Amalgamated health care

Newsom's incomplete health plan is merged with Ammiano's controversial one
Mayor Gavin Newsom has taken credit and sought the national spotlight for a plan he touts as an innovative way to deliver universal health care access to the city's uninsured. Yet Newsom has consistently ducked the vitriolic public debate over how to the pay for the plan, which a companion measure by Sup. Tom Ammiano would cover with a controversial employer mandate.
But as the measures were headed for the first of at least two hearings before the Board of Supervisors (on July 11 after Guardian press time), a board committee and Newsom's public health director, Dr. Mitch Katz, finally made it clear that Newsom's plan can't stand alone, as much as the business community would like it to.
"The two pieces of legislation were created to and do fit together," Katz said at a July 5 Board of Supervisors’ Budget and Finance Committee hearing. "One can't successfully move forward without the other."
Katz made the comments after budget analyst Harvey Rose said the mayor's plan doesn't contain a specific funding mechanism. Rose's admission prompted Sup. Ross Mirkarimi to characterize the mayor's proposal as "a one-winged aircraft that doesn't fly." Sup. Chris Daly added that "It's time to be up front that [the San Francisco Health Access Plan] only works if it has significant contributions from outside sources, including Ammiano's plan."
Neither Newsom nor his spokesman Peter Ragone returned repeated calls for comment on the issue. The Mayor's Office also has not fulfilled a June 22 request by the Guardian for public records associated with the plan in violation of deadlines set by the city's Sunshine Ordinance.
"Celebrating one resolution while pooh-poohing the other is disingenuous, because if they don't work together, nothing works," Mirkarimi added at the hearing, shortly before he, Daly, and a mostly mute Sup. Bevan Dufty voted to combine both proposals into one health care plan: the San Francisco Health Care Security Ordinance.
"After today's meeting," Ammiano wrote in a follow-up press release, "I'm confident that the citizens of San Francisco and the media will understand that the Worker Health Care Security Ordinance and the Health Access Program are one comprehensive health care plan, and are now codified as such in a single bill."
The decision to amalgamate left small business owners voicing fears over the economic impact of the employer spending mandate, which would raise an estimated $30 million to $49 million of the $200 million cost of providing health care access for San Francisco's uninsured.
As the controller's Office of Economic Analysis points out, most of the financial burden of the employer mandate "falls on businesses with 20 to 49 employees, since these firms currently are less likely to offer health care benefits to their workers."
With the cost of covering 20 full-time employees' health care estimated at $43,000 to $65,000, many business owners fear the mandate will result in layoffs, economic downturns, and the erosion of their already marginal profits.
Although the controller predicts a "nearly neutral impact" on the city's economic picture — a loss of 60 to 590 jobs from staff cuts or business closures mitigated by 140 to 250 new health care–related positions — small businesses worry about the controller's "moderately adverse impact" prediction for employers who currently aren't offering health care benefits at mandated levels.
"It's going to add another $50,000 to my already high health care costs," John Low, who runs a small company in the Tenderloin, said at the hearing. San Francisco Soup Company owner Steve Sarver claimed the mandate could force him to abandon expansion and hiring plans: "Projects that I was borderline on, I'm now going to go toward eliminating those jobs."
As written before the July 11 hearings, the mandate would kick in January 2007 for large businesses and the following January for small businesses.