Marin Healthcare District Initiative Measure
Shall the measure funding expanded and upgraded emergency room, intensive care, hospital, and other medical facilities to care for trauma, heart attack, stroke, and other patients and attract qualified doctors and nurses, with no funds for administrator salaries, by enacting a parcel tax of 14¢ per square foot of improved building area annually, generating approximately $12,400,000 annually for 30 years, subject to annual audits and citizens' committee oversight, be adopted?
YES NO
Votes required to pass: simple majority.
Arguments and Rebuttals in "support of" or in "opposition to" the proposed laws are the opinions of the authors.
Impartial analysis by County Counsel of Measure CC
Marin Healthcare District
Measure CC
This Measure was placed on the ballot following submission of a voter initiative petition containing the number of signatures required by law.
Because Measure CC was placed on the ballot through the initiative process, it will be adopted if approved by a majority of the votes cast in this election. If it is adopted, the Marin Healthcare District will levy a parcel tax beginning the first full fiscal year after the effective date. The Measure will remain in effect for fifteen years from the beginning of the parcel tax. The rate of the parcel tax shall be $0.14 per square foot of improved building area, which is defined as the area on a parcel of taxable real property on which there exists any building. The Marin Healthcare District estimates revenue from this Measure will average approximately $12,400,000 annually.
The revenue raised by this parcel tax must be placed in a special account and can only be used for the purposes stated in this Measure. The stated purposes for the funds raised by this special tax are the expansion and modernization of intensive care, trauma, triage, and hospital facilities, as well as additional capacity for the emergency room and patient rooms. The funds may also be spent to hire and retain doctors and nurses, with no funds for administrator salaries.
Dated: 8/24/26
s/BRANDON W. HALTER
County Counsel
Argument in favor of Measure CC
Vote YES on Measure CC to protect local access to life-saving emergency care and hospital services close to home by keeping MarinHealth staffed, equipped, and ready!
For victims of heart attacks, strokes, and accidents, seconds mean the difference between life and death. Measure CC ensures that we have access to life-saving medical care when we need it most.
In Marin County, access to emergency care is especially critical — we have only one major freeway, and traffic delays to the nearest hospital in San Francisco or Sonoma can exceed an hour.
MarinHealth Medical Center is the only designated trauma center in Marin County — and a full-service community hospital providing emergency care, heart and stroke treatment, cancer care, surgery, and mental health services. Studies show that trauma center care can increase survival rates by up to 25%.
Emergency room visits are increasing, and demand for emergency care is growing. Without investment, our hospital risks falling behind safety standards and losing critical services.
Vote YES on Measure CC to:
Upgrade medical technology for heart attacks, strokes, and cancer
- Modernize intensive care, trauma, and triage facilities
- Expand ER capacity to reduce wait times and overcrowding
- Improve outdated operating rooms, labs, and imaging facilities
- Improve mental health, addiction, and suicide prevention services
- Modernize hospital facilities for earthquake safety
- Attract and retain qualified doctors, nurses, and specialists
Measure CC requires strict fiscal accountability:
Ensures that MarinHealth Medical Center remains a public, community-owned hospital
- Every penny stays local and cannot be taken by State or Federal governments
- All funding must be spent as promised and not on administrators’ salaries
- Independent oversight and audits
When an emergency strikes, we need quick access to excellent medical care.
Join local first responders and doctors who rely on MarinHealth every day to save lives. Vote YES on Measure CC!
Jason Ruben, MD, Emergency Room Physician
Jared Huffman, US Congressman
League of Women Voters of Marin County
Andrew Apolinarski, Local Nurse
North Bay Leadership Council
Rebuttal to argument in favor of Measure CC
Marin residents support needed public services. We draw the line at “straight up dishonest” tactics that manufacture panic to fund a wish list through generational taxation.
Proponents claim they need tax to attract staff and save emergency care. The district’s own August 2026 metrics confirm no such crisis: nursing headcount rose, primary care waiting list fell from 3,000 to zero, and turnover dropped to 2%.
MarinHealth is nowhere near ruin, nor is its emergency room. It reported $661 million in revenue, a $24 million surplus, $23.6 million in gifts, and CEO pay in the top 5% nationwide. Taxpayers should fund needs, not wants. Let donors fund wish lists.
