Thanks to Obamacare, Meizhi Yi can buy health insurance. But the San Francisco resident is not interested – because thanks to Healthy San Francisco, she can afford to see the doctor.
Healthy San Francisco is not health insurance. But for many low-income and self-employed San Franciscans, The City's public option for health care is better – that is, more affordable – than insurance policies available under the Affordable Care Act.
And this cheaper option is here to stay for at least another year.
San Franciscans eligible to buy health insurance via the Covered California exchange – made possible thanks to ACA, or Obamacare – were to be phased out of Healthy S.F. this year.
In the long term, The City's option will be open only to people not eligible for private insurance, or publicly funded insurance coverage like Medi-Cal or Medicare, which includes undocumented immigrants.
Instead, all participants will now be able to stay enrolled in the program until the end of 2015, regardless of eligibility for other coverage.
Eligibility is also extended to seniors over 65, a change approved by the Health Commission earlier this month.
That's good news for many participants – 31,965 as of the last count July 1, or a little more than a third of The City's 87,000 adults who don't have health insurance, according to the most-recent Department of Public Health data.
A recent search for Affordable Care Act plans for a single, moderate-income adult in San Francisco revealed prices as low as $122 a month to as high as $296.
However, that figure does not include the cost of visiting doctors, having procedures and buying prescription drugs – all of which are common health care needs.
By comparison, the average Healthy S.F. participant paid $296 a month, which includes those common health care needs, according to SFDPH.
Two-thirds of Healthy S.F. participants said they do not have insurance because of The City's option, according to a program survey.
In Yi's case, her option is a $224 per month plan.
That sounds affordable, but for most services, she has to pay out of pocket until she hits a $5,000 mark, she told The Examiner.
“I have Obamacare, but I have to pay all costs,” she said. “The insurance company is the big winner.”
Enrollment in Healthy S.F. has declined by half since ACA went into effect.
Peak enrollment was 65,650 in September 2013, a figure that dropped to 46,302 at the beginning of 2014.
Healthy S.F. cost The City $83.12 million last fiscal year.
Despite the extension of eligibility, there will be a $95 penalty this year for people staying in Healthy S.F. who are eligible for ACA coverage. And that fine goes up to $325 per person next year.
Half of Healthy S.F. participants are Latino, according to the health department, and 53 percent are between the ages of 25 and 44. And nearly two-thirds are very poor: the annual income of 61 percent of participants is at or below the federal poverty level of $11,670 for a single adult.