Issue:  Vol. 47 / No. 3 / 19 January 2017

Protecting our health care safety net

Guest Opinion

Supervisor Jeff SheehyPhoto: Rick Gerharter
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For decades, San Francisco has been a leader in public health. But it has been in moments of health care crisis that our city's response has exceeded mere leadership – rising to challenges in innovative ways that were nothing short of heroic, and offering a beacon of hope for countless underserved communities. It was true with the advent of AIDS in the 1980s. And it was true again in the years that followed, as access to quality affordable health care slipped further and further beyond the reach of working families, immigrants, and others.

Now, another health care crisis looms.

With Donald Trump and the Republican Party set to take command of all three branches of federal government this week, their first target is Obamacare. Formally known as the Affordable Care Act, or ACA, it is a successful program upon which more than 250,000 San Franciscans rely to access to care. For thousands of residents, the stakes are potentially life and death if the program is dismantled.

Once again, our city must rise to the challenge.

As San Francisco's first supervisor living openly with HIV – and as a person whose professional career has been dedicated to public health – I know that our city is up for the fight. During years in which President Reagan ignored the AIDS crisis, San Francisco's elected leaders, nonprofits, and public health professionals responded compassionately and effectively by working together with common purpose. Today, that leadership endures in a Getting to Zero initiative that is on track to reduce HIV transmission and HIV-related deaths by 90 percent in San Francisco before 2020.

Another example of our city's bold leadership is Healthy San Francisco. After years of federal inaction to stem the spiraling costs of health care, Mayor Gavin Newsom and Supervisor Tom Ammiano a decade ago forged consensus to create an innovative program that dramatically expanded health care access to uninsured residents. Today, even with the ACA, Healthy San Francisco continues to offer immigrant communities and others access to care they would otherwise do without.

As a San Francisco supervisor, I am incredibly grateful for the opportunity to help lead our city's response to the crisis before us. Board of Supervisors President London Breed has appointed me to the Budget and Finance Committee. I will also serve on a special Select Committee on Federal Funding, which will assess the challenges San Francisco is likely to face from a Trump-led federal government. Both appointments will afford me important opportunities to fight Trump's efforts to convert Medicaid into a block grant program, which could cost millions of Americans their health care. In the coming months, committees on which I serve will hear testimony from experts, city departments, and – most importantly – those San Franciscans most likely to be adversely affected by federal cutbacks in health care coverage and funding.

Our strategy must first and foremost fight the federal government's retreat on health care, but we can't afford to stop there. We must also fight to encourage the state of California to be a backstop against federal abandonment. It's a prudent approach that will help preserve access to health care for the maximum number of residents.

San Francisco is blessed with extraordinarily capable leaders in Washington, Sacramento, and City Hall, and our partnerships and common purpose will be critical to forging an effective response to Trump administration cutbacks. U.S. House Democratic Leader Nancy Pelosi (D-San Francisco) last weekend rallied opposition to the Republicans' dismantling of ACA . State Senator Scott Wiener (D-San Francisco) will also be an enormously effective champion for San Francisco as chair of the Senate's Human Services Committee. Mayor Ed Lee and I have already begun meeting with health care leaders to ascertain the impacts of federal policy changes.

Thursday evening (January 19), I'll join neighbors at the Noe Valley Town Square from 6:30 to 8:30 p.m. for a pre-inaugural community vigil, and I hope I'll see you there. If you can't join us, I hope you'll contact me at (415) 554-6968 or

We have faced health care crises before. Working together with common purpose, we responded compassionately and effectively – offering a national model for how to do it right. As supervisor, I look forward to working with San Franciscans to do so once again.


Jeff Sheehy was appointed District 8 supervisor by Mayor Ed Lee earlier this month.


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