San Francisco's Public Option Receives High Marks

The Los Angeles Times reports on San Francisco's public option: "Over the last two years, three-quarters of San Francisco's uninsured adults have enrolled in a public program that guarantees access to medical services, an effort that is being touted as a national model during the rancorous debate over healthcare reform. More than 46,000 adults have enrolled in Healthy San Francisco since it was launched; this first-in-the-nation, city-run universal healthcare effort has received high marks in recent independent studies." Funding for the program depends in part on an employer mandate. "One analysis has concluded that this mandate on employers with 20 or more workers has not driven businesses away." And a recent survey indicates that patient satisfaction is high.

"Healthy San Francisco is not insurance," and doesn't function outside of the city limits. But "any uninsured adult who lives in San Francisco and earns up to 500% of the federal poverty level annually is eligible. … Patients must pick a medical home out of a network of more than 30 public and private clinics, physician groups and hospitals within the city limits. The idea is that patients get consistent care and the system avoids duplicating services. ... Preventative services, care for illness and chronic conditions, hospital stays and prescriptions are all covered."

Employers foot part of the bill for coverage. "Since 2008, private employers here with 20 or more on the payroll have been required to spend a minimum amount on healthcare coverage for their workers. They can fulfill that obligation by offering insurance, selecting Healthy San Francisco or paying into a medical reimbursement or health savings account. Businesses with 20 to 99 workers must pay $1.23 per hour per employee for coverage; those with 100 or more must pay $1.85 per hour. Healthy San Francisco costs about $125 million annually, of which about $14 million comes from employers" (LaGanga, 10/4).

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