Few San Francisco Residents Enroll In Health Care Program After City Increases Income Eligibility Limits

Main Category: Health Insurance / Medical Insurance
Article Date: 04 Jan 2008 - 12:00 PDT

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San Francisco on Wednesday expanded eligibility in its Healthy San Francisco program to individuals residing in the city with incomes up to about $32,000 annually who do not qualify for other health programs, but "few seemed to be taking advantage of it," the San Francisco Chronicle reports. While data on exactly "how many people enrolled Wednesday weren't calculated by city public health officials ... indications point to just a handful," according to the Chronicle.

Tangerine Brigham, the program's director, attributed the low enrollment to a slow start after the holidays and confusion over a recent court decision. She expects enrollment to increase during the coming weeks (Knight, San Francisco Chronicle, 1/3).

A U.S. District judge on Dec. 26, 2007, ruled that a provision of a San Francisco law requiring employers to meet minimum contribution levels to employee health insurance benefits or help fund a city program violated the 1974 federal Employee Retirement Income Security Act. However, city officials said they would move forward with plans to expand health services for uninsured residents while appealing the decision.

The program is intended to ensure access to health care services at San Francisco clinics and the city's public hospital for San Francisco's 82,000 uninsured residents. Under the law establishing Healthy San Francisco, private employers with at least 20 employees and not-for-profit groups with at least 50 employees must provide health care benefits at a cost that meets minimum spending levels or help cover the cost of the Healthy San Francisco program. Other funding comes from tax revenue and member premiums (Kaiser Daily Health Policy Report, 1/2).

A panel of judges on the Ninth Circuit Court of Appeals on Wednesday is scheduled to hold a hearing on a request for an emergency stay of the ruling. According to Brigham, if the city loses its appeal, program enrollment will be limited to 47,000 residents with incomes up to 300% of the federal poverty level. Since the program's trial phase began in July 2007, 7,350 of the city's estimated 73,000 uninsured residents have enrolled (San Francisco Chronicle, 1/3).

Editorial
The Ninth Circuit Court of Appeals "should grant [the] emergency order" to allow the city of San Francisco to fully implement its health care program, as the "health and well-being of the 26,000 residents who could remain uninsured outweighs the hardship employers will face on having to pay extra fees" if it is not implemented, a Chronicle editorial states. The judge's decision was a "serious setback," however, "it may not be a fatal one," according to the Chronicle.

The editorial concludes, "As we move into 2008, the presidential candidates and our Legislature will continue to talk up health care solutions. San Francisco's appeal is going to be a testing ground for the kinds of problems that our leaders will face as they seek to expand insurance access. That appeal will be highly politicized. So in the meantime, the court should look out for the uninsured" (San Francisco Chronicle, 1/3).

Reprinted with kind permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation© 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.