San Francisco Leads Nation with Health Care For Uninsured

New America Media, News Report, Viji Sundaram Posted: Aug 08, 2006

Editor’s note: After months of planning and tweaking, on August 7 Mayor Gavin Newsom signed into law a plan that will give every San Franciscan access to health care. The mayor believes the plan could serve as a model for the rest of the nation. Viji Sundaram is the health care editor at New America Media.

SAN FRANCISCO – With cameras rolling and flash bulbs popping, Mayor Gavin Newsom and Supervisor Tom Ammiano signed into law a plan they engineered to provide comprehensive health care access to the city’s uninsured, regardless of their immigration status.

Signing “We came up with a plan we hope is a model for all the cities and counties in the nation,” Newsom said just minutes before he signed health care legislation, billed as the first of its kind in the nation. The August 7 ceremony was held in front of the Southeast Health Center, a community health care facility on Keith Street.

Newsom said that the plan has already “changed the dialogue” in San Mateo and Oakland, as well as in other parts of the nation looking at San Francisco’s health care plan as a possible model.

“This (signing) is a very important first step,” said Ammiano, adding: “We’ve been contacted by a number of cities” interested in implementing similar plans.

The San Francisco Health Access Plan (SF HAP) will offer preventive, primary and emergency care by hospitals and community health clinics.

It will cover those individuals who earn too much money to quality for health care under Medi-Cal, the state’s public health insurance for the poor. An estimated 82,000 people will benefit from the plan. Expected to cost around $198,000 annually, or $2,400 per person, the legislation will be financed through a combination of tax dollars, local business contributions and individual premiums.

“We are already paying the price in emergency care,” Newsom said. The Mayor said the law's implementation details will be worked out over the next few months by a committee jointly chaired by Lloyd Dean, chief executive officer of Catholic Health Care West and Dr. Mitch Katz, director of the San Francisco Department of Public Health. It will be phased in starting July 2007, with 15,000 people at a time in the first three months.

“The committee will make sure we do not over-promise and under-deliver,” Newsom said.

He said the plan is vitally needed for the city, where a large number of Latinos and African Americans have no access to health care, a situation prevailing in the rest of the country.



One of the controversial elements of the plan is that it requires businesses employing 20 or more people to either pay into the plan or contribute to the cost of their employees’ health care through such means as private insurance or health savings accounts. Businesses with fewer than 20 employees are exempt from the plan.

The mayor said the plan will go through even if businesses proceed with their threat of suing the city for requiring some private employers to pay for it.

“Even if litigation prevails, we’re going to move forward,” Newsom said, noting that there was not too much of an onus placed on businesses.

“Only 28 percent of the projected $198 million is coming from the business community,” the mayor said.

He said that the plan will be closely monitored in the first year of its implementation to ensure that it does not “devastate” small businesses, which largely fuel the city’s economy. That aside, only 50 or more businesses will be included in the plan until April 2008, he said.

The one other major drawback of the SF HAP is that because it is not insurance, it will not cover enrollees who get sick outside the city.

Related Stories:

San Francisco's Health Care Plan Draws Mixed Reviews

New Health Plans Could Help Solve America's Crisis of Uninsured

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