House Speaker Emerita Nancy Pelosi used an event Monday about Covered California open enrollment to sound alarms over the number of Californians who may lose their healthcare due to Trump's Big Beautiful Bill.

Eight Senate Democrats rolled over and a temporary spending bill is making its way to the House today, where it will likely pass. And what's missing from the bill was the Democrats' central demand in this shutdown, which was the extension of Affordable Care Act (ACA) tax credits so that millions of Americans don't see their premiums skyrocket.

A leading force behind getting the ACA passed 15 years ago was Nancy Pelosi, who was Speaker of the House at the time. And Pelosi attended an event Monday at Book Passage in San Francisco, promoting the open enrollment period for Covered California — the state's healthcare marketplace established under the ACA.

Around 1.7 million California residents could see their premiums double following massive cuts to the Obama-era subsidies under the ACA, with those subsidies expiring on December 31. Open enrollment under Covered California began on November 1 and runs through January 31 — but assuming the tax credits expire, state residents are urged to sign up by December 31 to lock in current premiums for 2026.

"While Donald Trump and Republicans are inflicting a painful shutdown on the American people because they refuse to protect America’s health care, California is taking action to ensure working families have access to coverage," Pelosi said in a statement. "If Congress doesn’t extend the Affordable Care Act’s premium tax credits immediately, hundreds of thousands of families in California will lose their health care, and 1.7 million families will see their costs skyrocket. We must continue to fight for a responsible, bipartisan path forward that reopens the government and keeps health care affordable for the American people."

Around 40,000 San Franciscans rely on Covered California for their healthcare plans. And it's estimated that around California, an average increase in premium costs of 97% in 2026 will leave around 400,000 residents priced out of the marketplace.

"It covers folks up to a higher income level than Medi-Cal. But for many of those folks, health care is still otherwise unaffordable," says Daniel Tsai, SF's director of public health, speaking to ABC 7.

Pelosi added, speaking to ABC 7, "It is a remarkable thing that [the Republicans] would take half a trillion out of Medicare, millions of people out of Medicaid, and not renew the subsidies. Why? To give a tax break to the richest people in America."

When asked about her legacy, vis a vis the 15-year-old ACA, Pelosi tells the station, "Not so fast on the legacy... I have another year."

Related: Nancy Pelosi Says She'll Retire After 2026

Top image: Rep. Nancy Pelosi (D-CA) speaks during a prayer rally on the ninth day of a federal government shutdown in the courtyard of St. Mark's Episcopal Church on Capitol Hill on October 09, 2025 in Washington, DC. The federal government remains shut down for the ninth consecutive day after Congress and the White House failed to negotiate a deal on extending pandemic-era health care funding. (Photo by Chip Somodevilla/Getty Images)

The suspect in the shooting of UnitedHealthcare CEO Brian Thompson last week, 26-year-old Luigi Mangione, was thought by his mother to be living in San Francisco earlier this year, though it's not at all clear that he ever did.

Social media has been flooded for the last 24 hours with postings that cast Luigi Mangione as both folk hero and murderer, and with plenty of images of him shirtless and smiling culled from his Instagram and Twitter accounts, which have since gone offline. As CNN reports, friends have known him for years to post images from his travels, and to maintain a mostly positive-seeming social media presence.

That seems to have stopped earlier this year, and by July, friends were posting things publicly like "I haven’t heard from you in months," and "I don’t know if you are okay."

One user also posted to Xitter in October, "Nobody has heard from you in months, and apparently your family is looking for you."

Now we learn, as the Chronicle reports, that Mangione's mother filed a missing persons report with the San Francisco Police Department just a few weeks before the shooting, on November 18. In it she stated that she had last spoke to Mangione in July, and she believed he was working in the city at car-sales startup TrueCar, which is where he was listed on his LinkedIn as being employed.

Kathleen Mangione reportedly told the SFPD she believed he was working at TrueCar at 124 Montgomery Street, which was listed as permanently closed, and it's not clear if TrueCar, which is based in Santa Monica, ever had offices there.

