Universal Health Care Initiative - San Francisco

In 1998, San Franciscans passed Measure J with a 65 percent majority vote and made it city policy to provide affordable, preventive health care to the uninsured. In 2006, the city passed the San Francisco Universal Healthcare Initiative, with aims at giving an estimated 82,000 uninsured San Franciscans access to healthcare regardless of income, immigration status, or medical condition. Launched in July of 2007, Healthy San Francisco enrolled 3,100 people and has 14 city health clinics and 8 community affiliated clinics as of October of 2007.

Healthcare costs are distributed on an ability-to-pay basis. In January 2008, the eligibility for coverage was expanded to include all residents making less than 3 times the federal poverty line. Residents making less than the federal poverty line pay no fees, while those above are charged on an ability-to-pay fee schedule. Quarterly fees range from $60 to $675, co-payments for patients who don't qualify for free care range for $10 to $20 for clinic visits and $200-$350 for a hospital stay.

The plan would be paid for with tax dollars, local business contributions and individual enrollment fees that are income-adjusted.  The 15% of local businesses that do not currently provide healthcare to employees will be required to pay an annual fee to go towards the program—a provision that has put many from the business community on edge. 

If all 82,000 uninsured residents were to enroll, it would cost approximately $200 million per year.  The city already pays $104 million annually to cover uninsured care in emergency rooms and clinics.  According to Ammiano, the program could save taxpayers $8-24 million annually by requiring employers to share the costs of healthcare.  The program is also intended to stabilize the workforce by supporting healthier employees and to fulfill a moral obligation to the city's citizens.

More:

• Full Text of the San Francisco Health Care Security ordinance - passed July 2006
• City of San Franciso Home Page
• UC Berkeley Labor Center has links to several relevant documents and reports
• Analysis of the Worker Health Care Security Ordinance - by the San Francisco Office of Economic Analysis, June 23, 2006
• Healthy San Francisco - Health Care Access Program
• Universal Healthcare Council Final Report to the Mayor
• Measure J - Passed November, 1998