Few San Francisco Residents Enroll In Health Care Program

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

Tangerine Brigham, the program'sdirector, attributed the low enrollment to a slow start after theholidays and confusion over a recent court decision. She expectsenrollment to increase during the coming weeks (Knight, SanFrancisco Chronicle, 1/3).

A U.S. District judge onDec. 26, 2007, ruled that a provision of a San Francisco lawrequiring employers to meet minimum contribution levels to employeehealth insurance benefits or help fund a city program violated the1974 federal Employee Retirement Income Security Act. However, cityofficials said they would move forward with plans to expand healthservices for uninsured residents while appealing the decision.


Theprogram is intended to ensure access to health care services at SanFrancisco clinics and the city's public hospital for San Francisco's82,000 uninsured residents. Under the law establishing Healthy SanFrancisco, private employers with at least 20 employees andnot-for-profit groups with at least 50 employees must provide healthcare benefits at a cost that meets minimum spending levels or helpcover the cost of the Healthy San Francisco program. Other fundingcomes from tax revenue and member premiums (Kaiser Daily HealthPolicy Report, 1/2).

A panel of judges on the Ninth CircuitCourt of Appeals on Wednesday is scheduled to hold a hearing on arequest for an emergency stay of the ruling. According to Brigham, ifthe city loses its appeal, program enrollment will be limited to47,000 residents with incomes up to 300% of the federal povertylevel. Since the program's trial phase began in July 2007, 7,350 ofthe city's estimated 73,000 uninsured residents have enrolled (SanFrancisco Chronicle, 1/3).


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

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

Reprinted with permission fromkaisernetwork.org.You can view the entire KaiserDaily Health Policy Report, search the archives, andsign up for email delivery at kaisernetwork.org/email. The Kaiser Daily Health Policy Report ispublished for kaisernetwork.org, a free service of The Henry J.Kaiser Family Foundation.