Healthy San Francisco

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Could Healthy San Francisco Help People Buy Obamacare Plans?

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(Deborah Svoboda/KQED)

A lot of San Franciscans are saying “no thanks” to the Affordable Care Act. As the cost of living rises in the city, even subsidized health insurance doesn’t feel affordable to many residents.

Supervisor David Campos says that, as a result, not enough people in the city are signing up for health insurance. He wants to change that.

“Without supplemental help, many people won’t get insurance,” he says. Continue reading

Future of Healthy San Francisco Unclear in Face of Obamacare

Many San Francisco restaurants pass along at least part of their cost of Healthy San Francisco to patrons. (Angela Hart/KQED)

Many San Francisco restaurants pass along at least part of their cost of Healthy San Francisco to patrons. (Angela Hart/KQED)

By Angela Hart

San Francisco is scrambling to figure out how the Affordable Care Act will impact the city’s own landmark universal health legislation, less than three months before the full rollout of Obamacare.

Barbara Garcia, who runs the Department of Public Health, is leading a task force of health experts, business groups and labor leaders who have until the end of November to decipher what health experts are calling confusing and complex details in both the local and national health laws.

“How do you make these two laws correspond?” 

“The question for the task force is how do you make these two laws correspond,” said Ken Jacobs, chair of the Labor Center at UC Berkeley who specializes in health policy, and who is also on the task force. “In my view, they correspond quite well, though there’s some work to do around the edges.”

Healthy San Francisco rolled out in 2006 to provide universal health access to the city’s 85,000 uninsured. Today, it covers about 60,000 people.

Now, health experts and city leaders are floating the idea of using Healthy San Francisco monies to help uninsured residents pay their Covered California premiums. Even with federal subsidies available under Obamacare, the cost of insurance may be out of reach for many, they say.

And, experts familiar with Healthy San Francisco say additional financial incentives for consumers will increase the number of young healthy people who sign up for insurance under Covered California, the state’s new health insurance marketplace. Continue reading

How ‘Healthy San Francisco’ Matters – and Doesn’t – in Obamacare

Fernando Gomez-Benitez, with San Francisco's Mission Neighborhood Health Center is undergoing  training to help enroll San Franciscans in Medi-Cal or Covered California. (Angela Hart/KQED)

Fernando Gomez-Benitez, deputy director of San Francisco’s Mission Neighborhood Health Center, is being trained to help enroll San Franciscans in Medi-Cal or Covered California. (Angela Hart/KQED)

By Angela Hart

Government shutdown temporarily aside, effective Jan. 1, 2014, most people need to carry health insurance or pay a fine. It’s called the “individual mandate.”

If you’re signed up with Healthy San Francisco, there’s one very important thing you need to know: Healthy San Francisco is not health insurance. So, it’s not going to get you off the hook for that individual mandate.

A little background: In 2007, San Francisco leaders spearheaded the implementation of universal health care for the city’s estimated 82,000 people who lack health insurance. The idea was to give people access to a range of medical services, including primary care. Participants choose a provider, or “medical home,” from a list exclusively in San Francisco. In the years since, 60,000 people have enrolled.

“We are a leader in delivering health care,” said Barbara Garcia, the director of health for the San Francisco Department of Public Health. “We created Healthy San Francisco to provide care for everyone regardless of their immigration status, their income level, or their health issues.” Continue reading

Healthy San Francisco: Snapshot of Universal Care

Jack Snook expresses his appreciation for Healthy San Francisco in a panel discussion last night. (Photo: Kamal Menghrajani)

Jack Snook expresses his appreciation for Healthy San Francisco in a panel discussion last night. (Photo: Kamal Menghrajani)

It’s been almost five years since San Francisco launched its innovative, universal health plan–Healthy San Francisco–and last night a panel of public health experts and care providers gathered at the Tenderloin’s Glide Foundation to provide a snapshot of how the program is faring.

Glide has a long history of providing services to the poor and marginalized–and advocating on their behalf. Glide’s Freedom Hall was packed, with a smattering of people who indicated they were participants in Healthy San Francisco. Tangerine Brigham, director of the program, spoke first and described the program’s goals: to provide improved access to care through a network of community clinics and hospitals. Of primary importance is for people to have a relationship with a doctor or clinic so they don’t resort to the emergency room for what are essentially primary care problems.

Healthy San Francisco has enrolled 80 percent of San Francisco’s uninsured–about 55,000 adults.
Since its inception in 2007, Healthy San Francisco has enrolled 80 percent of San Francisco’s uninsured–about 55,000 adults. And people are using the primary care benefits. “Over 70 percent of the people in Healthy SF are getting a primary care visit at least once a year,” Brigham said. “Because they’re using primary care, we saw a reduction in emergency room utilization at San Francisco General Hospital. We compared that to other public hospitals in California and what that analysis showed was that San Francisco emergency utilization was declining while others’ was rising.” Continue reading

Healthy SF: Not So Healthy Financially

(Flickr:a.drian)

(Flickr:a.drian)

Four years ago, the City of San Francisco launched an ambitious attempt at health care coverage for all. Today, the San Francisco Public Press devotes its winter edition to an analysis of how well “Healthy San Francisco” is working. While tens of thousands of previously uninsured people have enrolled, and now have health care access they did not have before, the costs have been daunting.

In the Public Press report Stephen Shortell, Dean of the UC-Berkeley School of Public Health appropriately summarized the problem, “Healthy San Francisco is a model for health care delivery, but not for payment.”

“The program is very, very important, but I think we should recognize that it does not pay for the care of the population.”
Healthy SF is not insurance. Instead, it is access to community clinics and other safety net providers, but only those in San Francisco. Participants are not covered if they visit providers outside San Francisco. It is largely uninsured adults, people who earn too much money to qualify for Medi-Cal, who have signed up. In a state where more than 20 percent of people lack health insurance, only three percent of San Franciscans now are without health care. The Public Press reports that many people who had not seen a doctor in years are now receiving treatment.

Continue reading