Where the Race and Ballot Measures Stand Before Tuesday’s Election
With the election days away, we wanted to share a nonpartisan read on where things are heading and what it could mean for California medicine. CSA members hold a wide range of political views, and this update is meant to inform, not to advocate for any candidate or ballot outcome.
Polling points to a likely win for former Health & Human Services Secretary Xavier Becerra. Several tax measures are trending toward defeat, including one that would have directed most of its revenue to health care programs. And whoever is sworn in this January inherits a tight budget, made tighter by federal cuts to Medi-Cal. That is the environment CSA will be advocating in next year.
This is based on the Public Policy Institute of California’s final poll of the cycle: 1,086 likely voters, surveyed October 16–22, margin of error ±3.8 points.
Where Things Stand Going Into Tuesday
- Governor. The polling shows Becerra with a wide and steady lead, 61% to 37%, and at or above 50% in every major region — including the Central Valley, which leaned the other way a month ago.
- The billionaire wealth tax (Prop 40) has moved from winning to losing in a single month, from 52–46 yes to 46–52 no. The measure would have directed most of its revenue to health care programs. The California Medical Association (CMA) opposes it, citing a Legislative Analyst’s Office warning that the one-time tax could drive capital flight and reduce the state’s ongoing revenues, undermining sustainable health care funding over time. Two other measures on the ballot could also cancel it out even if it passes, since the conflicting measure with the most “yes” votes prevails.
- Most other close measures are trending toward “no.” Housing funding is the exception, gaining ground over the past month.
- Voters are gloomier about the economy than a month ago. 77% expect economic bad times over the next year. Cost of living is the top concern for 45% of voters. Health care registers as the top issue for just 3%.
The Full Ballot at a Glance
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| Prop | What It Does | PPIC Sept. (Yes–No) |
Late Movement | Likely Read |
|---|---|---|---|---|
| 1 | $11.25B housing bond | 55–43 | Gained (housing) | Lean Yes |
| 2 | Larger state rainy-day reserve | 60–39 | — | Likely Yes |
| 3 | Make the high-income tax permanent | 58–40 | — | Lean Yes |
| 4 | Allow public campaign financing | 42–53 | — | Lean No |
| 5 | Change the recall process | 35–59 | — | Likely No |
| 37 | $25B middle-income home loan program | 61–35 | Gained (housing) | Likely Yes |
| 38 | $8.4B immunology research bond | 55–42 | — | Lean Yes |
| 39 | Voter ID requirement | 43–55 | — | Lean No |
| 40 | One-time billionaire wealth tax | 52–46 | Flipped to 46–52 (No) | Lean No |
| 41 | Limit new taxes outside the state spending cap | 51–44 | Tightening; turnout-dependent | Toss-up |
| 42 | Ban new personal-property and retroactive taxes | 54–43 | Turnout-dependent | Toss-up |
| 43 | Two-thirds vote for local special taxes | 43–51 | Now below 50% statewide | Lean No |
| 44 | 90% spending rule for community clinics | 34–61 | — | Likely No |
| 45 | CEQA review deadlines | 49–46 | Now trailing | Toss-up (lean No) |
Toplines are PPIC’s September likely-voter survey, except Prop 40, which reflects the October final poll. “Late movement” shows shifts PPIC reported in October; “—” means the October poll did not publish an updated figure. “Likely read” is the CSA advocacy team’s interpretation of the polling, not a PPIC projection or a CSA recommendation. Measures polling in the low 50s this early often lose ground as campaigns spend. CMA and other healthcare groups have formally opposed Prop 40 and Prop 44.
Two Measures the Physician Community Is Watching
CMA and other healthcare groups oppose both Prop 40 and Prop 44. On Prop 40, opposition points to the long-term risk to Medi-Cal funding described above. On Prop 44, which would set a 90% spending rule for community health centers, opposition warns the restriction would divert resources from patient care, raise state health care spending, and threaten access.
What This Means for California Medicine in 2027
- A tight budget with little new money. Depending on how the tax measures land, new state revenue may be limited, while federal changes to Medi-Cal will land in the new governor’s first budget. Expect real pressure on health care spending.
- Cost framing will shape what moves. In this climate, proposals framed around lowering costs tend to travel furthest, and anything seen as raising costs faces stiffer headwinds. CSA will position its priorities on physician payment and patient safety with that in mind.
- Health care is not front of mind for this electorate. That makes it CSA’s job to keep anesthesiology’s priorities visible to a Legislature focused heavily on affordability.
CSA’s advocacy team will watch returns Tuesday and follow up with what the results mean for the specialty and for the 2027 session.