City staff fight hikes in rates for health care

San Francisco is considering approving higher health care rates for more than 47,000 city employees and early retirees starting in July, but workers say they can’t afford to pay more during a pandemic and an economic recession.

About two dozen employees and labor leaders spoke against the increases Thursday during a meeting of the San Francisco Health Service Board, saying frontline workers are under economic stress. A San Francisco General Hospital employee’s voice broke on the phone line talking about how her household has lost income, forcing her to pull her kids out of day care and work 20 extra hours a week.

Supervisor Dean Preston, who sits on the Health Service Board, said that raising rates is “highly problematic, especially amidst this health crisis.”

Employees bear a fraction of the monthly costs of their health care plans — anywhere from zero to 17% — while the city pays the rest. They have an option of five plans with the cheapest monthly rate for a single person at $48 and the most expensive for someone with two or more dependents at $1,393.

Under proposed changes, nearly 62% of em

ployees with Kaiser Permanente plans would pay 5.8% more. A smaller percentage of city employees on certain Blue Shield of California plans would see rates increase by 3.6% while other Blue Shield members would see rates rise by 6.3%. For a small fraction of workers with UnitedHealthcare plans through the city, rates could rise 9%.

Employees said that in the midst of a pandemic, with economic stresses and an increased demand for health care, the city shouldn’t let insurance companies raise rates. Workers and union representatives said the city should protect employees during this pandemic.

“It’s immoral in a public health crisis,” said Rudy Gonzalez, executive director of the San Francisco Labor Council, which represents 130 unions. “While we appreciate the designation as heroes, essential workers and disaster workers really need your support.”

Workers most strongly protested an alternative plan to raise Kaiser rates by less — 5.6% — but to double copays for inpatient hospitalization and nearly triple them for outpatient surgery, on par with Blue Shield’s charges. Most city officials also opposed the idea of raising outofpocket expenses for care, and the board agreed not to consider raising copays.

The Health Service Board did not vote on the rate increases but agreed to revisit the subject on May 28. The officials need to formalize the plan and send it to the Board of Supervisors for final approval by July.

Kaiser’s main justification for the increase was higher use of behavioral and mental health services from 2018 to 2019, which raised costs, an insurance consultant explained Thursday.

The proposed rates “represent our efforts to sustain and deliver highquality health care for all our members over the long term, and reflect the expected costs of providing coverage for our members,” a Kaiser spokesman said.

Blue Shield’s main drivers for rate hikes are the rise in provider costs and increases in prescription drug costs, spokeswoman Erika Conner said.

“We are committed to ensuring all Californians have access to highquality health care at an affordable price,” she said.

Jessica Shih, a spokeswoman for the San Francisco Health Service System, said the agency shares workers’ concerns about any increase in rates.

“Rate increases are not desired in a normal year, and certainly not in a year where many of our members are impacted by COVID19,” she said, adding that the city agency “will work hard, and under the guidance and leadership of our board, to do right by our members.”

The proposed rate increases are not drastically different than those of previous years, a citycontracted insurance expert reported Thursday. Kaiser raised rates 5.9% in last fiscal year’s plan. Blue Shield had increases of 2% last year.