Golden Gate Restaurant Association v. City and County of San Francisco

The City of San Francisco (city) (defendant) enacted a healthcare-security ordinance (ordinance) that created a city-administered healthcare program for uninsured low- and moderate-income residents called the Health Access Plan (HAP). The ordinance required covered employers to make healthcare expenditures on behalf of their covered employees who worked in the city (employer spending requirement). The employer spending requirement was an hourly rate ranging from $1.17 to $1.76 depending on a covered employer’s number of covered employees. The employer spending requirement could be met in several ways, including but not limited to contributions to health savings accounts, reimbursement for healthcare-related expenses incurred by covered employees, and direct delivery of healthcare services. An employer that did not make expenditures on behalf of covered employees in one of these ways was required to make payments directly to the city (city-payment option). If a covered employer elected the city-payment option, its covered employees who satisfied age and income requirements and were otherwise uninsured were eligible to enroll in the HAP, and the employer’s other covered employees were eligible for medical-reimbursement accounts with the city. The ordinance also imposed minimal recordkeeping requirements on covered employers. The Golden Gate Restaurant Association (association) (plaintiff) filed suit, alleging that the ordinance was preempted by the Employee Retirement Income Security Act (ERISA). The district court granted the association’s motion for summary judgment and enjoined the implementation of the employer spending requirement. The city appealed.