San Francisco healthcare debate continues amid tense political wrangling 

The Board of Supervisors effort to close a loophole in San Francisco’s landmark universal healthcare law remains the center of debate despite months of discussions and political wrangling over how to fix the problem.

One proposal introduced by Supervisor David Campos was approved by the board but only with six votes and then Mayor Ed Lee vetoed it. It takes eight votes to override a mayoral veto.

Now the board is focused on a different solution, which was introduced by Board of Supervisors President David Chiu as a compromise with business advocates who denounced Campos’s proposal.

On Tuesday, Supervisor Malia Cohen made amendments to Chiu’s legislation, which is taking shape as being the solution everyone can live with.



 “These amendments are the result of many, many months of conversations with many stakeholders,” Cohen said.

Mayor Ed Lee signaled his support of the amended legislation in a statement.

“I applaud President Chiu, Supervisor Cohen, organized labor, small business owners and the Department of Public Health for finding the solutions to this important public policy that can strengthen our city’s landmark Health Care Security Ordinance,” Lee said in the statement. “By closing the loophole through these proposed amendments, we can increase access to health care, protect jobs in our small businesses and protect consumers while growing our economy at the same time. These are goals I have embraced from the beginning of this discussion, and I thank the board for putting forward amendments that align with these goals.”

About 860 businesses — mostly restaurants — put money in what is known as a health reimbursement account to comply with the law, which mandates a certain amount of money is spent per employee per hour worked. It was recently exposed that 80 percent of the money for worker health care costs returns to the employer, which amounted to $50 million last year.

The main issue is how much and for how long money should remain in the accounts. Chiu’s legislation would have required accounts have a year’s worth of funding at any given time. But Cohen amended it to ensure there are two year’s worth of funding at any given time.

Campos’s proposal would have the money remain in the accounts year after year. But business advocates said that would be a $50 million hit and result in job losses and even business closures.

There is a loophole that needs to be closed and we need to figure out the best way to do that, in a way that ensures that we are getting health care to our employees but do that in a way that is minimizing job loss.”

Chiu said that the “the two year time frame does make sense.”

Campos, who realizes his proposal is doomed by Lee’s veto, supported Cohen’s amendments. “I’m still trying to understand the implications of the amendments but I think that it’s a very positive step forward, he said.”

The board is scheduled to take a vote on the amended legislation on Nov. 15.

jsabatini@sfexaminer.com

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