San Francisco officials compete to change health fund rules 

click to enlarge Employees who don’t use the funds in their health reimbursement accounts lose the money at year’s end. (Getty Images file photo) - EMPLOYEES WHO DON’T USE THE FUNDS IN THEIR HEALTH REIMBURSEMENT ACCOUNTS LOSE THE MONEY AT YEAR’S END. (GETTY IMAGES FILE PHOTO)
  • Employees who don’t use the funds in their health reimbursement accounts lose the money at year’s end. (Getty Images file photo)
  • Employees who don’t use the funds in their health reimbursement accounts lose the money at year’s end. (Getty Images file photo)

For those of you keeping score at home, there are now three proposals to amend The City’s Health Care Security Ordinance — one by Supervisor David Campos, one by Supervisor David Chiu and one by Mayor Ed Lee.
 
Before we get to the various proposals, let’s recap the issue all three laws are trying to fix. Under The City’s universal health care law, an employer can either provide private insurance, pay a certain amount to The City and enroll the employee in the medical benefits plan called Healthy San Francisco, or the employer can contribute a certain amount into a health reimbursement account, or HRA. It is these HRAs that are the subject of all this legislation.

The Internal Revenue Service allows employers to contribute unlimited pretax dollars to an HRA. The money in that account can be used to pay health insurance premiums and just about any other legitimate medical expense (though “baby-sitting,” “dancing lessons” and “teeth whitening” are excluded). Employers have the choice as to whether the accounts can roll over from one year to the next or whether the unused balance is forfeited back to the employer at the end of the year.

When employers choose the “forfeit” option, the result is that an employee who gets sick in November has a pot of money at his or her disposal, but if that same employee gets sick three months later, in January of the next year, they are out of luck. Oh, and employers get a big pile of money back that was assumed to go to employee heath care.

All three politicians — Campos, Chiu and Lee — agree that this is wrong, but each is attacking the problem differently. Campos’ legislation will be voted on today at the full Board of Supervisors meeting, thanks to what appears to be a heroic effort by Campos to get this law in front of Lee before Election Day. (I dare you to veto this!)  Campos’ law would prohibit employers from ever exercising the “forfeit” option. Instead, each employee account would have to remain open and accumulating the employer contribution until 18 months after the employee leaves his or her job or the employee dies, whichever comes first.

Chiu’s legislation would cap each employee account at one year’s accumulated benefits, but require that the account roll over so that an employee always has access to at least the amount of one year’s employer contributions at his or her disposal.

Lee’s proposal is to put an 18-month hiatus on any forfeiture of account balances to study why more employees aren’t using the HRA funds to purchase insurance. According to Jason Elliott, Lee’s legislative director, ideally the accounts allow employees to buy health insurance, not open-heart surgery. (The employer contribution for a full-time employee is between $2,800 and $4,300 per year, so an employee would have to work for 10 years or more to afford even the simplest procedure.) Allowing the accounts to simply grow isn’t really helping employees deal with health care costs.

Look for the mayor to veto Campos’ legislation. Although he will not confirm the veto directly, according to Elliott, “The mayor is committed to making sure all employees have access to health care. It’s just that he would like to base any decision on facts, not hyperbole.”

 

School proposition unlikely to sway education board

Proposition H on November’s ballot is a policy statement of the following: “The system for assigning children to schools should give the highest priority to the proximity of a child’s home to a school, after assigning siblings to the same school.”

This proposition was put on the ballot by an organization called San Francisco Students First, a group of parents that takes issue with the current
student-assignment system.

The Board of Education is using a new formula for student assignments as of this year, which gives children in certain areas with low standardized test scores first dibs on school placement, and only after that group is settled, students in a school’s “attendance area” are allowed in. For high school placement, one’s “attendance area” is not listed as a factor in assignment.

In the voter pamphlet for this election, opponents of Prop. H argue that “it will cause chaos in our schools by mandating the local board create reassignment of students in our district even after they have started the school year!”  But I doubt that is true.

I spoke with Rachel Norton, a Board of Education member who explained that the board worked for years to develop the new assignment system and it is working well.

Thus, far from creating “chaos,” Prop. H (which is just a policy statement) will likely be ignored by the board because its members do not believe there is a problem. In other words, the election that will really make a difference for student assignment is not Nov. 8, 2011, but Nov. 6, 2012, when four seats on the Board of Education will be up for grabs.

 

Public nudity draws outraged letters

Supervisor Scott Wiener’s legislation to restrict certain behavior by naked people has really brightened up the City Hall mailbag. Here are excerpts from messages to the Board of Supervisors in recent weeks:

“It is your responsibility to see that anarchy does not destroy our city.”
“Now when I come to visit my sister [who lives near San Francisco], I can anticipate a display of nudity with impunity!”

“It’s harmful to children and it’s a potential health issue (where does one sit?) and can put us on a slippery slope to other health matters (public sex, urination, etc.).”

There could be public urination? I’m fairly certain this person has never been to San Francisco.

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Melissa Griffin

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