Mangione's mother did not suggest that her son presented any kind of threat, and she reportedly told police she didn't know where he may have frequented in town.

As SFist reported Monday shortly after Mangione's arrest, we know that he had an interest in AI and engineering, and that he had spent a summer in the Bay Area at Stanford in 2019, while he was attending undergrad at UPenn.

He graduated in 2020, and CNN reports that he had been working remotely for TrueCar while living in Honolulu for about six months in 2022. The New York Times reports that, according to TrueCar, he had not been an employee since 2023.

According to his family, Mangione had dropped out of contact sometime after having back surgery around August 2023, and that July contact with his mother is the last we know of. (His last post on his now-removed Instagram account had been photos from the Big Island in Hawaii in 2021.)

A friend who runs a co-living compound in Honolulu for remote workers, RJ Martin, has spoken to both the Times and CNN and said that Mangione was mostly "upbeat," and they had been in touch until earlier this year, but Mangione went silent sometime around March or April. Martin said that Mangione had confided in him about his back issues — a spinal misalignment that caused him a good deal of pain — and said that he said he was not able to be physically intimate with another person without pain.

Martin also said that Mangione's back problems were exacerbated after he took a surfing lesson in Hawaii in 2022, after which Mangione was "in bed for about a week."

After last seeing family in Baltimore sometime last year, it seems like no one is sure where Mangione has been living for the past six to 12 months or more, and many friends have expressed disbelief that he could have undergone any sort of mental break.

Indeed, a brief handwritten note found in his backpack when he was arrested Monday in Altoona, Pennsylvania suggests pretty solid lucidity, and he appeared to take full responsibility for the shooting death of Thompson.

Per the Times, the note reads, "To save you a lengthy investigation, I state plainly that I wasn’t working with anyone... [healthcare companies] continue to abuse our country for immense profit because the American public has allowed them to get away with it," and he noted that during the time UnitedHealthcare’s market capitalization has grown, American life expectancy has not.

While being escorted into an extradition hearing Tuesday, as CBS News reports, Mangione was heard having an outburst before being pinned to a wall by officers in Blair County, Pennsylvania. He reportedly shouted, "This is completely unjust and an insult to the American people!"

Previously: Man Arrested In Connection With Healthcare CEO Slaying Spent Time In Bay Area

A man whom New York police are describing as a "strong person of interest" in last week's murder of UnitedHealthcare CEO Brian Thompson has been arrested in Pennsylvania and identified as 26-year-old Luigi Mangione.

Mangione was recognized while dining in a McDonald's in Altoona, Pennsylvania, and as the New York Times reports, so far, Mangione's only known connection to Pennsylvania is that he attended UPenn. An Instagram post (since removed) from the spring of 2019 showed him with the Phi Kappa Psi fraternity at Penn.

The caption reads: "'WARNING: EMITS SHOWERS OF SPARKS. DO NOT PUT IN MOUTH. LIGHT FUSE AND GET AWAY' - the live firework in my mouth."

Mangione appears to have grown up well off in Maryland, and attended an expensive private school there, Gilman High School, where he graduated as valedictorian of his class in 2016.

He graduated Penn in 2020 with an engineering degree, and he also reportedly received a Master of Science in Engineering in computer and information science.

He lived in Hawaii in recent years, and his last Instagram post was from August 2021, from the Big Island.

He also appears to have spent the summer of 2019 at Stanford, and posted a series of photos and videos from there, saying he was "getting paid in half of these photos." A LinkedIn account suggests he was a "head counselor" and artificial intelligence teaching assistant at the school for that summer.

The Chronicle notes that Mangione appears to have reviewed the Unabomber Ted Kaczynski's 1995 manifesto on GoodReads, in addition to reviewing Aldous Huxley's Brave New World.

