Federal Employer Law Could Derail California Health Reform
A federal law that limits states' authority to require employers to provide health care benefits could hamper provisions of San Francisco's universal health access program and aspects of a state legislative proposal to expand health insurance coverage, the Christian Science Monitor reports.
The Employee Retirement Income Security Act already has been applied in courts in New York and Maryland to bar state and county governments from requiring businesses to contribute to health insurance.
The Healthy San Francisco program -- which is intended to ensure universal access to health care services in San Francisco -- includes a provision that would require businesses that do not offer employees health benefits to contribute toward the cost of the program.
The Golden Gate Restaurant Association filed suit against the city, claiming the program's mandatory employer contributions violate ERISA and could also put some restaurants out of business.
The law also could cause a roadblock on the state level if Gov. Arnold Schwarzenegger (R) and lawmakers reach a compromise plan on health care reform that requires employer contributions (Arnoldy, Christian Science Monitor, 9/27).
The governor has proposed that employers must spend at least 4% of payroll on health care coverage, while Democratic legislative leaders have proposed mandatory contributions of at least 7.5% of payroll (Zapler, MediaNews/Contra Costa Times, 9/27).
A court ruling that rejects San Francisco's universal health access program or a health care reform plan for California could put additional pressure on Congress to clarify ERISA or issue waivers to states trying to expand health coverage, according to the Christian Science Monitor.
However, experts argue that any revisions to ERISA are unlikely and that health care reform is best undertaken at the national level (Christian Science Monitor, 9/27).
The impact of an overhaul of California's health care system will vary among the population, MediaNews/Contra Costa Times reports.
Marian Mulkey, senior program officer for the California HealthCare Foundation, said that because both the governor's reform proposal and Democrats' reform proposal "build on the existing patchwork system of employer-based coverage and public programs, there are a number of different paths that people would experience."
For example, low-income, uninsured workers would benefit more from an expansion of health care coverage than an insured worker at a high-paying job. Middle-class workers also could be affected differently, according to MediaNews/Contra Costa Times.
If voters are asked on a ballot initiative next year to approve funding for a health care overhaul plan, their vote likely will be influenced by how the plan will affect them (MediaNews/Contra Costa Times, 9/27).