SAN FRANCISCO: Plan Unveiled To Insure 130,000 Residents
After two years of work, a 30-member task force yesterday released a plan to "provide medical coverage to some 130,000 uninsured San Franciscans," the San Francisco Chronicle reports. The plan has received the endorsement of Mayor Willie Brown. According to Dr. Sandra Hernandez, chair of the task force and former city public health director, the proposal would "create a novel pool of public and private workers that could use its large numbers to win lower insurance rates." The plan would put the city's 28,000 employees and their 88,000 dependents into a pool that small businesses would be invited to join. Subsidies would be provided on a "sliding scale" for those who earn less than 300% of the federal poverty level. The base premium "would be $110 to $139 a month," a figure Hernandez says "is right in the middle of premiums for such large groups." The indigent population could also opt into the plan at subsidized rates, provided they have lived in the city for more than six months.
The Price You Pay
Brown and Hernandez say the plan will cost no more than what the city currently spends on health insurance, and it may actually save money because "the uninsured now frequently wait until they need expensive emergency room treatment or hospitalization before seeking care." However, critics charged that since the plan does not mandate preliminary health screenings for enrollees, it "would be inundated at the outset with those who are ill and uninsured." But John Bertko of the actuarial firm PM Squared downplayed the impact of this phenomenon. He said, "It's known as pent-up demand. But if you've properly budgeted for them, it can drop down to a more normal level." Scott Hauge, president of the California Small Business Association, said, "This will make it more appealing for businesses to join. We're spending all this money in San Francisco on health premiums and health costs and we're not getting the best bang for the buck. This could fix that."
The Chronicle reports that "the plan faces major hurdles, including the need to seek voters' approval." Voters would have to okay a revision to the city's charter to allow city workers to transfer to the new plan. Such a vote probably would come sometime before next year (Epstein, 5/20).