Should California voters approve Proposition 38? (November 3, 2026 ballot)

What's this about?

People disagree about whether California should approve Prop 38 on Nov. 3, 2026.

The plan would borrow billions for immune-system research, but it would also create years of debt.

What supporters say

• New immune drugs have helped some people with cancer.
• The plan would fund state schools and groups, with some help for patients.
• Successful new drugs could bring money back to the state and lower its costs.
• Public research can lead to new drugs and other health tools later.

What critics say

• No one can know if the research will bring new cures or enough money.
• The bond would force the state to make large payments for many years.
• The plan may give too much power to a small group and limit fair contests.
• A state-only price cut may make it harder to sell new drugs.

How to read this

The number of points on each side does not show who is right; strong proof matters more than a long list.

California voters will decide whether to approve Proposition 38 on Nov. 3, 2026. The measure would borrow billions for immunology research, offering the possibility of new treatments and economic benefits while committing the state to decades of debt.

The case for

Public biomedical research can create a pipeline for future treatments. Government-funded science often produces knowledge and technologies that private companies later develop into medicines. Those benefits may take many years to appear and are difficult to attribute to a single investment, but research funding has been linked to later drug approvals and broader medical and economic gains. 1

Proposition 38 focuses on immunology, a field that has already produced important clinical advances. Drugs that target the PD-1 and PD-L1 pathways have shown benefits for some cancer patients, and researchers have developed both approved and experimental immune-based treatments. Results vary, however, with ongoing problems involving treatment resistance, side effects and identifying which patients are most likely to respond (see Figure 1). 2

The measure also tries to connect research spending to California institutions and patients. Its structure would fund California public and nonprofit research organizations, require audits and public reports, offer discounts on qualifying treatments sold in the state, and direct 10 percent of revenue from funded discoveries toward repaying California. 3 If the research leads to successful products, royalties and licensing income could reduce the bond’s net cost. In-state discounts could also give Californians a direct benefit.

Supporters therefore can defend the proposal as a long-term portfolio investment, not a promise of a particular cure. Over time, discoveries could produce enough medical or commercial value to offset some public costs, although that would depend on research reaching the market and on the terms of any resulting deals. 4

The case against

The strongest objection is fiscal. Proposition 38 would create an $8.4 billion general-obligation bond, with estimated annual payments of roughly $500 million to $600 million for about 20 years. The state would repay the debt, with interest, from the General Fund—regardless of whether the research produces treatments or revenue. 5 That could limit money available for other public priorities, and borrowing would cost more than making an equivalent payment upfront.

The medical and financial payoffs are also highly uncertain. Promising laboratory results often fail in human trials, and immunotherapy works differently across diseases, patients and clinical settings. Research reviews have found limits in using animal studies to predict human safety and effectiveness, as well as problems with reproducibility and reporting in early-stage research. Clinical results also vary substantially. 6 The available evidence cannot reliably predict whether Proposition 38 will produce major treatments, how quickly that might happen, or whether royalties would cover a meaningful share of the debt.

The proposal’s structure raises additional concerns. About half the money would go to one qualifying UC-affiliated nonprofit institute, while a council made up of member institutions would help select grants. Audits, reporting rules and conflict-of-interest protections offer safeguards, but they do not show that the resulting research portfolio would be the most competitive or diverse. 7

A requirement for discounts on treatments sold in California could improve access if a product is developed. But it might also affect licensing decisions, pricing strategies and the revenue available for repayment. Those effects are plausible but have not been measured. 8