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asks voters to allow the state to borrow $8.4 billion to support medical research in immunology and immunotherapy conducted by California research institutes and universities. Half of the bond proceeds would go to a single nonprofit immunology research institute affiliated with the University of California, while the rest would be distributed as competitive research grants to public or nonprofit universities and institutions.
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Immunology is the study of the body’s immune system and immunotherapy develops treatments that help the immune system fight diseases more effectively. At least half of the borrowed funds are to be used for research on cancer, heart disease and Alzheimer’s disease.
The proposed measure materialized as a response to the Trump administration’s cuts and freezes to thousands of medical research grants in recent months. Shrinking resources and the accompanying uncertainty is delaying medical research and threatening progress towards finding cures, the team behind Proposition 38 said. The goal of the measure is to allow immunology research to advance unimpeded.
While backers of Proposition 38 spent the summer getting thousands of registered voters to sign onto their petition so it could appear on the November ballot, California lawmakers were simultaneously pushing for a multibillion dollar bond proposal to fund scientific research through the Legislature. That initiative failed to meet the June deadline to secure its place on the November ballot. However, legislators are now aiming to present that $7.5 billion bond to voters in the March 2028 primary election.
Fiscal impact of Prop. 38
A bond is a way for the state to borrow money, then repay it with interest over time. A general obligation bond is typically repaid from the state’s general fund, the pot of money it uses to pay for most public services, including education and healthcare.
According to the Legislative Analyst’s Office, the state will have to pay $500 million to $600 million annually for about 20 years to repay the Proposition 38 bond. That is about 0.25% of the state’s annual general fund budget. The total cost of the bond would be about 10% more, after adjusting for inflation, than if the state paid that same $8.4 billion upfront.
The state is currently repaying more than $71 billion in general obligation bonds. In addition, the state previously approved nearly $38 billion in bonds that have not yet been sold.
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Per the proposed measure, 10% of all proceeds from the immunotherapies developed as a result of the bond must be given to the state to offset its repayment costs. Any additional revenue must be used for future immunology research, it says. In addition, treatments developed through funded research are to be offered at a 20% discount in California.
Supporters of Prop. 38
Proposition 38 is supported by a broad coalition of doctors, nurses and patient advocates. This includes the Alzheimer’s Association, ALS Association, The Michael J. Fox Foundation for Parkinson’s Research, American Nurses Association California, Prostate Cancer Foundation and Kidney Cancer Association.
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The Yes on 38 committee formed to support the measure had received more than $13 million in campaign contributions by July 1. More than $8 million in contributions came from nonprofit Michelson Center for Public Policy and its president, Gary Michelson, the chief backer of the proposition.
Michelson, a billionaire philanthropist and medical inventor, is the co-founder of the not-yet-open California Institute for Immunology and Immunotherapy, an independent medical research organization affiliated with UCLA. Earlier this summer, CalMatters reported only one research institute in California appeared to meet the criteria included in the measure for the nonprofit that would be awarded half the bond proceeds. That institute is Michelson’s California Institute for Immunology and Immunotherapy. Meyer Luskin, co-founder of the institute, has so far contributed at least $5 million to the Proposition 38 campaign.
Opponents of Prop. 38
A coalition of physicians, scientists and taxpayer advocates have come together under the “No on Proposition 38” banner to oppose what they called “ballot-box science” that will result in decades of bond debt for California. The League of Women Voters of California, a nonpartisan political organization, endorsed this view.
Robert Kaplan, a senior scholar at Stanford School of Medicine’s Clinical Excellence Research Center and former associate director of the National Institutes of Health, is the leading voice of opposition against Proposition 38. He criticized the practice of funding research focused on specific diseases rather than investing in medical research more broadly, especially when the Trump administration’s cuts affected public health programs across the board, and selecting priority areas through elections.
“Research priorities should be established through scientific review and public health planning — not by election campaigns,” Kaplan wrote. “Cancer, Alzheimer’s disease, and heart disease deserve attention, but so do mental illness, kidney disease, eye diseases, and many other conditions. Ballot-box science inevitably favors the most visible topics rather than the greatest scientific opportunities or public health needs.”
In his opposition letter, he also noted that the claim that the measure would eventually pay for itself through revenue generated from new immunotherapies was only “speculative.”
Despite criticism over the structure of the funding, California voters have previously backed large biomedical research initiatives. In 2004, voters approved Proposition 71, creating the California Institute for Regenerative Medicine and authorizing $3 billion in bond funding for stem cell research. Californians approved an additional $5.5 billion for the institute in 2020 but with only 51% of voters in favor.
Proposition 38 needs “yes” votes from a majority of California voters in November to be approved.
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