Healthy SF eligibility extended for US citizens

San Francisco residents who lack health insurance and cannot afford the coverage available via Covered California won’t be dropped from The City’s landmark public-health care option this year as originally planned.

Instead, they’ll be allowed to remain in the Healthy San Francisco program through at least the end of 2014, giving the Department of Public Health time to figure out how to offer them some form of insurance.

Confusion and mixed messages have gripped the country’s health care system since the Affordable Care Act — popularly known as Obamacare — went into effect Jan. 1.

And San Francisco, a special case with its Healthcare Security Ordinance extending care to undocumented immigrants as well as those who can’t afford health insurance on the open market, is no exception.

At its peak, as many as 60,000 uninsured San Franciscans were seeing doctors at community clinics or at San Francisco General Hospital under Healthy SF, which offered an easier and cheaper way to access existing public-health services.

Under the Affordable Care Act, Americans are required to carry some kind of health insurance. If they do not, they pay an annual penalty. Healthy SF is not considered to be insurance. Late last year, DPH staffers began informing some of the 13,449 American citizens enrolled in Healthy SF that they were no longer eligible under the Affordable Care Act.

Enrollees were told to sign up for Medi-Cal or purchase insurance on the Covered California marketplace. Healthy SF was only for undocumented immigrants, DPH staffers told the public.

As many as 12,838 Healthy SF participants were scheduled to be dropped from the program this year, according to records. That included American citizens deemed ineligible for Healthy SF who could not afford private insurance.

Confusion ensued at The City’s clinics, which irked Assemblyman Tom Ammiano, who authored the Healthcare Security Ordinance while a member of the Board of Supervisors.

Such enrollment instructions “should not be happening,” Ammiano told The San Francisco Examiner, adding that such messaging “undermines” the program.

But DPH Director Barbara Garcia said Healthy SF’s eligibility requirements never changed. The law as originally written excludes people who are eligible for some kind of insurance, she told The San Francisco Examiner.

DPH had been preparing to “disenroll” Healthy SF participants who were eligible for other coverage as early as last May, records show, but mixed messages reached the public.

“There is inconsistency at the enrollment sites in how 2014 HSF renewals are being handled,” Kim Oka, the deputy director of managed care, told Garcia in a Dec. 10 memo.

A self-employed San Francisco resident, who is a citizen but could not afford Covered California insurance, said she was allowed to stay in the program.

“At no time did they say that people eligible for Covered California weren’t eligible for HSF,” she said, speaking on condition of anonymity.

Public health officials say they will continue steering the public away from Healthy SF and towards available insurance options.

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