News in brief - Jan. 26, 2009

Physicians defend San Francisco universal access program

California physicians are asking the 9th U.S. Circuit Court of Appeals to reject a bid to overturn its recent decision upholding San Francisco's universal access program for uninsured and underinsured residents.

The program, known as Healthy San Francisco, relies on a local ordinance requiring employers with 20 or more workers to spend a certain amount on health coverage or put the money into a funding pool. A 9th Circuit panel in September 2008 rejected arguments from the business community that the mandate violates the federal Employee Retirement Income Security Act. The Golden Gate Restaurant Assn., which challenged the ordinance, has asked the full 9th Circuit to review the case.

But the California Medical Assn. and the San Francisco Medical Society say the court got it right the first time. Doctors argued in a friend-of-the-court brief filed in December 2008 that the program has helped relieve the strain of the rising uninsured population on emergency departments, Medicaid, and other parts of the health care system. Such initiatives typically have been left to state and local regulation and do not conflict with federal law, the brief states.

Physicians support comprehensive health system reform at the federal level, said CMA President Dev GnanaDev, MD. But until that is accomplished, "state and local governments must fill the void, when necessary, to avoid a health care crisis."

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