold in California at discounted prices, while attractive, could give companies an incentive to prioritize selling those products in other states where prices are not controlled. It closes by saying California has better options, pointing to legislation by Senator Scott Wiener to create a state-funded research agency modeled on the National Institutes of Health and the National Science Foundation that would set priorities through expert scientific review, which the argument says received support from the University of California, the United Auto Workers and the Union of American Physicians and Dentists but did not advance. These are the opponents' claims and their stated alternative.S5S6
  • The rebuttal to the argument in favor, also signed by Robert M Kaplan, Ph.D., says the claim that the measure will pay for itself is speculative and that audits, disclosure and limits on administrative costs cannot guarantee that research investments will generate enough returns to offset billions in bond repayments. It says California faces a continuing structural budget deficit, that recent federal actions have put funding for essentials such as disease surveillance, emergency preparedness, HIV prevention, vaccination infrastructure, laboratory capacity and community prevention at risk, and that if California replaces declining federal support elected officials should be able to weigh all health priorities together rather than earmarking borrowed dollars for one scientific field. These are the opponents' claims.S5S6
  • The campaign against the measure argues it is an abuse of the ballot process because the criteria appear to leave only one institution qualified to receive more than $4 billion, and that public research funding should be awarded through open competition based on scientific merit rather than determined by whoever can afford to put an initiative on the ballot. The campaign lists the criteria it considers decisive, including an existence date of January 1, 2025, an affiliation agreement with a University of California campus by that date, an affiliation with a UC health system recording more than 35,000 inpatient admissions and 3.5 million outpatient visits a year, at least 200,000 square feet of research space, at least $250 million in identified philanthropic support and two separate $50 million commitments for designated research programs. These are the opponents' claims and their summary of the criteria, which the text of the measure states in the same terms.S7S16
  • The campaign against the measure also argues that the debt is certain while the pay-for-itself claim is not, that taxpayers remain responsible whether or not the research produces profitable treatments, that the 2004 stem cell research bond cost an estimated $6 billion with interest while the program has returned only about $16 million in royalties, and that the transparency and ethics exemptions the measure gives the selected institute and its decision makers mean the public would not have access to records, meetings or conflict-of-interest disclosures it would otherwise have. These are the opponents' claims.S16
  • Nonpartisan summary of the case against, as CalMatters and the Institute of Governmental Studies report it: critics fault the measure for focusing on just one subset of biomedical research rather than a wider array of health research, question whether research from this fund can produce commercial drugs given how hard it is to get a drug approved and to market, question why just one nonprofit stands to receive half the money, and note that it would add $500 million to $600 million a year in debt payments for 20 years. The Institute of Governmental Studies summarizes the opposition as arguing that the measure is designed to benefit its billionaire donor by funneling state resources toward a single institution using arbitrary criteria, and that state research funds should instead be allocated through a fair and competitive process.S10S13
  • Money reported on the oppose side: the Secretary of State's contribution totals page for this measure reports one committee formed to oppose it, NO ON PROPOSITION 38, committee ID 1495405, with $3,782 in reported contributions through 10/06/2026. The Fair Political Practices Commission's top 10 contributors list for the November 2026 general election states that no committee opposing this ballot measure raised enough money to reach the reporting threshold for its list, which covers committees that raised at least $1,000,000, so the list reports no opposing committee for the measure and no top contributors are recorded here.S8S9

