Commuters may get city health care money 

Uninsured San Francisco workers who commute in from other parts of the Bay Area could get an employer-funded health care reimbursement account worth $2,000 or more annually under legislation to be introduced to the Board of Supervisors on Tuesday.

The legislation, introduced by Supervisor Tom Ammiano, and backed by Mayor Gavin Newsom, amends a law passed last year to provide every San Francisco resident with either employer-provided or city-provided health care.

A controversial component of the new Health Care Security Ordinance is a funding mandate that requires businesses with 20 employees or more to pay $1.06 to $1.60 per employee hour, for worker health care. The health care expenditure could be made in the form of employer-funded insurance or a health savings or reimbursement account, or the employer could give the money to The City to pay for a worker’s membership in San Francisco’s new Health Access Program.

Although small businesses are excluded from the requirement, business owners say the added cost will create a financial hardship.

Estimated to cost nearly $200 million, the San Francisco Health Access Plan, or SFHAP, aims to provide health care, within city limits, to San Francisco’s approximately 82,000 uninsured adults — including a primary care doctor, hospital services and prescription drugs.

Although the original legislation required San Francisco employers to pay for health care for uninsured workers that live outside of The City, the ordinance excludes those workers from participating in the SFHAP.

Employers participating in city-sponsored focus groups said they were less likely to put money into SFHAP if it meant they’d have to still maintain separate accounts or health plans for nonresident workers, according to Tangerine Brigham, the health department official charged with implementing the new universal health care program.

Ammiano’s amendment would authorize the Department of Public Health to create and maintain reimbursement accounts that could be used by the nonresident, San Francisco employees. That way, employers who don’t want to hassle with providing insurance or accounts can just write a check for all uninsured employees, Brigham said.

As a result of the ordinance, full-time, nonresident San Francisco workers who were previously uninsured will either get insurance or some form of reimbursement for health expenses at a minimum value of $178 per month, if they work for a business with 20 or more employees.

The new amendment would also delay implementation until January 1, to allow The City more time to prepare the infrastructure necessary for the program, Brigham said. The current schedule has businesses with 50 or more employees starting to make health care contributions on July 1, 2007.

A later implementation date may also allow The City to see the outcome of a lawsuit that challenges the legality of the employer spending mandate, filed by San Francisco’s Golden Gate Restaurant Association. A June 1 court hearing date for the lawsuit had been scheduled, according to GGRA President Kevin Westlye, but this week The City asked for an extension.

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Bonnie Eslinger

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