Health opportunities and burdens associated with transportation are often not distributed equitably, disproportionately negatively impacting low-income communities and communities of color. This is particularly the case for large transportation infrastructure projects, which can have the potential to transform an entire region and can have significant direct and indirect public health implications. Additionally, how equity is defined can impact whether equitable outcomes are realized through a transportation project. This paper argues for incorporating a health equity framework into all phases of the planning, development, and operation of a potential third crossing. This framework calls for measuring equity based on the health outcomes of communities, rather than the metric consistently used by public officials - the level of funding different geographies receive. An integral part of the health equity framework calls for working collaboratively with communities in the San Francisco Bay Area that have been consistently disproportionately harmed by large transportation projects to develop third crossing project elements to improve health within their communities. As a possible starting point of discussion for this necessary collaboration, this paper lists potential health equity benefits that could be incorporated into the third crossing project.