An employee at the McDonald's in Altoona recognized Mangione around 9 am today from the widely circulated photos of his face taken at a hostel in New York City last week.

Two police officers, afteer being tipped off by the employee, approached Mangione, as the Times reports, who was sitting with a laptop and a surgical mask on his face. The officers reportedly asked him to pull down his mask, and when they asked if he had been in New York City recently, Mangione reportedly started "shaking."

After giving the officers a fake ID, and being called out on it, they asked why he lied about his identity, and according to police Mangione replied, "I clearly shouldn’t have."

In his backpack, officers allegedly found a ghost gun and silencer, both made with a 3D printer.

The shooter who killed Thompson last week used a silencer.

According to the Times, via the officers, Mangione was also carrying "a handwritten manifesto that criticized health care companies for putting profits above care."

Business Insider reports that, according Mangione's online activity, he may have suffered from chronic back pain, and at one point posted an x-ray image showing four pins in what appeared to be his spine. He also reviewed several books on GoodReads related to back pain.

The publication further reported that Mangione was one of 37 grandchildren of a prominent Baltimore real estate developer, the late Nick Mangione Sr., who died in 2008.

Mangione was brought into a courtroom in Blair County, Pennsylvania Monday at 6 pm local time to be arraigned on gun charges. He is being held without bond.

This is a developing story.

LGTBQ health advocates, along with City Clinic doctors and members of the Harvey Milk Democratic Club are rallying today outside the clinic on Seventh Street to protest Mayor London Breed's omission of clinic funds in a proposed bond measure.

Alarms were raised earlier this week when details of a $360 million proposed bond measure were released, as Mayor London Breed hopes to put the bond on the November ballot — on which she will also be up for reelection in what is sure to be a contentious race. Members of the LGBTQ community in particular raised objections to the fact that $25 million of the bond money is allocated to the renovation of Harvey Milk Plaza outside the Castro Muni station, while a planned $29 million for the relocation and modernization of City Clinic was missing.

As the Bay Area Reporter explained, the Harvey Milk Plaza project, which has been in the works for over seven years, was expected to be covered by mostly private funding, and was never part of the city's capital spending plan. Meanwhile, a $28.5 million allocation for the relocation of City Clinic, whose current building the city has called "functionally obsolete," was part of the plan.

The bond measure does include $167 million to be used to expand or improve three other city-owned healthcare facilities: the Chinatown Health Clinic, Zuckerberg San Francisco General Hospital, and Laguna Honda Hospital. And there are also allocations for addressing erosion on the Great Highway, and renovating Hallidie Plaza at Powell Station.

While City Clinic, which serves around 85 people per day and is an important sexual health resource for the uninsured, is not in danger of closing, advocates worry that it is being shunted from the priorities of the Department of Public Health.

"Never once before was Harvey Milk Plaza or Great Highway or $70 million for downtown renovations or Hallidie Plaza mentioned for the bond measure — that's not how capital projects and general obligation bonds work," says Jeffrey Kwong, the president of the Harvey Milk LGBTQ Democratic Club, speaking to the Bay Area Reporter. "I 100% support Harvey Milk Plaza but that's no excuse for cutting the $29 million planned for critical capital improvements at the City Clinic — which has been in the plans for years."

And as as Vince Crisostomo, director of aging services at the San Francisco AIDS Foundation, tells the paper, "For people of my generation, I am 63 years old, City Clinic has been a huge part of our history... I do think the people of my generation, if they had to choose between their sexual health and making the plaza pretty, they would choose their sexual health."

A rally is scheduled for today, Thursday, May 2, at 5 pm outside the clinic at 356 Seventh Street. In a release, the Milk Club says that advocates will be "taking a stand against Mayor Breed’s $350 million bond proposal cutting vital public health services, including the City Clinic, to instead fund pet projects like downtown sidewalks and panda-related traffic."

