Thread: SF:Court delays healthcare ruling

Despite setback, city's health care for uninsured program grows
Bob Egelko, Chronicle Staff Writer

Tuesday, January 1, 2008

(12-31) 17:14 PST SAN FRANCISCO -- San Francisco's first-in-the-nation program to provide health care for the uninsured will expand Wednesday, but employers won't have to share the cost, at least for now.

City officials had asked a federal appeals court for an emergency order allowing them to put the health plan into full effect on Wednesday while they appealed a federal judge's ruling in favor of employers. But the Ninth U.S. Circuit Court of Appeals declined to take immediate action Monday, and instead said it would hold a hearing later in the week.

That means San Francisco will have to put on hold plans to begin opening the health care program to all of its 73,000 uninsured adult residents - regardless of their income. Instead, the city will extend coverage on Wednesday to those making up to three times the federal poverty level, or about $32,000 a year for an individual.

Since its start in July, eligibility has been limited to those making no more than the federal poverty level. Officials say 7,350 residents have enrolled since the program, authorized by city supervisors in 2006, went into effect.

Costs will continue to be paid entirely from tax revenues and co-payments and premiums from patients, without any fees from employers. Without those fees, about 26,000 uninsured residents who make more than three times the poverty level will remain ineligible for coverage, at least until the court decides the case. City officials had hoped to phase them into the program over the next 18 months to two years.

The program's director, Tangerine Brigham, said the 22 clinics already taking part in the program would also serve the new clients.

The ordinance is a potential model for other city or state governments seeking to provide health coverage for all residents in the absence of a national health care plan. The court case could determine the fate of a proposed California law, approved by the state Assembly and awaiting debate in the Senate, that would seek voter approval to require payments from employers.

The legal dispute involves an employer mandate that would pay for less than a fourth of the $200 million-per-year program. Private employers with at least 20 employees and nonprofits with at least 50 were to be given the choice of providing health coverage, at dollar amounts set by the city, or paying a fee to support the health program.

On Wednesday, U.S. District Judge Jeffrey White ruled that the employer mandate violated a 1974 federal law that prohibits state and local governments from regulating employee benefit plans. By requiring businesses to spend certain amounts on each employee or pay a fee, White said, the city was trying to regulate their existing health plans, which are governed solely by federal law.

City Attorney Dennis Herrera asked the appeals court on Thursday for an emergency stay of White's ruling during the city's appeal, which is unlikely to be decided until next summer at the earliest. Herrera argued that the ruling ignored past decisions allowing state and local governments to regulate employee benefits as long as they don't require employers to establish new health plans.

The Golden Gate Restaurant Association, which filed the November 2006 suit challenging the employer fees, told the court in written arguments Monday that the city was trying to sidestep the appeal process by seeking an emergency order to implement a law that has been ruled invalid.

Court orders while an appeal is pending are usually supposed to preserve the status quo, but the city's request "would radically change the status quo by permitting application of local regulation that has never existed in the past," said Richard Rybicki, the association's lawyer. "If granted, the stay would immediately create a patchwork of local regulation and impose serious ongoing administrative and financial hardships for employers."

The association, which has more than 900 members, has proposed that the city find another way of financing an expanded health program, such as a quarter-cent local sales tax.

Deputy City Attorney Vince Chhabria, the city's lawyer, said the court's decision to schedule a hearing on a request to stay a judge's order was highly unusual. "It shows that they are taking the issue very seriously and that's all we can ask and hope for," he said.


Healthy San Francisco
San Francisco's landmark health care program is available to:

-- Uninsured adult residents who make up to $32,000 a year and don't qualify for Medi-Cal for the poor or Medicare for the elderly. Children are already covered under a separate city plan.

For questions about the program and to see if you qualify, call (415) 615-4500.

Chronicle staff writer Heather Knight contributed to this report. E-mail Bob Egelko at begelko@sfchronicle.com.

This article appeared on page B - 1 of the San Francisco Chronicle

http://www.sfgate.com/cgi-bin/article.c ... RU7FG6.DTL

Another government-sponsored program designed to create a constituency group dependent on government largesse.

Socialism at work, where else but land of Feinstein and Pelosi?

I would not be opposed to publicly funded health programs if they went to those who were truly in need. For example, where an area is experiencing high unemployment rates and then someone with no insurance has a major illness. But it is too easy for those who have abused their health and wasted their chances to qualify. I was just reading a local story about a 58 year old sheet metal worker now getting a disability retirement. The article stated that this man had also had three episodes of heroin addiction. Well, make your own conclusions on that one...The Social Security disability pensions are not supposed to be given to those with substance abuse conditions.

The statistics of how many people are living in poverty can be significantly skewed by the influx of illegal immigrants. These may or may not get counted by social statisticians, but if they do then it inflates the numbers of people who are living in impoverished or disadvantaged conditions. This may make it look like we have a much bigger "problem" than we actually have. This may produce a rationale for a much more expensive, taxpayer funded program than would ever be necessary. Politicians who implement these programs may point to the number of people they have "helped" as the evidence of their success.

If these are necessary the line should be drawn at excluding those who have willfully or wantonly ruined their health with drugs and alcohol and those who sneaked in here. I doubt that SF will make these distinctions.

AKA COVERAGE FOR ILLEGAL ALIENS.....