San Mateo County Has Setback in Universal Plan

San Mateo County's legal counsel on Thursday informed officials that the county's plan to provide health care coverage for all uninsured adults cannot rely on mandatory contributions from businesses to help fund the plan, the Oakland Tribune reports.

According to the memo, counties cannot impose payroll taxes under state law, nor can they impose impact or mitigation fees on businesses in the county's 20 incorporated cities. The memo was sent to the Blue Ribbon Task Force on Adult Health Care Coverage Expansion.

Data provided to the task force Thursday found that the county would need about $21 million annually to fund the plan, which seeks to extend coverage to an estimated 60,000 to 80,000 uninsured adults in the county.

Jerry Hill, county supervisor and co-chair of the task force, said there are other options to fund the plan, but the payroll tax "definitely would have been the easiest."

Hill said a likely option could be increasing business license fees. Other possibilities include:

• An expansion to more cities of local health care districts, which would generate about $18 million annually in taxes;
  
• A temporary occupancy tax;
  
• An increase in the county sales tax; and
  
• Differential charging for services and procedures by medical care providers (Gordon/Horgan, Oakland Tribune, 3/30).