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

38 Pages Posted: 12 Jul 2010 Last revised: 17 Sep 2010

See all articles by Carrie Colla

Carrie Colla

The Dartmouth Institute for Health Policy and Clinical Practice

William Dow

University of California, Berkeley - School of Public Health

Arindrajit Dube

University of California, Berkeley - Institute for Research on Labor and Employment

Date Written: July 2010

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 and Dow, William and Dube, Arindrajit, How Do Employers React to a Pay-or-Play Mandate? Early Evidence from San Francisco (July 2010). NBER Working Paper No. w16179. Available at SSRN: https://ssrn.com/abstract=1636648

Carrie Colla (Contact Author)

The Dartmouth Institute for Health Policy and Clinical Practice ( email )

Hanover, NH 03755
United States

William Dow

University of California, Berkeley - School of Public Health ( email )

50 University Hall #7360
Berkeley, CA 94720-7360
United States

Arindrajit Dube

University of California, Berkeley - Institute for Research on Labor and Employment ( email )

2521 Channing Way #5555
Berkeley, CA 94720
United States
510-642-9951 (Phone)

HOME PAGE: http://www.irle.berkeley.edu/cwed/dube.html

Register to save articles to
your library

Register

Paper statistics

Downloads
35
Abstract Views
398
PlumX Metrics