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

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

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

  • Carrie Hoverman Colla & William H. Dow & Arindrajit Dube, 2010. "How Do Employers React to A Pay-or-Play Mandate? Early Evidence from San Francisco," NBER Working Papers 16179, National Bureau of Economic Research, Inc.
    • Handle: RePEc:nbr:nberwo:16179
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    References listed on IDEAS

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    1. Carrie H. Colla & William H. Dow & Arindrajit Dube, 2011. "The Labor Market Impact of Employer Health Benefit Mandates: Evidence from San Francisco's Health Care Security Ordinance," NBER Working Papers 17198, National Bureau of Economic Research, Inc.
    2. Carrie H. Colla & William H. Dow & Arindrajit Dube, 2017. "The Labor-Market Impact of San Francisco's Employer-Benefit Mandate," Industrial Relations: A Journal of Economy and Society, Wiley Blackwell, vol. 56(1), pages 122-160, January.

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    More about this item

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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