What it would do:

Give the state permission to borrow $1.5 billion to fund renovations, expansions, and upgrades at hospitals that treat children. Most of the funding is reserved for the state’s eight private non-profit children’s hospitals ($1.08 billion) and the five hospitals run through one of the University of California campuses ($270 million).

What it would cost the government:

According to the Legislative Analyst’s Office, the state’s nonpartisan budgetary scorekeeper, paying back the bond with interest will run the state government an extra $80 million annually for the next 35 years on average. This is roughly equivalent to six ten-thousandths of the state’s current general fund—or what the state Legislature spent on its legal department this year. The total cost of the bond is expected to be $2.9 billion.

Why it is on the ballot:

The California Children’s Hospital Association regularly turns to the taxpayer for help. In 2004, voters backed a $750-million bond to fund similar infrastructure investments. Four years later, they approved another $980-million in borrowing. This year’s proposal looks pretty similar—only bigger.

Full text of Prop. 4

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Arguments in Favor:

Kids deserve the best possible care. Medical technology is constantly changing, but because children’s hospitals are dependent on the low reimbursement rates from Medi-Cal, the state’s public insurance program for low-income residents, they often can’t afford to keep up. These bond funds would allow the state’s health care providers to make these necessary investments.


Arguments Against:

Why should the taxpayer throw more money at hospitals, many of which are privately-owned and operated? And if they insist on doing so, why borrow rather than make use of existing funds?


See for yourself



California Children’s Hospital Association

California Teachers Association

California Democratic Party

California Chamber of Commerce

The Sacramento Bee editorial board

The Bakersfield Californian editorial board


California Republican Party

California Controller Betty Yee

The League of Women Voters of California


Prop. 4 Campaign Contributions

Going Deeper

Children’s Hospitals Again Cry For Help From Voters, But Are They Really Hurting?

FS Productions/Getty Images



Editorial: Chronicle recommends Yes on Prop. 4, for children’s hospitals


No on Proposition 4 and its bond debt


Vote yes on Prop. 4 for children's hospitals


Prop. 4 provides sound spending on 13 children's hospitals


Pro and Con on Proposition 4


Pay-to-play ballot measures are flourishing