Universal health care has been a rallying cry for the Democrat party in recent years and will continue to be a hot-button issue as we move toward the 2020 election. With a solid plan a necessity for any viable presidential nominee, some candidates are turning their attention to Europe for solutions – while others are looking at answers closer to home.
San Francisco, California has taken matters into their own hands, becoming the first major U.S. city to offer universal health care access. Designed to complement the Affordable Care Act (ACA) and other state and local laws, the Healthy San Francisco (HSF) program was created to provide health care access to all residents within the city’s limits regardless of employment, immigration or health status. To meet the criteria, city residents must be 18 years old and have no other health care options. They may earn up to 500 percent of the federal poverty level and still qualify.
HSF was the brainchild of Democratic council member Tom Ammiano, who came up with the idea back in February 2006. It quickly won the support of labor unions and citizen groups who had been stymied in their efforts to expand health care access at the federal and state levels. Arnold Schwarzenegger, governor at the time, had vetoed a single-payer bill and the future of any widespread legislation being passed at the federal level looked shaky at best, prompting the city to take the lead. In the intervening years, HSF is providing inspiration for other cities around the country who want to enact their own local health initiatives.
Funding for HSF is acquired through a number of sources including the city’s general fund, an employer mandate and participant fees. Approximately 14,000 patients are served through nearly three dozen community health centers and six hospitals. Patients enroll in a “home clinic” where their doctor can determine when specialty care at a hospital is required. 96.7 percent of San Francisco residents now have health care coverage, a number well in excess of the statewide average of 92.7 percent.
Other cities around the country are following suit. Los Angeles launched My Health LA in 2015, a similar program that provides health care access for patients who can’t qualify or are unable to afford other types of coverage. And New York City announced an NYC Care program just a few weeks ago that will provide care and coverage for all city residents. There are differences among all three plans, but this is to be expected; health care coverage is not a one-size-fits-all proposition and cities have different medical infrastructures in place. But it’s a promising start to a nationwide problem, one that is now at the forefront of the political agenda.