Jeff Cretan, a spokesperson for Mayor London Breed, told the Bay Area Reporter this week that City Clinic is in no danger of closing. "The City Clinic is an important public health resource and we are exploring options for the future of the clinic. Some have said the clinic is being closed or shut down, which is not true," Cretan said. "It will continue to operate and we will continue to work with DPH on investments to improve the patient experience."

Update: Mayor Breed quickly relented and said Thursday that the bond can grow by $30 million in order to include funding for the relocation of City Clinic.

Related: Mayor Breed Proposes a $360 Million Bond Measure to Fund a Potpourri of Seemingly Unrelated Causes

The biggest healthcare worker strike in the nation’s history technically only lasted three days, but resulted in a 21% wage increase for pandemic-frazzled employees of the Oakland-based healthcare conglomerate Kaiser Permanente.

It was last Wednesday when Kaiser Permanente healthcare workers went on strike in California, Colorado, Oregon, Virginia, Washington state, and Washington, D.C. And it was only a three-day strike. But it apparently did enough to disrupt the Kaiser network’s appointments, procedures, and lab work that it forced the healthcare giant to the bargaining table.

And now the Chronicle reports that Friday morning, Kaiser and its workers’ unions announced a tentative labor deal, which would raise worker wages, and curtail Kaiser’s subcontracting and outsourcing.

Workers say they’ve been overworked, underpaid, and burnt out during the pandemic, claiming Kaiser facilities have been short-staffed and overly reliant on non-union subcontractors. The new labor deal established a new Kaiser minimum wage of $25 in California ($23 in the other states), an across-the-board wage increase of 21% phased in over four years, and increased investments in hiring and training.

“Millions of Americans are safer today because tens of thousands of dedicated health care workers fought for and won the critical resources they need and that patients need,” Coalition of Kaiser Permanente Unions director Caroline Lucas said in a statement. “This historic agreement will set a higher standard for the health care industry nationwide.”

For their part, Kaiser is being gracious, saying in a Friday statement on Twitter that, “We are excited to have reached a tentative agreement with the frontline health care workers of the @UnionCoalition this morning. We are thankful for the instrumental involvement of Acting U.S. Labor Secretary @ActSecJulieSu.”

According to the New York Times, the various unions representing Kaiser lab technicians, medical assistants, receptionists, and sanitation workers had threatened another week-long strike in November if they didn’t get a new contract to their liking. Those unions represent around 75,000 employees in eight different states.

It’s a big win for acting Department of Labor Secretary Julie Su, who flew in from Washington, D.C. to help broker the deal. A former California Labor Secretary, Su is currently an “acting” U.S. Labor Secretary, basically because senators Joe Manchin and Kyrsten Sinema have been holding up her nomination.

The labor deal is still not final. Still needs to be ratified in a worker vote, a process that’s expected to begin October 18, according to the Chronicle.

Related: Kaiser Employees, SF School Staff Head to Picket Lines [SFist]

Image: @SEIU via Twitter

Those One Medical offices that have popped up around town over the last ten years are actually a national chain, and Amazon just bought up that SF-based chain for nearly $4 billion.

If you're not familiar with One Medical, the private, concierge-esque primary care medical provider that has opened multiple offices around San Francisco over the last decade — mostly in the Financial District, but also in the Castro, Hayes Valley, Pac Heights, and elsewhere — it's been a go-to for those without any attachment to a particular doctor and who like the ease of appointment-getting. The only time the company has been in the news was over allegations off letting people jump the line for vaccine access in the early days when vaccine supply was still quite limited, for which they had their vaccine access revoked in SF, Alameda, and San Mateo counties. Also in those early vaccine days, The Verge broke a mini-scandal that One Medical was charging $56 for vaccinations, though that seemed like just a few isolated cases and appears to have been quickly addressed.

And this was not enough to scare off Amazon, as the Chronicle reports Thursday morning that Amazon is buying One Medical for a reported $3.9 billion. The Associated Press adds Amazon “will acquire One Medical for $18 per share in an all-cash transaction.” One Medical is actually owned by San-Francisco-based parent company 1Life Healthcare, Inc.; it is not (yet) profitable, and its stock has had a terrible year, but is obviously performing well on today’s news that Amazon is buying the company.

