San Francisco Chronicle examines 'Healthy San Francisco' program enrollment progress

Although city officials estimated in July 2007 that Healthy San Francisco would offer access to health care to all city residents by January, the program one year later remains open only to individuals with incomes up to 300% of the federal poverty level, the San Francisco Chronicle reports.

The city has halted expansion of the program while it awaits a verdict from the Ninth U.S. Circuit Court of Appeals in San Francisco in a lawsuit challenging the program's legality.

Under Healthy San Francisco, residents are assigned to one of 27 primary care facilities in the city, which focus on preventive care, and have access to a range of other health services. Enrollees contribute a quarterly fee and copayments depending on their incomes. Coverage does not extend beyond the city. The program, projected to cost $200 million annually, is designed to be funded by employer contributions, a state grant and beneficiaries' fees.

City public health officials have committed to allowing people with incomes up to 500% of the poverty level to enroll beginning in February 2009, and they said that they expect all city residents will be able to apply by the summer of 2009. However, there is no new estimate for when full coverage will be achieved. Mitch Katz, director of the city Department of Public Health, said that he understands why people are frustrated but that he believes gradual enrollment makes better economic sense. Katz said that if everyone enrolled at once, there would not be enough health care providers to meet the demand.

Len Nichols, director of the New America Foundation, said, "For a city to try to do it at all is pretty amazing. Ultimately, we're going to need federal help to make health care access a reality in this nation, and it's impressive San Francisco is trying to do it in whatever patchwork they can" (Knight, San Francisco Chronicle, 7/2).