we're in this really sort of ironic situation that for the first time in this country's history, there's a mandate for individuals to purchase health inshoe znswer and we're allowing a mechanism to allow with the spending equipment that does not allow workers to access that money for the cost of health insurance. i wanted to give you a sense of the scope we're talking about. current san francisco law allows employers to reclaim money under hra after 24 months. in 2012 which was the most recent date, of the 107 plus million dollars that was allocated through these accounts accident employers reimburse 26 plus million of those dollars to workers. that represented 24.6 percent of the total dollars

placed into those accounts. therefore, in 2012, over 80 million was pocketed by employers and this is what we refer to as the loophole. the office of labor standards enforcement has not published their data for 2013. we asked them for preliminary numbers and things have gotten worse. of the 124 plus million dollars placed in reimbursement accounts, only 20 possess were reimbursed. only 24.5 percent of the dollars were actually used to support work -- support worker's health change. it was pocketed by businesses. and this is the

equivalent of $1.8 million per week that should have gone to worker haelts change and did not. >> i wanted to give you a sense using the current publication. it's a minority of employers that's exploiting this loophole and they're undermining those who are following the spirit of the law and creating unfair playing field. that's another policy aspect that we don't think makes any sense. so of the 1.8 -- 1 billion 8 hundred million dollars plus dollars that was spent in 2012, you can see that

the -- 55 million was given to the city which is the healthy san francisco program or the reimbursement account. so i know you're really educated on this, but for the public, i wanted to make sure to walk-through a couple case studies so we can really absorb the impact of this loophole and really -- the harmful affects it's causing for san francisco workers. as you know, the cost of the plans under covered san francisco is expensive and the cost sharing components are significant. so a bronze plan , you know, 60 percent of the cost is paid for and the first $5,000 of a plan must be covered by the individual, the silver plan is

70 percent cost of services and the physical 2,000 paid are paid by the individual and it's really the gold plan that doesn't include the deductibles. that's more positive for people that are trying to make ends meat and don't have any money leftover at the end of the month. if you -- if we're considering a single 30 year old person who is earned $15 an hour and working two skrobs with a median size employer in san francisco, working 45 hours a week, and as we know, many of our lower wage workers in san francisco do have multiple jobs in order to make ends meat. that person is taking home -- we use the mit calculate. and they're estimating the cost of living

in san francisco. we adjusted it slightly for the high cost of housing in the city. and what we're finding and you can see sort of listed out in detail, the expenses that we've estimated on the bottom is this person after paying for basic expenses every month is already before purchasing any health care is running at $100 plus deficit every month. i'm sure you know many people in that situation and i certainly do. at this point, we're in the profound accountability and all of us know this is not an unrealistic scenario. we want to south california and tried to sign up for insurance and the monthly premium would be $152-172 a month and a gold plan, 127-362. if i'm running on a one

hundred dollar deficit, $127-362. if i'm running on a one hundred dollar deficit, i can't afford these premium, let alone through a bronze and gold program and the co-pays would be out of reach. i'm looking at needing closer to a gold plan in order to actually use the health insurance. the payments that's due to this person under the employer spending requirement are $318. the cost almost of a gold plan. so if there wasn't a loophole in the ordinance allowing certain employers to recover money only by using the worse option in terms of employee health, then most likely that money would have been coming to the city through the city option and under current law without any of the health access assistance programs that were implementing, the employee could purchase basically a gold plan through the system. so this person who is barely

making ends meet meat if san francisco could have top quality insurance. i'm going to go through this faster. it's a 48 year old cook at a restaurant earning 27,000 and struggling to make ends meat. because this person is earning less money, they're getting more federal subsidy but can the deductible when this person is struggling to survive, their payment is due was several times allow them to get a gold plan and perhaps a

platinum plan. our final example profile of family, so it's a 39 year old couple with a young child. one parent is earning 28,000 and the other is earning 36,000. their monthly income is $5,401 and they're just making it. $11 a month -- trying to make that up. you could see the costs under the affordable care act of a bronze, silver and gold plan and the payments do under the hcso would allow them to afford a silver plan. so i -- i took the time to walk-through these examples and talk about the other portion of the really important ordinance that you have before you because so far the

department of public health has not taken a position on closing the loophole in the health care security ordinance. i really felt like the health commission should know that over $90 million last year that should have been going to get workers insured was not going there and it was being pocketed to employers because i think this is something you should care about. it affects the workers and it makes no sense. we're asking for your support not only of the entire ordinance, but we're hopefully able to work with the department of public health in order to make workable, but we're asking you to take a stand and to say -- an employer shouldn't be able to steal $90 million a year in money that should go to worker health care. thank you. i'm happy to answer any questions. >> thank you. let's finish the presentation and i understand