So what is One Medical? The Verge describes them as “healthcare for Millennials,” where you pay an annual $199  subscription fee for a primary care physician. The platform says it allows you to “Connect to care 24/7,” though some of this is just “over video” or “Message our care team.”

I’m always skeptical of companies hawking “experiences” that are "reimagined." (Like, can’t you “reimagine” some new words that aren’t already in every single goddamn press ever sent these days?) The video above makes a great show of how their furniture is fancier than most doctor’s waiting rooms, whatever that does for you.

Still, Amazon thinks that the “telehealth” concept makes sense, and it can certainly clear bottlenecks in the healthcare process. As The Verge notes, it’s Amazon’s third-largest acquisition ever, behind “Whole Foods ($13.7 billion) and the recently closed purchase of MGM ($8.45 billion).”

Related: One Medical Has Vaccines Revoked By SF, San Mateo, and Alameda Counties Over Allegations of Improper Distribution [SFist]

Image: One Medical

A bill to bring publicly funded healthcare to every Californian did not even make it to the floor for a vote, to the delight of opponents who called it a “government healthcare takeover.”

Last night was shaping up for a huge debate in the California Assembly, as a Guaranteed Healthcare For All bill called AB 1400 was set to go before the chamber. The landmark bill would have created the first universal healthcare system in the U.S., for everyone regardless of immigration status. It’s the holy grail of the Medicare For All crowd, while opponents called it “the largest tax increase in state history” and complained it would “degrade our medical services and expand coverage to illegal immigrants.”

The showdown was even more dramatic because the bill had to pass by 11:59 p.m., or else would be shelved for another year.

There was no dramatic showdown. The San Francisco Business Times reports that the single-payer healthcare bill was yanked from the floor before any vote was cast. “It became clear that we did not have the votes necessary for passage and I decided the best course of action is to not put AB 1400 for a vote today,” the bill’s author, Assemblymember Ash Kalra (D-San Jose), said in a Monday statement.

The nurses who’d supported Kalra’s bill seem pissed.

“Today, elected leaders in California had the opportunity to put patients first and set an example for the whole country by passing AB 1400, the California Guaranteed Health Care for All Act, in the State Assembly,” the California Nurses Association said in their own statement. “Instead, Assemblymember Ash Kalra, the main author of the bill, chose not to hold a vote on this bill at all, providing cover for those who would have been forced to go on the record about where they stand on guaranteed health care for all people in California.”

According to The Hill, the bill would have covered the three million Californians (roughly 10% of the state population) that do not have health insurance. But very significantly, the bill did not have any mechanism to pay its estimated $350 billion cost, which supposedly would have been addressed in some future bill.

Governor Gavin Newsom, who has many times campaigned for universal healthcare, seemed to dislike this bill because it was not his. “This bill comes out of nowhere,” he complained to KTVU. The bill was also opposed by the California Chamber of Commerce, and all the standard anti-tax types.

But really, there was no point to this vote, it was not going to pass, it didn’t have the votes. There was some interest among progressives to put legislators on the record and “see where they stand,” as if there would be some huge electoral blowback in November. That seems unlikely. But there probably will be another version of universal healthcare proposed in the California legislature by then, just as this bill was a do-over of a failed single payer, universal healthcare bill from last year.

Related: San Francisco Offers Free 12-Hour Child Care For Healthcare Workers at 35 Rec & Parks Sites [SFist]

Image: assembly.ca.gov

Sup. Hillary Ronen popped up on 60 Minutes Sunday night to proclaim “We are getting screwed” over Sutter Health’s alleged monopoly and price-gouging practices.

The novelty of seeing a sitting member of the San Francisco Board of Supervisors appear on Sunday night’s episode of 60 Minutes will quickly pass, and give you more a feeling of hair-on-fire rage, in the segment’s examination of Sutter Health’s business practices and how they’re causing California health care costs to skyrocket.

