Teresa Mosqueda, candidate for Seattle City Council Position 8, is proposing for Seattle to create a health plan for all city residents. Her proposal is based on Healthy San Francisco, which provides coverage to over 50,000 San Francisco residents who are at or below 500 percent of the Federal Poverty Level and are ineligible for other public insurance programs.

Mosqueda’s proposal does not identify a specific income eligibility requirement, only mentioning “low-income individuals who cannot get free or subsidized coverage through Medicaid, Medicare, or subsidized insurance” as the intended beneficiaries.

In addition to providing coverage, Mosqueda’s plan also calls to:

• Create a medical home model in Seattle, where patients choose a primary care provider and clinic or hospital where they get most of the outpatient care they need. Collaborate with health clinics and other community providers that already serve many of the individuals who could get care through a program like this
• Focus on primary and preventive care while making it easier for patients to get care from specialists and hospitals, when they need it. Fill existing gaps in care by providing access to a broad range of outpatient services, including some that are often unavailable from safety-net providers, like dental care and diagnostic tests.
• Coordinate registration and screening with community-based agencies that already help individuals apply for Apple Health and Exchange-based coverage.
• Require that cooperating providers provide culturally appropriate care and equal access for patients with disabilities or whose primary language is not English.
• Additionally, for small businesses: Advocate for our state HBE (Health Benefit Exchange) to merge the SHOP (Small Business Health Options Program) and individual exchange markets into one risk pools; Simplify small business process by requiring the exchange to do premium aggregation; Require state reinsurance programs to cover small business insurance products.

“If we can actually create a pool that will allow people to get the comprehensive services that they need, then we should,” Mosqueda said in an interview with Seattle Magazine. “I think it’s definitely possible in a post-ACA world” to have cities deliver health-care services.

Healthy San Francisco is funded by the city’s general fund, by fees from participants, and a payroll tax on businesses with more than 20 employees. In FY2015-16, Healthy San Francisco reported an approximate $74.39 million in costs, with an estimated per participant per month expenditure of $436.

While Mosqueda has not proposed a funding plan, she has noted the revenue differences between San Francisco and Seattle, and the need to have larger conversations with businesses and employees in order to fund the health plan.

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