the officer of assembly men omenio is here and wish to make a presentation on behalf of the assembly. >> not so much a presentation, but i have a few words regarding this ordinance. as someone who was the original author and the work that campos is doing this on ordinance really holds a really intent the original legislation. the goal of health care security ordinance as inro dused when the assembly member was a supervise is to make sure -- access to the health care -- and we see that the city has become a model for making care available, but as hillary has mentioned, there

are some loopholes that have been exploited by actors in the bids community that need to be closed and it's urgent, this legislation would do that, and secondly as she mentioned, the affordable issue is running ram pid and there's many people who fall through the cracks and can't get care through obama care. this creates a safety net that have been there and the city has a great opportunity here. we hope that today you have the opportunity to really support something that can bring health care to so many people who need it very urgently. thank you. >> commissioners, we have several comments and we're going to hold as it said on our form to a limit of two minutes so that everybody can be heard following which we'll have --

>> i didn't hear that. >> two minutes for each and i'll call them in order. first is rebecca, ian lewis, and -- >> i'm a public health nurse for this city and county and a member of csiu and one the labor coach chairs. i testified on this issue in 2011 and at that time i noticed restaurant after restaurant after restaurant opposing to closing the loophole and they were putting an additional fee on your receipt when you ordered pizza saying they were paying for healthy san francisco and then using the hra's as a way to try and get the money back into their pocket. this

is a very simple issue. either we spend money on health care or we don't. it's time for the commission and the department to step up, it wasn't passed in 2011 and it should be passed now. thank you. >> thank you. next speaker, please. >> commissioners, the hotel and restaurant employees union local two. family health insurance in this city is closing in on $10 million. that's what it cost. as an organization and a group of 9,000 workers who struggle each and everyday with employers to make sure that all those family was covered, it has been going to us, the small amounts required under the health security ordinance has been evaded by a small number of businesses and it's time that loophole is

closed. i do want to speak to the cover san francisco element of the legislation because it really is important. when the hcho was first passed, this city jumped in feet first to health care reform and led the company with dynamic initiatives, healthy san francisco being among them. today as it stands through the medical reimbursement accounts, they have the ability to make the affordable health care act work. it does great things for people, but for a lot of working peemg -- people. it leaves people out exclude from the changes and in terms of meaningful affordable for working families. this is our chance to fix some of those problems and lead the country

onto its next phase of haelts care reform. the structure is in place and the legislation before you gives the city more flexibility than it has right for fine and tuning that program. so it can serve as a model for this country for the kind of health care the aca should have been and may be one day. thank you. >> dina and the next three is, i believe this is tom, dawn and -- >> we're the con soergs. clinics who work closely with the department of public health to lower health care. i know this legislation is complicated and i know it's to implement things on their moving parts but i want to go back to the patients we

see. we were very activity and remain active in enrolling people in expanding med-cal and covered california and it would break our hearts when we would have someone in front of us saying i have to get coverage and i want to get coverage, i'm working two jobs and i've got these kids, i know i'm going to have to pay a fine if i don't get coverage, but all i can afford is the bronze plan. there's a culture of coverage and there's an expectation of health care. that's already happened so for us not to use money that is available and sitting there to help people buy insurance doesn't make sense. healthy san francisco is great and we support it and we provide the services in it.

one thing this legislation will do is expand it slightly so people over 65 who don't qualify for medicare can take average of healthy san francisco. they get cut off at 65. i can't see the real reason why public health does not want -- isn't eager to embrace this in knowing if they do need more time, we set deadlines and we have reports back and figure out how to do it. we're eager to help and we know it can be done. thank you. >> thank you. next speaker. maybe i've got the name wrong. tom from the labor council. >> president and commissioners i'm tim and i'm the executive drether of the san francisco labor council who represent over 100 unions here in san francisco both in the

public and the private sector. i'm here to speak on behalf of the amendments to the san francisco health care security act. and in support of it. i was also on the mayor's universal health care council and i was also involved in the high end negotiations and the campaign to implement this law within supervisor aviana and we're proud to have the greatest health system and the legislation that's the closest thing to the universal health care in the united states and we fully believe the tens of millions of dollars that's not going to the -- this department, the department of public health really, when we pass that legislation initially, this department really stepped up and really got tens of thousands of

other people covered that never been covered before and we still have the same opportunity to do that. we've had years to figure out what the affordable act is going to be doing. when we did the health care security ordinance, the department jumped right in and do it. we're hoping that the legislation gets passed because there's flexibility. it department has always had to try to figure out what to do. we're here to support that and i hope that we move forward with that support. thank you. >> thank you. belcher. >> dawn. i live in district 8. i support the campos amendment. i think if you have $93 million on the table, you should grab it. you should use it. it's there to be taken to use for the health care

