A shout out to the health nerds

First thing’s first — if you want to see it for yourself, the Ninth Circuit’s ruling to suspend the lower court Judge Jeffrey White’s stay on the Healthy San Francisco Plan, click here.

The ruling is interesting in light of the work being done this year to reform health care and expand health coverage statewide — in part — through an employer mandate. In fact, when the ruling came down against the San Francisco plan right after Christmas, there was no shortage of Scrooges in the streets, praising the decision that would have left 26,000 middle-income San Franciscans uninsured.

(Background: Golden Gate Restaurant Association sued to prevent an employer-mandate piece of the Healthy San Francisco Plan from going into effect, saying the ordinance violated the federal ERISA law. ABX1 1, a measure that will be heard in the Senate Health Committee next week and has been agreed to by both the Speaker and Governor, contains an employer mandate as part of a package to extend coverage to more than 3 million uninsured Californians).

Reasons the Ninth Circuit ruled against the Restaurants and for the City:

  • The ordinance does not require businesses to adopt any specific kind of health plan, it merely sets a spending threshold that employers would have to meet, therefore, it does not violate ERISA. (ERISA was intended to assure that employers would not have to contend with a hodgepodge of different benefit laws etc in each and every city, county, state they operated. This has nothing to do with levels of expenditures)
  • If an employer does not meet the spending requirements, they pay money to the city — again, with no reference to benefit structure of a health plan for which they will pay.
  • The ordinance doesn’t require employers who already provide coverage to provide certain benefits (thereby altering their ERISA plans.)
  • Lastly, there is no additional burden to complying with the ordinance, as employers would be tracking this information anyway.

On top of the technical details, the court also found the hardships borne by San Francisco residents would be far greater than those borne by businesses. Approximately 20,000 San Francisco workers would be harmed, including “human suffering” — contrasted with economic injuries.

While ABx1 1 is not exactly the same as the San Francisco ordinance, the arguments used by opponents against an employer mandate (which IS part of ABx1 1) are essentially the same. This ruling should put that hollering to rest — until the next court ruling…

Health Access California promotes quality, affordable health care for all Californians.
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