Healthy San Francisco - a model for Los Angeles?

Healthy San Francisco is the name of the innovative program San Francisco developed to provide affordable health care for uninsured residents.

Healthy San Fransisco is not complete health care insurance. It instead provides a baseline of care. One of the solutions that San Fransisco came up with to limit costs is to only cover health care within city limits. Participants are given a "medical home" at one of the participating clinics (there were 27 in July, 2008). Members pay a fee four times a year, as well as small co-pays, and have access to: preventive care, prescription medicines, specialists, urgent care, mental health care, etc. (Vision and dental are not included.)

The law was passed in 2006 and went into effect in 2007. It is being rolled out slowly, starting with the poorest residents. Eligibility was recently to people making up to 5 times the federal poverty level. (According to the San Francisco Chronicle, that means just over $54,000 for one person and just over $110,000 for a family of four.) As of July 2008, 24,000 of San Francisco's estimated 73,000 uninsured residents were enrolled.

The program is free to the poorest residents; eligibility and prices are based on income so that it is affordable for all who qualify. The program is paid for by participant fees, a state grant, and fees from employers. San Francisco requires businesses with more than 20 employees to cover employees' health care costs. The employer contribution can go to private insurance or Healthy San Francisco.