needs san francisco. i don't think anybody here can admit that we are flushed with money. it's there to be taken. i'm also a little -- it's a little embarrassing the reports on why we can't do this because it's too complicated. it's 2016, the other day it was 2017 and when asked how long it will take, 18 to 24 months, that means 2019. it's like, take all the money and put it in a rainy a fund at least for future needs. there's like 30,000 people who need assistant to buy insurance, take the money, help them out, keep a little bit so you can have this program ongoing and things change. the opening words in the budget from governor brown is we have this change, and this change and that change and somebody is

raising and there's somebody at general hospital is raising 30,000, that's nice, but it's not $93 million. budgets always change and it's our job to deal with changing budgets and changing times. it's this commission's job to deal with changing times and budgets and it's the job of this commission of san francisco to deal with the health care needs of san francisco. thank you. >> donna followed by dan, or former commissioner, rome and kim. >> hello commissions. i'm donna and i'm a leader with the san francisco organizing project which recently merged with business inter face action and both our part of the pico national network of

-- we help enact the affordable care act and we do not wish to see either of them harm the other. we believe firmly they can work together and create more than any can alone. the universal health care council agreed on some principals that we believe the ordinances of supervisor campos will advance. maximizing enrollment into health insurance and shared responsibility which i would like to emphasize because the goal is the notion of collective responsibility, all sectors must take a rule in reducing the number of residents and assuring access to care. in

particular the loophole must go now. it's unfair to the vast that -- majority of employees. it's unfair to the employees who can't put their hands on that money or buy health care inshoe znswer. it's unfair when the money goes back into the restaurant. >> i'm the political coordinator. i represent thousands of worker in this city and we support this legislation. both pieces of the loophole is incredible, but it exists that we're back before any board or individuals. they should be used for health care

and the second piece, we -- here if san francisco, there's a great opportunity to make the aca and take -- take great steps to be the leaders in this and i believe all great minds can do this and i think i would love to ask this commission to please move forward with this entire legislation. thank you and good evening. >> thank you. >> commissioner guy. >> kim, national union of health care workers. on the way over here today being i was listening to the radio and the lot came out that it cost -- a house hold has to have $170,000 to buy a house in the bay area. that's not specifically san francisco. and $30,000 in

cleveland. that's when aca came out. those news were adjusted for national averages. no way did it account if the bay area. most of us are here today to ask the commission to lead the way. take the bull by the horns and close this loophole. the legacy goes way back, back to la guna honda. the aids epidemic. this commission has led the way. and in the past, it has bucked political pressure from the mayor's office and said health care is our number one priority. the health and welfare of the citizens of san francisco is in your hands. and we're asking you one more

time to embrace the disinfrack chiezed. we're talking about people getting their first pap smear and they may be 40 years old or someone to get their first physical from a doctor. they have been locked out because of cost. do not allow employers to pocket this moneyment they make ridiculous rules around using the money for health care and this is our opportunity to make sure it goes to these franchise folks. >> thank you very much. >> welcome, our former commissioner. >> i'm happy to stand in front of you. thank you very much. director garcia and chou, i'm happy to see you leading the

way. chou has been the longest serving and he was here as i was sitting where you are when the first health care security ordinance was passed. and not to repeat what other people have already said, but i like to add my edge on it which is aca and the health care security accident -- and this one with its amendments assume we need partnership to insure all of us. it does create complexities that we don't have the data for today. that was true in the original. we took a risk. we took the date that we had, the projections as we could. on the part part of the amendment, you have

the data, $90 million a year out of compliance. we've tried to amendments to obtain the voluntary parts of this. the parts of the private industry is not complying. we need them to comply. so that's the first part of the ordinance. the data is there. its been this for over four years. that's not an issue. it's not asking you to plow new ground, but asking you to recognize what is and take a stand for equity which is one of our priorities that we're leading on. and support plowing away as she discusses the amendment ask -- amendment and the flexibility. it has been contentious and it was

way back when, okay. and then mayor nusan and 100 percent of the board of supervisors supported the cautionary risk can the date that was available. we must adopt aca and its public private relationship with our hcso and it's public private commitment and your resolution should reflikt this and recognize until hca disappears. that's when we can talk at another ordinary, but the private sector needs to comply and we need to plow new ground in that relationship to make aca adoptable and get people subsidized so we can continue

on our equity path. i really appreciate it. i know it's hard, but i hope we go there. thank you. >> thank you for your comments and your previous chairing of our committee also. >> hermanton and jim and amber and michael lion and those are the remaining public comments i have. if anybody else has public comments, turn in your form. >> commissioners, my name is berry. i am a green party activist and i also work very closely with the group called single or pay now. i'm an advocate for