@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.},
}