@techreport{NBERw16179, title = "How Do Employers React to A Pay-or-Play Mandate? Early Evidence from San Francisco", author = "Carrie Hoverman Colla and William H. Dow and Arindrajit Dube", institution = "National Bureau of Economic Research", type = "Working Paper", series = "Working Paper Series", number = "16179", year = "2010", month = "July", URL = "http://www.nber.org/papers/w16179", 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.}, }