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How Do Employers React to a Pay-or-Play Mandate? Early Evidence from San Francisco

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  • Colla, Carrie Hoverman
  • Dow, William H.
  • Dube, Arindrajit

Abstract

In 2006 San Francisco adopted major health reform, becoming the first city to implement a pay-or-play employer-health spending mandate. It also created Healthy San Francisco, a "public option" to promote affordable universal access to care. Using the 2008 Bay Area Employer Health Benefits Survey, we find that most employers (75%) had to increase health spending to comply with the law, yet most (64%) are supportive of the law. There is substantial employer demand for the public option, with 21% of firms using Healthy San Francisco for at least some employees, yet there is little evidence of firms dropping existing insurance offerings in the first year after implementation.

Suggested Citation

  • Colla, Carrie Hoverman & Dow, William H. & Dube, Arindrajit, 2010. "How Do Employers React to a Pay-or-Play Mandate? Early Evidence from San Francisco," Institute for Research on Labor and Employment, Working Paper Series qt2sw0q5dh, Institute of Industrial Relations, UC Berkeley.
    • Handle: RePEc:cdl:indrel:qt2sw0q5dh
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