How it could affect your household

Household type Effect Explanation Confidence
Homeowner Neutral The measure creates no new tax, fee or assessment on homeowners and does not change property tax or income tax rules. It is financed by general obligation bonds repaid from the state General Fund, which is existing state revenue rather than a new charge to this household, though the Legislative Analyst estimates $500 million to $600 million a year in General Fund repayment costs for about 20 years, or about 0.25 percent of the state's total General Fund budget. A homeowner is not directly affected beyond that indirect budget effect, and there is no eligibility rule that turns on homeownership.S2S3S7 Medium confidence
Renter Neutral The measure does not change rent rules, housing programs or any tax or fee a renter pays. Its costs come from the state General Fund, which is existing state revenue rather than a new charge to this household. The benefit provisions, the 20 percent discount on treatments developed from funded research and the research programs themselves, are not housing related and depend on future discoveries, so there is no direct effect on a renter now.S2S3S7 Medium confidence
W-2 earner ($100k to $250k) Neutral The measure adds no tax, surcharge or bracket to the personal income tax and creates no new fee, so this household's state tax bill does not change because of it. The bond is repaid from the General Fund, which is funded by state revenue that includes this household's taxes, and the Legislative Analyst puts that repayment at $500 million to $600 million a year for about 20 years with the state possibly recovering part or all of it later, so the effect on this household is indirect and runs through the state budget rather than through a direct charge.S1S2S3S7 Medium confidence
High earner (over $1M) Neutral The measure does not raise the personal income tax or add a bracket and does not change the tax treatment of investment income or business income, so it does not directly change this taxpayer's state taxes. The bond is repaid from the General Fund, which draws on the state's existing revenue including the income taxes this household pays, so the effect is indirect. There is no income limit or eligibility rule in the measure that applies to a household at this income level, because the measure's funding goes to research institutions rather than to households.S2S3S7 Medium confidence
Small business owner Mixed There are two directions in the text. On one side, grant recipients must make a good faith effort to buy more than 50 percent of their goods and services from California suppliers, and the purpose section states the measure is intended to expand California's biotechnology industry, create good-paying jobs and generate economic output, which creates potential demand for California suppliers and life sciences employers. On the other side, the measure awards no grant funds to for-profit organizations or pharmaceutical companies, because recipients must be public or nonprofit institutions, so a for-profit business is not a direct funding recipient. A small business outside research and life sciences gets no direct benefit and no new tax or fee. The competitor for funding is the state budget, since the Legislative Analyst estimates $500 million to $600 million a year in General Fund repayment costs for about 20 years.S2S3S7 Medium confidence
Retiree Unclear The measure creates no tax on retirement income, Social Security or pensions and does not change Medi-Cal eligibility or Medicare rules, so it takes nothing directly from a retiree. The possible benefit is the price rule: a treatment developed from funded research and sold in California must generally be priced at least 20 percent below the national average price calculated by excluding California, which could help a retiree who needs such a treatment. That benefit depends on research that has not produced a treatment yet, so it is speculative. The Legislative Analyst separately says that if the funded research leads to new treatments, the average cost of patient care could either increase or decrease, so the effect through state health programs is uncertain.S2S3S7 Low confidence
Local government services user Mixed The measure creates a state cost rather than a local one: the Legislative Analyst estimates $500 million to $600 million a year from the state General Fund for about 20 years to repay the bond, with the total cost about 10 percent more than paying up front after adjusting for inflation, and the analysis notes California faces the same budget pressures as the state's other obligations. That means less General Fund capacity for the state services this person relies on than there would be without the measure. In the other direction, the same analysis says the state could recover part or all of the cost in later decades if the research generates revenue, and that the measure could indirectly affect costs for state health programs such as Medi-Cal in either direction, since new treatments could raise or lower the average cost of patient care. Local government budgets are not directly charged, and the measure states the bond proceeds are not proceeds of taxes for purposes of Article XIII B of the California Constitution and are not subject to that article's spending limit.S2S3S7 Medium confidence

Tradeoffs

  • A funded research program against a twenty year General Fund obligation: the measure creates a stable source of money for immunology and immunotherapy research, which supporters say is needed while federal medical research funding is being cut. The Legislative Analyst estimates the cost at $500 million to $600 million a year from the state General Fund for about 20 years, about 0.25 percent of the General Fund budget, and says the total cost of the bond would be about 10 percent more after inflation than paying up front. The opponents frame the same cost as debt that comes certain while the revenue does not.S2S3S5S6S16
  • Concentration against breadth: half the bond goes to one nonprofit research institute selected by the California Department of Public Health, which the measure describes as a way to cut through bureaucracy and fund focused, outcome-driven research, while the other half is distributed as competitive grants to public and nonprofit institutions. The argument against says concentrating half the funding in one institute is unfair and that research priorities should be set by scientific review and public health planning rather than by a ballot measure, and CalMatters reports that the criteria very likely exclude all but one institute in the state. The measure's purposes section also states that funds are dedicated to California institutions and that no funds go to for-profit organizations or pharmaceutical companies.S2S5S6S7S11
  • A promised return against revenue that is uncertain in amount and timing: the measure requires recipients to pay the state 10 percent of revenue from selling or licensing discoveries, with payments going to the General Fund until the bond's full cost including interest is covered, and the purpose section describes this as making the measure effectively a loan program so taxpayers fully recoup their investment. The Legislative Analyst says the state could receive revenue that could be significant but that the amount is uncertain, depends on how many projects lead to marketable treatments and could take decades. The argument against says universities rarely commercialize new therapies on their own and that public benefits generally do not flow back to the state treasury, and the campaign cites the 2004 stem cell program's royalty record.S2S5S7S16
  • A California price discount against an incentive to sell elsewhere: the measure requires that a technology or drug developed through funded research and sold or licensed in California be made available to California patients, hospitals and insurance companies at a price at least 20 percent below the national average calculated by excluding California, with recalculation each year. The argument against says that while this sounds attractive, it could give companies an incentive to prioritize selling those products in other states where prices are not controlled.S5S6S7
  • Audits and reporting against the transparency exemptions in the same text: the measure requires annual public reports, independent financial audits, a Controller review with public meetings and a Citizens' Financial Accountability Oversight Committee, and it caps state administrative costs at 2 percent. At the same time, the text states that the institute is not a public agency for purposes of the California Public Records Act, the open meeting requirements of the Government Code and the Political Reform Act of 1974, and it applies the Political Reform Act to the council with specific exceptions that let members vote on grants to entities in the same field as their employer and on research into a disease they or a family member has. The opposition campaign makes this combination its transparency argument.S7S16
  • What the vote does and does not decide: the measure sets the bond amount, the split between the institute and the grants, the disease set-aside, the eligibility criteria, the 10 percent revenue share, the 20 percent price rule, the 2 percent administrative cap and the audit and reporting structure. It leaves the identity of the institute, the grant selections, the research priorities within immunology and immunotherapy and the pace of bond issuance to decisions made after the election, by the California Department of Public Health and the council the measure creates. The Institute of Governmental Studies notes the department makes the final selection, and the campaign for the measure has said the final decision lies with the department.S7S13S15
  • Money is not symmetrical: the Secretary of State reports $64,215,472 in contributions to the two committees supporting the measure through 10/06/2026, and the Fair Political Practices Commission reports $76,215,595.20 in top aggregated contributions in support, while the one committee opposing the measure reported $3,782. That asymmetry means most of the arguments the public sees against the measure come from its official argument in the voter guide, the opposition campaign's own material and nonpartisan news analysis rather than from a funded advertising campaign.S5S8S9S16