The report from Lesley Stahl — last seen having Trump storm out of his interview with her — uncovers a myriad of outrages. Among them, it costs twice as much to have a baby in Northern California than in Southern California, that Sutter Health has bought up all the hospitals in some regions in order to control prices, and they actively block patients from being able to visit more affordable hospitals. But perhaps the most infuriating revelation came in Ronen’s segment, that as a “not-for-profit company,” Sutter Health pays no taxes on their $13 billion in annual revenue.

“Sutter avoids tens of millions of dollars a year in local property taxes. And at one hospital alone they're avoiding $20 million a year,” Ronen said on the program. “At any way you look at it, any path you look, we are getting screwed.”

The gist of the arguments against Sutter Health in the segment are that they’ve bought up so many hospitals that they’re able to set prices at unrealistic levels, but with no pushback, and then as the only healthcare option, were forcing cities and large companies into far larger plans than they needed. Sutter Health did respond in a statement to CBS that they were delivering “high-quality, affordable care" and "healthier patient outcomes at a lower total cost of care,” though the substance of the 60 Minutes reporting showed pretty much the opposite of that.

California Attorney General Xavier Becerra, who's just been nominated to the Biden administration, did just squeeze a $575 million settlement out of Sutter Health for these practices (it is waiting on a judge’s approval), though they do not have to admit wrongdoing, or even change any of these practices.

People fairly wondered why president-elect Joe Biden is tapping Becerra for Secretary of Health and Human Services, considering his lack of healthcare background. His watchdog approach to big corporate hospital chains may provide the answer to that, though we’d rather see real structural change than ass-covering legal settlements.

Related: Supes Protest Letting Sutter Health Close Long-Term Care Unit at St. Luke's [SFist]

Screenshot: 60 Minutes, CBS

San Francisco's Board of Supervisors on Tuesday unanimously approved a new ordinance requiring many employers with workers at SFO — including catering workers, cabin cleaners, and baggage handlers — to pay for healthcare family plans for those workers.

After initially approving the ordinance last week, the Board took its "second reading" vote Tuesday and unanimously voted in favor of it once more. The new law came about after SFO has seen 156 COVID-19 cases among airport workers — and recognizing that some workers who are most at risk, like airplane cabin cleaners, are not always adequately insured.

"For far too many airport workers — the majority of whom are low wage, and many of whom live below the Bay Area poverty line — sky-rocketing co-pays and deductibles and expensive family plans mean workers and their families regularly forego medical visits because they can’t afford to take on thousands of dollars in debt," said Supervisor Rafael Mandelman, who co-sponsored the ordinance, in a statement. "This health care crisis not only threatens the safety of SFO, but also threatens to further widen the gap between the richest and the poorest in our economy. The Healthy Airport Ordinance will help end this race to the bottom for frontline airport workers."

As the Examiner reports, the ordinance comes after years of organizing by airport workers for both higher wages and expanded healthcare coverage — something that catering companies and airlines have suggested they can't afford.

Last November, SF Supervisors Matt Haney, Gordon Mar, and Ahsha Safai were among 50 people who were arrested at SFO during a protest staged by Unite Here Local 2, which represents catering workers at two companies, LSG Sky Chefs and Gate Gourmet. That protest was aimed at getting higher wages and more healthcare benefits.

"Workers at SFO are mostly Black, Latino and API (Asian Pacific Islander) workers, and they have been already hard-hit by this pandemic," said Supervisor Matt Haney in a statement to the Examiner. "I am committed to supporting these workers, and every day that we fail to take action is another day that airport workers risk COVID-19 exposure without affordable health care for themselves and their families."

As the SF Business Times reports, airlines opposed the measure and suggested that it will result in higher ticket prices and likely layoffs of workers.

