Federal reforms could shrink Healthy SF 

San Francisco’s universal health care program could shed up to 60 percent of its patients and much of its costs when federal health care reforms take effect in 2014.

But city health officials say Healthy San Francisco will still be necessary because an estimated 68,400 San Franciscans will remain uninsured despite the reforms.

Healthy SF is The City’s attempt at universal health care coverage, funded largely from city coffers, but also with taxes on large employers who don’t provide health care for their workers. It subsidizes care within San Francisco, but does not provide coverage for people once they leave city limits.

After President Barack Obama signed health care reform into law last year, then-Mayor Gavin Newsom created a task force to analyze the program’s potential impact on San Francisco. Today, that body will present its final report to the Health Commission, including some 37 recommendations about how to smooth the transition.

Among the most important findings is that federal reforms will not make Healthy SF redundant, said program director Tangerine Brigham, who sat on the task force.

Brigham said federal health reform is not universal, as about 68,400 people living in San Francisco will remain uninsured, including undocumented immigrants, individuals with financial hardship or religious objections, and the incarcerated. Brigham said those people will continue to rely on The City for health care.

Following implementation of the president’s health care reforms, about 60 percent of the 55,000 people currently enrolled in Healthy SF would be eligible for MediCal or other state-provided insurance, according to the report. Once they are, they would no longer be allowed to participate in San Francisco’s program.

That means The City’s universal health care program could shrink substantially, Brigham said. As of today, Healthy SF provides health care to some 55,000 otherwise uninsured residents and costs some
$140 million a year, about $100 million of which comes from The City’s general fund, she said.

Once there are fewer people in the program, the cost to The City should shrink substantially.

Most of the report’s recommendations involve the transition, such as transferring patient data between local security net services and the state, and working to make sure there are enough doctors and nurses available to treat all the newly insured people.

Brigham said while there have been some proposals put forth to alter federal health care reforms, for now The City will move forward with the legislation that passed.

“In the state of California, we’re proceeding forward just as the legislation requires us to,” she said.

kworth@sfexaminer.com

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