Sources

  1. Proposition 38 Official Title and Summary (Official Voter Information Guide, November 3, 2026) California Secretary of State Accessed 2026-10-17
  2. Proposition 38 Analysis by the Legislative Analyst (Official Voter Information Guide, November 3, 2026) California Secretary of State and Legislative Analyst's Office Accessed 2026-10-17
  3. Proposition 38 [Ballot], Propositions on the November 3, 2026 Ballot Legislative Analyst's Office Accessed 2026-10-17
  4. Proposition 38 summary page (Official Voter Information Guide, November 3, 2026) California Secretary of State Accessed 2026-10-17
  5. Proposition 38 Arguments and Rebuttals (Official Voter Information Guide, November 3, 2026) California Secretary of State Accessed 2026-10-17
  6. Proposition 38 print version, Official Voter Information Guide (title and summary, analysis by the Legislative Analyst, argument in favor, rebuttal, argument against, rebuttal) California Secretary of State Accessed 2026-10-17
  7. Proposition 38 Text of Proposed Laws, Official Voter Information Guide (Health and Safety Code Division 110.5, commencing with Section 130350, California Immunology and Immunotherapy Medical Research Act and California Immunology and Immunotherapy Bond Act of 2026) California Secretary of State Accessed 2026-10-17
  8. Proposition 38 – Authorizes Bonds for Immunology Research. Initiative Statute., 2026 Ballot Measure Contribution Totals California Secretary of State (Cal-Access) Accessed 2026-10-17
  9. Top 10 Contributors List, November 2026 General Election California Fair Political Practices Commission Accessed 2026-10-17
  10. CalMatters California Voter Guide 2026: Proposition 38, Research bond, borrow $8.4 billion for immunology research CalMatters Accessed 2026-10-17
  11. This CA proposition will send $4 billion to a single nonprofit. Who's behind it? (Mikhail Zinshteyn, July 31, 2026, updated August 3, 2026) CalMatters Accessed 2026-10-17
  12. Prop 38 (2026), Bonds for Research on the Immune System, CaVotes ballot measure guide League of Women Voters of California Education Fund Accessed 2026-10-17
  13. Proposition 38: The California Immunology Research & Cures Initiative, California Ballot Proposition Guides, November 3, 2026 General Election Institute of Governmental Studies, University of California, Berkeley Accessed 2026-10-17
  14. Prop. 38: Authorizes bonds for immunology medical research, LAist 2026 voter guide LAist (Southern California Public Radio) Accessed 2026-10-17
  15. Your guide to Proposition 38: Immunology and immunotherapy research funding (Karen Garcia, October 1, 2026) Los Angeles Times Accessed 2026-10-17
  16. Key Arguments Against California Proposition 38 (2026), campaign website of the committee opposing the measure No on Prop 38 campaign Accessed 2026-10-17