Marin County voters will decide this November whether to tax every improved parcel in the Marin Healthcare District for the next 30 years to help rebuild aging hospital facilities at MarinHealth Medical Center in Greenbrae. Measure CC, headed for the November 3, 2026 ballot, would charge property owners 14 cents per square foot of improved building area, raising an estimated $12.4 million in its first year and roughly $372 million over three decades.
The measure, as reported by the Marin Independent Journal, would fund expanded and upgraded emergency, intensive care, and other medical facilities at the hospital, along with required earthquake safety upgrades. The Marin Healthcare District covers most of Marin County. Because the measure was placed on the ballot through a citizen initiative rather than by the district board, it needs only a simple majority to pass rather than the two-thirds supermajority typically required for special taxes.
That ability to propose taxes through a citizen initiative traces back to a 2017 California Supreme Court decision, California Cannabis Coalition v. City of Upland, which addressed the constitutional power to propose taxes by initiative, according to a summary from the UC Davis School of Law. The measure's use of a citizen initiative and its spending provisions are part of the debate.
Why the Redwood Pavilion Is on Borrowed Time
At the center of the campaign is the Redwood Pavilion, a 120-patient-bed building built in 1952 on the MarinHealth campus. Under regulations enforced by the California Department of Health Care Access and Information, some general acute care hospital buildings must stop inpatient acute care operations by January 1, 2030, according to the California Department of Health Care Access and Information. That deadline is central to the measure's case.
If the Redwood Pavilion is not repaired or replaced, MarinHealth's operational capacity would drop from 267 beds to about 204, the newspaper reports. The potential effect on hospital capacity is central to the campaign. The stakes are heightened by rising demand, the newspaper reports.
A Trauma Center With No Local Backup
MarinHealth Medical Center is Marin County's only designated trauma center, according to the hospital's own MarinHealth materials. That concentration of emergency capacity in a single facility underscores why supporters frame the seismic deadline as an urgent local problem rather than a routine capital project.
The current proposal follows the opening of the hospital's Oak Pavilion. The four-story, 260,000-square-foot facility opened in 2020 and includes 114 private rooms, per the Marin Independent Journal.
Governance History and Financial Debate
MarinHealth Medical Center operated under a 30-year lease with Sutter Health beginning in 1985 before the Marin Healthcare District resumed direct public operational control of the Greenbrae hospital on June 30, 2010, according to the Marin Healthcare District. In a new arrangement reported in September 2024, MarinHealth and UCSF Health purchased equity stakes from Surgical Care Affiliates, expanding outpatient capacity, according to the North Bay Leadership Council.
MarinHealth Medical Center's financial footing is also part of the debate. A report described losses and financial pressure at the hospital.
Money, Endorsements and Opposition
The campaign committee Friends of MarinHealth is backing the measure, according to the Marin Independent Journal. Kentfield resident Bruce Braden was identified as a major donor. Supporters are campaigning for the measure.
The measure text includes fiscal safeguards such as an independent citizen oversight committee, annual public audits, and a lockbox provision ensuring revenues stay within the district and cannot be diverted by state or federal authorities, according to Marin County election filings. The election text also specifies that funds cannot be used to pay administrator salaries.
Staffing Concerns Loom Over the Campaign
The debate over the district's physical infrastructure also raises questions about staffing, adding a labor dimension to a discussion that now centers on how the district pays for its physical infrastructure.
If approved, Measure CC would support care for trauma, heart attack, stroke and other patients, along with recruitment of qualified doctors and nurses, according to the Marin Independent Journal. Whether Marin voters agree to shoulder a 30-year parcel tax to get there will be decided at the ballot box on November 3.
