Employer Challenge Could Limit San Francisco Health Program

A pending lawsuit will determine the scope of San Francisco's pioneer program that seeks to provide access to health care services to all city residents, the San Francisco Examiner reports (Sabatini, San Francisco Examiner, 5/9).

Healthy San Francisco, formerly the Health Access Program, is expected to cost about $200 million annually. The city will contribute $104 million that it already spends on medical care for the uninsured. Premiums from plan members are expected to generate $56 million.

The program also would rely on mandatory contributions from businesses (California Healthline, 2/9). Businesses with 50 or more employees that currently do not provide health coverage to workers beginning Jan. 1, 2008, will be required to contribute $1.76 per hour worked per employee. Employers with 20 to 49 workers in April 2008 will be required to begin contributing $1.17 per hour worked per employee.

Tangerine Brigham, director of the plan, said the mandatory employer contributions are expected to generate $6.7 million to help finance the plan's first year.

The provision requiring contributions from businesses prompted the city's Golden Gate Restaurant Association to file a lawsuit against the city, claiming the employer mandate violates federal law.

Mitch Katz, San Francisco's public health director, said the city might have to "retreat" to providing health care coverage only to low-income residents if the restaurant association wins the lawsuit.

However, Supervisor Tom Ammiano, who authored the plan along with Mayor Gavin Newsom (D), said, "My feeling is the city is not going to lose this lawsuit." He added, "We're certainly more than prepared to do an appeal."

Oral arguments in the lawsuit are scheduled for Sept. 14, but the date could be moved ahead to this summer (San Francisco Examiner, 5/9).