In February 2006, San Francisco Mayor Gavin Newsom created a Universal Healthcare Council (UHC) to develop a plan to provide access to health care for San Francisco's uninsured adults.  This collaborative effort, comprised of representatives from the health care, business, labor, philanthropy and research communities, met for four months. The Council reviewed demographic and actuarial data, and heard from community advocates and employers to identify and quantify the needs of the uninsured.

Mayor Gavin Newsom and Supervisor Tom Ammiano

In a report released June 2006, the UHC presented its recommendations for the development and implementation of a San Francisco Health Access Program (SF HAP).  Shortly thereafter, Supervisor Tom Ammiano incorporated the SF HAP into his Worker Health Care Security Ordinance (WHCSO).  The ordinance, which passed unanimously on July 18, 2006, calls for implementation of SF HAP in tandem with an employer spending requirement.  The date set in the ordinance is July 1, 2007.

In April 2007, SF HAP became Healthy San Francisco. 

Unlike past City and County efforts to serve the uninsured, Healthy San Francisco is not health insurance. It will instead provide a primary medical home to participants, allowing a greater focus on preventive care, as well as a specialty care, urgent and emergency care, mental health care, substance abuse services, laboratory, inpatient hospitalization, radiology, and pharmaceuticals. Healthy San Francisco will be administered by the San Francisco Department of Public Health (DPH).

Federal court upholds San Francisco healthcare program

The three-judge appeals panel rules that the law does not violate federal regulations on employee benefit programs.

A federal appeals court today upheld San Francisco's first-in-the-state comprehensive citywide healthcare program.

Ruling on a suit brought by the local restaurant association, the three-judge panel found that the year-old San Francisco Health Security Ordinance does not violate federal laws regulating employee benefit programs.

The law, which took effect Jan. 9, requires all for-profit employers with 20 or more workers to either offer health insurance, set aside funds in health reimbursement accounts or pay a fee to the city's Healthy San Francisco program. Nonprofit employers with more than 50 staffers are also covered.

Many San Francisco restaurants have been paying for the plan by tacking a surcharge of 3% to 6% on bills.

Proponents of the program, including Mayor Gavin Newsom, point to the law as a model for the state to provide healthcare for 7 million uninsured Californians.

"This is a pioneering program that is having tangible results and making a big difference in the lives of tens of thousands of workers," said Tim Paulson, executive director of the San Francisco Labor Council, a major booster of the plan. Healthy San Francisco, he noted, has already provided health coverage for 30,000 people who formerly had no access to routine medical and hospital care.

News in brief - Jan. 26, 2009

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Physicians defend San Francisco universal access program

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Physicians defend San Francisco universal access program

California physicians are asking the 9th U.S. Circuit Court of Appeals to reject a bid to overturn its recent decision upholding San Francisco's universal access program for uninsured and underinsured residents.

The program, known as Healthy San Francisco, relies on a local ordinance requiring employers with 20 or more workers to spend a certain amount on health coverage or put the money into a funding pool. A 9th Circuit panel in September 2008 rejected arguments from the business community that the mandate violates the federal Employee Retirement Income Security Act. The Golden Gate Restaurant Assn., which challenged the ordinance, has asked the full 9th Circuit to review the case.

But the California Medical Assn. and the San Francisco Medical Society say the court got it right the first time. Doctors argued in a friend-of-the-court brief filed in December 2008 that the program has helped relieve the strain of the rising uninsured population on emergency departments, Medicaid, and other parts of the health care system. Such initiatives typically have been left to state and local regulation and do not conflict with federal law, the brief states.

Physicians support comprehensive health system reform at the federal level, said CMA President Dev GnanaDev, MD. But until that is accomplished, "state and local governments must fill the void, when necessary, to avoid a health care crisis."

The battle continues . . .

~OGD~

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