Health plan hinges on lawsuit 

The City could be forced to scale back its ambitious plan to provide health insurance for an estimated 82,000 uninsured adults if it loses a lawsuit over the legality of requiring employers to fund it, according to San Francisco’s public health chief.

Authored by Supervisor Tom Ammiano and Mayor Gavin Newsom, the Health Access Program — recently renamed Healthy San Francisco — is designed to ensure every San Francisco resident has access to health coverage. It is expected to begin rolling out in July.

"We’re currently assuming that we would be enrolling come January people from employers. If The City were to lose the lawsuit I think we would look hard at that. That feature wouldn’t really exist," Department of Public Health Director Mitch Katz said during Tuesday’s Board of Supervisors hearing on the status of implementing Healthy San Francisco.

If The City were to lose the lawsuit, Katz said, a decision would need to be made whether to "retreat" to universal health coverage for just the poorest residents.

Healthy San Francisco will be funded in part by grant money as well as the most controversial aspect of the program, employer contributions.

Of the 82,000 uninsured adults, it is estimated that there are 16,000 workers who do not receive health benefits, of which 4,200 to 4,500 are expected to enroll in Healthy San Francisco, according to Tangerine Brigham, director of Healthy San Francisco.

Employers with 50 or more workers will be required beginning Jan. 1, 2008, to invest $1.76 per employee for each hour worked for health care, and beginning April 1, 2008, employers with 20 or more workers will be required to invest $1.17.

San Francisco’s Golden Gate Restaurant Association filed a lawsuit over the legislation, claiming the employer-spending mandate violates federal law.

Oral arguments are expected to be heard in court on Sept. 14, although the date may be moved up to sometime during the summer.

"My feeling is The City is not going to lose this lawsuit," Ammiano said. "We’re certainly more than prepared to do an appeal."

The employer contributions are expected to provide Healthy San Francisco with $6.7 million during fiscal year 2008-09, when the program would be functioning for its first full year, according to Brigham.

"Healthy San Francisco is a huge undertaking for The City. We need all of your help, all of your smart ideas, all of your support if we are going to successfully pull this off," Katz said.

jsabatini@examiner.com

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