Skip to main content.

Less Universal, Less Care? Health Reform's Impact on "Healthy San Francisco" Experiment

Less Universal, Less Care? Health Reform's Impact on "Healthy San Francisco" Experiment

Picture of Barbara Feder Ostrov

reporting on health, healthy san francisco, san francisco public press

San Francisco's unique program to provide universal access to health care to city residents may have to scale back to providing access only to the poor, Angela Hart reports for the San Francisco Public Press, which has covered the program in depth. The reason? National health reform is likely to serve the working and middle class patients that Healthy San Francisco has targeted as well as the poor. Hart writes:

the program could take a financial blow within the next two years as cities and counties adapt to national health reform. While thousands will get insurance, the federal law leaves some of the most vulnerable populations exposed and in need of care. Because fees are means-tested, that will reduce the income Healthy San Francisco earns from the patients themselves.

As patients who use Healthy San Francisco move to the national program, San Francisco's system starts to look more like a safety-net model. Yet, while medical experts and politicians say the city is unusually dedicated to caring for the needy, it could lose political support in the long run if middle-class users exit the program. As the "universal" moniker falls apart, the program could be more vulnerable to future budget cuts, say officials who have championed the program.

What's happening in your community as state and local agencies prepare for national health reform? Here are some resources for your reporting:

Reporting Resources:

Health Reform Story Ideas for 2012

Sarah Kliff's Story Ideas for Covering Health Reform in Your State

Your Safety-Net Hospital and Health Reform: Questions to Ask Now

2014 Is Coming Sooner Than You Think: New Ideas for Reporting on Health Reform's Rollou

Kaiser Family Foundation Health Reform Resource Page

Photo credit: Leonardo Pallotta via Flickr

Leave A Comment


The pandemic has thrown into brutal relief the extent to which the U.S. health care system produces worse outcomes for patients of color. And yet there has been scant focus on one of the biggest drivers of structural racism in health care: How doctors and hospitals are paid. In this webinar, we’ll highlight the ways in which the health care system’s focus on money and good grades is shortchanging the health of communities of color. Sign-up here!

U.S. children and teens have struggled with increasing rates of depression, anxiety and suicidal behavior for much of the past decade. Join us as we explore the systemic causes and policy failures that have accelerated the crisis and its inequitable impact, as well as promising community-driven approaches and evidence-based practices. The webinar will provide fresh ideas for reporting on the mental health of youth and investigating the systems and services. Sign-up here!

The USC Center for Health Journalism at the Annenberg School for Communication and Journalism is seeking two Engagement Editors and a social media consultant to join its team. Learn more about the positions and apply.


Follow Us



CHJ Icon