After a four-year legal battle, the city of San Francisco's pioneering health care program overcame its last legal hurdle today when the U.S. Supreme Court refused to hear an appeal by a business group.
The Golden Gate Restaurant Association challenged a provision of the Healthy San Francisco program that requires employers to help pay for health insurance for their workers.
The group asked the high court to review a decision in which the 9th U.S. Circuit Court of Appeals upheld the employer spending mandate in 2008.
But the court today declined to take up the appeal, leaving the appeals court ruling as the final decision in the case.
Mayor Gavin Newsom released a statement late this morning in response to the development.
"The Supreme Court's rejection of the challenge to Healthy San Francisco is a victory for the 53,000 San Franciscans who have health care today through our groundbreaking universal health care program," Newsom said.
San Francisco City Attorney Dennis Herrera, whose office defended the program, said, "I am extremely grateful to the high court for allowing to stand a model of health care reform that works."
Herrera said the program is successful "not just for thousands of San Franciscans who would otherwise go without coverage, but for the vast majority of employers."
Restaurant association executive director Kevin Westlye said, "We are disappointed that our members will have to administrate and execute a local plan and a national plan that may be very different."
The group argued in a 2006 lawsuit that the employer spending requirement conflicted with a federal law regulating employee benefit plans.
The city plan requires businesses with more than 20 workers either to provide health insurance or to pay a fee to the city program. The business spending is slated to provide $14 million of the total $200 million cost of the program for uninsured city residents.
The program, enacted in 2006, aims to provide coordinated health care for the estimated 73,000 residents who lack health insurance and are not eligible for other government health programs. About 53,000 people have enrolled in it thus far.
Participants are each assigned a city or community clinic as their "medical home."
Businesses with 100 or more employees must spend $1.76 per hour per worker on either a health plan or fees to the city. Those with staffs of 20 to 99 must pay $1.17 per hour.
Other funding for the program is provided by city, state and local governments and a sliding fee for patients.
In late May, the Obama administration weighed in on the case and asked the Supreme Court not to take up the appeal.