Healthy San Francisco is not health insurance. Still, it is providing primary and emergency healthcare to thousands who were uninsured.
It does that by using a mandate. Businesses that hire more than 20 workers must provide insurance or contribute to the city program.
Amanda Basler enrolled Wednesday in /*Healthy San Francisco*/. The psychotherapist lost her health insurance when she left her job at the YMCA to start her own practice.
Since her former employer is a contributor to the health plan, Basler pays nothing.
She does, however, have one concern.
"They don't cover you outside of San Francisco and I do go to Tahoe and ski regularly," she said.
But Basler says that is minor, compared to having your medical needs covered.
Basler will be one of 45,000 San Franciscans enrolled in the health plan.
"You have individuals making close to $50,000 a year, you also have individuals earning less than $1,000 a month," Healthy San Francisco administrator Adrian Nunez said.
But two-thirds of the plan's members are at or below the poverty line.
Charles Baughman is one of them. The former bill collector lost his job four years ago.
He was afraid to go to the doctor even though he should have had preventive care.
"Heart risk is in my family and everything so I was worried that something like that would happen and I wouldn't have insurance," he said.
Baughman joined Healthy San Francisco a year ago and now goes to the Glide Health Services Clinic.
"Then they found these other things they're treating me for, high blood pressure and cholesterol and everything," he said.
Ed Erhardt, like Baughman, is being treated at Glide. He is bi-polar and has a bad back.
Erhardt had no insurance for five years before enrolling in Healthy San Francisco last year.
"I never went to see a doctor about my back and I stayed away from the doctors for my mental health," Erhardt said.
But now, Erhard goes to see his doctors regularly.
The plan is funded by the city, state grants, member fees and employer contributions.
San Francisco Chamber of Commerce President Steve Falk believes the plan is working because it provides health care at a reasonable cost overall. But he also says it has put a big burden on businesses with less than 100 employees.
"The contribution right now for the smallest business is a $1.23 per hour and if a restaurant pays $10-$12 an hour to employees that could amount to a 12 to 15 percent increase in their payroll costs," Falk said.
Falk estimates employers pay about 25 percent of the $120 million a year cost of Healthy San Francisco.