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Healthy San Francisco: Local Model for Universal Coverage |
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From The Commonwealth Fund: Healthy San Francisco (HSF) is a new program that provides medical homes to the city's uninsured adults. Early enrollment exceeded expectations---there were 1,900 members as of late September---and the program could eventually enroll all of the city's estimated 82,000 uninsured adults. Championed by San Francisco Mayor Gavin Newsom, HSF is based on recommendations by a Universal Healthcare Council comprised of local stakeholders including health care industry, business, labor, philanthropy, and research representatives. The services are provided by a network of local providers, primarily public health department providers and community health clinics as well as San Francisco General Hospital. To be eligible for HSF, a person must be 18 to 64 years old, uninsured, live within city limits, and be ineligible for other public coverage programs. In November, it will be expanded to include all residents, regardless of income or immigration status. HSF will also be open to workers whose employers select the program as part of a minimum employer health care spending requirement. Beginning in 2008, employers with at least 20 employees must make required "Health Care Expenditures" to or on behalf of their local employees. A local restaurant association is challenging the employer health care spending requirement, claiming that it violates ERISA, a law governing employer health benefits. This will be financed by redirecting some of the $110 to $115 million city funds currently spent on treatment and services for the uninsured, supplemented with federal funds of $24 million per year for three years, together with members' fees and copayments and fees from participating businesses.
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