Proponents promise strict fiscal accountability. In the fine print, oversight is advisory only, without enforcement, relying on routine district audits. Worse, the district may pledge this 30-year tax to issue bonds, borrowing cash upfront, piling debt and locking revenue so repeal is impossible.
Their record: taxpayers approved $394 million in 2013 and got a front-loaded, interest-heavy structure. More than borrowed ($593 million) remains owed through 2047. Fiscally irresponsible.
The district is extending its seismic deadline while the measure does not even require spending on seismic work.
Measure CC charges per square foot, so modest homes pays like mansions, with no exemption for seniors or low-income residents already afraid of hospital bills. It will take from everyone just to pad their budget.
Examine the numbers. Vote no on CC. It’s double crazy.
CLAY HESS, MD, MPH
Independent Public Health Physician
Argument against Measure CC
A child starting kindergarten this fall will be mid-thirties when Measure CC expires. Crazy.
Her parents will pay it like a mortgage; but Marin, we already pay one since 2013. Now the hospital wants more. Double crazy.
Measure CC is well named: double crazy. A double mortgage funding a wish list: “upgrade,” “expand,” “attract.”
It’s crazy to charge by the square foot, not by what a home is worth: a modest house pays like a mansion. It’s double crazy when the hospital’s foundation already raises twice this tax in gifts.
In 2013 the hospital borrowed $394 million for building and earthquake upgrades. It’s crazy that only $33 million is paid off, 8%. It’s double crazy that ballooning $593 million is still owed through 2047, $232 million of it interest.
Measure CC seeks a second tax of $372 million, 30 more years, combining to $965 million. Crazy. Scaled to a home: owing $965,000 on a house built for $394,000, then renovation borrowing again before one-tenth is paid. Double crazy.
Atop your current bill, a 2,000-square-foot home pays $280 more yearly, $8,400 total, with no senior or low-income exemption. Crazy.
Only another vote can repeal it, and the district may bond against it. Proposition 43 on this ballot restores the two-thirds vote for such taxes. Measure CC asks that it not apply. Double crazy.
It’s crazy for the rich to tax the poor. Hospital 2024 revenue: $661 million. Surplus: $24 million.
Gifts: $23.6 million. CEO pay: over $2 million. It’s double crazy that a director and a taxpayer advocate said on the record that petition gatherers told them the hospital would close if they did not sign, conduct called “straight up dishonest.”
Vote no on Measure CC: a double crazy double mortgage that makes no sense and leaves no cent behind.
CLAY HESS, MD, MPH
Independent Public Health Physician
Rebuttal to argument against Measure CC
To be clear — this is an extremely serious issue facing Marin County.
Measure CC’s sole opponent cares more about quippy taglines and misleading statistics than protecting our community’s emergency care.
As an educated Marin County voter, you deserve the facts about Measure CC, not misinformation:
FACT: MarinHealth Medical Center is the only designated Trauma Center in Marin County. During an accident, heart attack, or stroke, we need care close to home. Being treated at a Trauma Center can increase a patient’s chance of survival by up to 25 percent.
FACT: In an emergency, you need help fast. Seconds can mean the difference between life and death. Voting YES on CC ensures you and your family have rapid access to life-saving care.
FACT: MarinHealth Medical Center is the only hospital owned by the residents of this County. Measure CC keeps all profits reinvested locally.
FACT: There is only one major highway in and out of Marin County. In an emergency, patients can’t afford to sit in traffic for hours or cross a bridge to get to a neighboring hospital.
FACT: Every penny from Measure CC stays in Marin to improve our emergency
healthcare. No funds can be taken away by the state or federal governments or be used for administrators’ salaries.
FACT: Under Measure CC, larger homes pay their fair share. State law prohibits healthcare districts from offering senior exemptions.
FACT: Measure CC is supported by community leaders including doctors, nurses, and first responders.
Vote YES on CC to protect local emergency healthcare!
DR. ANNIE YUAN
Emergency Room Physician
JARED HUFFMAN
US Congressman
LEAGUE OF WOMEN VOTERS OF MARIN COUNTY
KATHERINE BOESCHENI
Local Nurse
MARIN PROFESSIONAL FIREFIGHTERS, IAFF 1775