Researchers at the University of California at Berkeley and University of Massachusetts at Amherst surveyed San Francisco employers on changes to health benefits in 2008, the year the city's health spending mandate went into effect.
The law, which survived a legal challenge after the U.S. Supreme Court last month declined to consider it, sets a minimum for how much businesses must spend per worker, per hour for most everyone on the payroll working at least 10 hours each week, the authors said. Small businesses are exempt from the law.
To meet the spending mandate—roughly $2,425 to $3,633 per year per employee, depending on the size of the company, researchers said—the law gave employers the option to pay into a newly created healthcare safety net, Healthy San Francisco, or provide private insurance options.
So what did they do? Researchers said results suggest San Francisco employers opted for the safety net payments to expand coverage, but generally did not drop private health benefits in place prior to the law.
Results were drawn from a telephone survey of 523 San Francisco for-profit employers and another 20 not-for-profits comparing 2007 and 2008 health benefits.
Of businesses surveyed, one in five reported they made or planned to make safety net payments, but 87% said contributions covered only some employees.
“This figure suggests that employers were using the Healthy San Francisco public option for workers” not previously eligible or covered prior to the law, the authors wrote. Of those that previously did not offer insurance, 41% reported plans to start offering coverage.
Meanwhile, only 4% of employers reported they dropped benefits or planned to do so.