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By Wyatt Buchanan
San Francisco Chronicle
San Francisco’s groundbreaking program to provide health care to all 73,000 uninsured city residents received a major lift this week as more than 700 businesses in the city signed up for the plan.
The businesses represent 12,900 employees, more than half of whom are eligible for the Healthy San Francisco program, which currently enrolls 19,000 people. The other employees are eligible for a health-care reimbursement account.
Mayor Gavin Newsom praised the businesses that joined the program and called on others to follow.
"There are still businesses that are not participating, and we want to get them to participate, to get engaged and not look at this as something that is punitive and harmful, but instead something extraordinary and historic," Newsom said.
Businesses that don’t offer health insurance and have staffs of between 20 to 49 people had until Wednesday to meet a city-mandated minimum-spending requirement on health care for their employees. One option to satisfy the city’s requirement was to join the Healthy San Francisco program.
Employers with 50 or more workers had to meet that requirement in January. Together, a total of 734 employers have decided to use Healthy San Francisco to provide health care to their workers.
Every participant in Healthy San Francisco is assigned to a primary-care facility at a health-care center or clinic that stresses preventive care, and enrollees also have access to urgent care, emergency care, mental health care, substance abuse services, radiology, pharmaceuticals and other medical services.
More high-level medical care, such as surgery, is offered at San Francisco General Hospital.
To qualify, an individual must be an adult (children are already covered in San Francisco through another program), uninsured, live in the city and be ineligible for Medicaid or Medi-Cal. It is not called an insurance program because medical care is only available within the city limits.
Employment status, immigration status and pre-existing medical conditions are not factors in coverage. People who do not meet the program’s requirements are eligible for the health-reimbursement accounts, employer-funded accounts that reimburse employees’ medical costs. City officials will contact employees of the businesses and tell them what they are eligible for and how to receive it.
For San Franciscans not working for one of these businesses, the Healthy San Francisco program is open to those making up to three times the federal poverty line, or about $31,000 for a single adult. The city plans to eventually eliminate that limit, but has not set a date to do so.
Some San Francisco employers - led by the restaurant lobby - are fighting the requirements, arguing that federal law prohibits state and local governments from regulating employee benefit plans. In December, a federal judge agreed, but his ruling was put on hold by a panel of the Ninth U.S. Circuit Court of Appeals. That panel heard oral arguments on the issue last month and a ruling is pending.
The program is expected to cost about $200 million a year, with a portion of that paid by employers who join. So far, businesses have contributed about $6 million to the program, according to the Department of Public Health.
The head of the Golden Gate Restaurant Association, which has taken the lead in opposing the requirement, said he does not know of any restaurants that signed up with the city program. Instead, they offered employees other health benefits that satisfy the city law.
"We still believe Healthy San Francisco is a good program that can be funded in a legal and affordable fashion that wouldn’t break the back of small business," said Kevin Westlye, executive director of the association.
Supervisor Tom Ammiano, who crafted the program with Newsom, said the new enrollees show the program is working as intended.
"This is what was supposed to happen and this is what happened," Ammiano said.
Newsom said the program has the potential to become a model for local governments nationwide.
"Cities shouldn’t have to do this, but I’m very proud that our city is doing it," Newsom said.
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