California's $8.4 billion cancer and Alzheimer's research bond is ahead—but the result is not final – Medical Daily

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California’s Proposition 38, an $8.4 billion bond for immunology and immunotherapy research on cancer, heart disease, and Alzheimer’s disease, was leading with about 56% of the vote as counting continued Wednesday. Yes votes stood at 55.7%, or 4,181,327, to 44.2% no, with about 58% of votes counted early Nov. 4, according to Associated Press figures published by KQED.
The result is preliminary. California counts mail ballots for weeks, and about two of every five ballots were still being tallied Wednesday, KQED reported. The state has not certified the result.
For patients and families living with cancer or Alzheimer’s, the measure promises a long-term research investment and a price break on future treatments. Neither would arrive quickly, since the treatments it may fund do not exist yet.
The vote also comes as researchers across California worry about federal grant cuts. Backers framed the bond as a way to keep immunology research running in the state as federal science funding becomes less reliable, while critics questioned its cost and structure.
Immunotherapy uses the body’s immune system to fight disease, and several such treatments are already approved for certain cancers. Prop 38 would fund new research in that field, with at least $4.2 billion going to immunology research on cancer, heart disease, and Alzheimer’s, according to the nonpartisan Legislative Analyst’s Office.
About half the money would go to one research institute chosen by the California Department of Public Health. The other half would be awarded as competitive grants by a council of representatives from seven University of California campuses and 10 to 15 other California universities and nonprofits.
Only one institute currently appears to meet the criteria: the California Institute for Immunology and Immunotherapy, affiliated with UCLA, CalMatters reported. Its principal funder, billionaire Gary K. Michelson, wrote the measure and was by far its largest donor. The institute had three employees as of September, and the UCLA research park that will house it is not expected to be fully built until at least late 2028.
The measure says treatments developed with Prop 38 money and sold in California must generally be offered at a 20% discount, meaning 20% below the average national price, according to CalMatters’ election coverage.
The LAO analysis does not explain how the discount would be enforced. It is not clear whether savings would go to patients at the pharmacy counter, to insurers, or to Medi-Cal. The discount also would not lower the price of any immunotherapy already on the market.
That matters for families budgeting for care. A patient with good insurance may see little direct change, while an uninsured patient or one with a high deductible could benefit more, if a qualifying treatment is ever approved. The LAO said the net effect on state health programs such as Medi-Cal is uncertain.
The state would receive 10% of any revenue from discoveries, which would go first toward repaying the bond. Opponents say that revenue would need to exceed $120 billion after 20 years for California to recoup its investment. Jonathan Eisen, a UC Davis biologist, questioned whether the measure could generate enough to repay Californians. “It is remarkably hard to do,” he said.
Supporters argue California must step in as federal science funding becomes less reliable. Gov. Gavin Newsom, the California Democratic Party, and the state Republican Party endorsed the measure, along with patient and research advocacy groups.
Opponents raised about $12,000, compared with roughly $71 million for supporters, KQED reported. Marianne O’Malley, a retired LAO analyst who opposed the measure, said, “It seems like a profoundly corrupt and deceitful measure,” because half the money is steered to a single institute.
Critics also note that the institute is exempt from public records and open-meeting laws, though it must publish annual reports and undergo independent financial audits. They point to California’s 2004 stem cell bond, which was also pitched as paying for itself. Opponents say the state has received only $16 million of what it was owed from that program.
If approved, repayment would cost the state $500 million to $600 million a year for about 20 years, roughly 0.25% of the state’s general fund budget, according to the LAO. That money competes with schools, health programs, and other services.
The people most likely to benefit are patients with cancers or immune-related conditions who may join California clinical trials and, eventually, residents who use any approved treatment that comes from the research. Moving from lab work to an approved therapy often takes many years.
Patients with cancer, heart disease, or Alzheimer’s should keep following their current treatment plans. Those interested in immunotherapy trials can ask their oncologist or neurologist about studies open now through ClinicalTrials.gov or a nearby academic medical center.
Counties will continue counting ballots in the coming weeks before the secretary of state certifies statewide results. If the lead holds, the Department of Public Health would decide which institute receives half the funding. A separate $7.5 billion science bond is expected before voters in March 2028. MedicalDaily will report the final result.
What is California Prop 38? An $8.4 billion state bond for immunology and immunotherapy research, with a focus on cancer, heart disease, and Alzheimer’s.
Did Prop 38 pass? It was leading with about 56% on Nov. 4, but ballots are still being counted, and results are not certified.
How would the 20% discount work? Treatments developed with bond money and sold in California would generally cost 20% below the average national price. Enforcement has not been explained.
Who gets the money? About half would go to one institute, likely the UCLA-affiliated California Institute for Immunology and Immunotherapy, and half to competitive grants.
How much would it cost taxpayers? About $500 million to $600 million a year for roughly 20 years, according to the LAO.
Will this lower my current treatment costs? No. The discount applies only to future treatments developed with the bond money.
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