Photo: Duke Cullinan

The U.S. Attorney's Office in San Francisco on Thursday announced the filing of charges against 30 defendants — two corporations and 28 individuals — in an illegal kickback scheme connected to an East Bay home health care provider.

Hayward-based Amity Home Health Care and Advent Care hospice were named in the case as being at the center of a bribery scheme in which Bay Area doctors were bribed to refer patients to the company through Medicare. As the Chronicle reports, the scheme runs afoul of a federal anti-kickback statute that "criminalizes influencing referrals for federally funded health care through payments." The law comes with a maximum of 10 years in prison and a $500,000 fine.

At the center of the case is Amity CEO Ridhima “Amanda” Singh, who stands with others accused of doling out bribes to 13 doctors and five nurses to the tune of $8 million. In exchange for the bribes, Singh and her company reportedly reaped $115 million in fraudulent Medicare billings. The bribes also reportedly included trips to Las Vegas, Warriors tickets, lavish dinners, and pricey handbags.

As KPIX reports, Singh faces up to 35 years in prison given other charges that include witness tampering, and lying to federal investigators.

Among the accused doctors are Bhupinder Bhandari of Pleasanton, Kimberly Hicks of Oakland, Yelena Kabanskaya of San Jose, Gerald Myint of Union City, Tam Nguyen of San Jose, Juan Posada of Cupertino, Scott Taylor of Oakland, Henry Watson of Oakland, Zheng Zhang of Saratoga, April Mancuso of Los Gatos, Kerisimasi Reynolds of Los Gatos, Andre Nicolas Gay of Union City and Mariam Hasan of Milpitas.

While Amity and Advent did in fact provide care to all the patients involved in the scheme, the payments it received were fraudulent under federal rules.

The charges announced Thursday were the result of a multiyear undercover operation, as the Chronicle reports, and the investigation is ongoing. An employee at Amity and Advent agreed to cooperate with federal investigators. The investigation revealed that Amity has ended up dominating the home health industry in the Bay Area in recent years by controlling its own referrals.

So this is funny: There's a robot-manned coffee bar thing at the Metreon called Cafe X, and even it wants you to chip for its healthcare. Local blogger Mr. Eric Sir alerts us to the situation after he was unnecessarily charged the "SF Health Mandate" surcharge after this robot arm handed him his macchiato. "I, for one, welcome our new robot food service overlords," he writes. "What I'm not fine with, however, are spurious surcharges."

There on his bill for his $3.50 coffee beverage is a 30-cent sales tax, and a 14-cent healthcare surcharge, because hey, this robot might get carpal tunnel someday.

Mr. Eric Sir acknowledges that, sure, "human employees maintain this robot. But if you think about it, Cafe X is nothing more than a fanciful vending machine." And we don't pay healthcare surcharges on vending machine snacks.

Controversy over the Healthy SF law dates back about a decade now, after the always slim-margined restaurant industry cried foul over having to provide healthcare for their employees, and responded by adding this visible surcharge to most restaurant checks. Having made their point, Chronicle critic Michael Bauer called for restaurants to stop being stubborn about this and simply fold their healthcare costs into their pricing — however in 2014 he did learn why some restaurants still include the line item, which is that their rent can be tied to their gross receipts, and if they simply raise their prices their rent can go up.

And I guess even a robot cafe has to abide by the law too?

Previously: Billionaire Bubba Gump Shrimp Co. Owner Complains That SF's Healthcare Mandate Hurts Restaurants

Billionaire restaurateur turned reality TV host Tilman Fertitta, the man behind chains like Rainforest Cafe and Bubba Gump Shrimp Co., just gave some of his own quotes to CNBC regarding changes to healthcare mandates and President Trump, saying, "Why should the city of San Francisco be able to do absolutely whatever they want to do?" Fertitta doesn't think the restaurant industry should have to pay for its employees' health insurance, and he's not afraid to complain to a national news outlet about SF's liberal ways.

Fertitta, who's now hosting the second season of the CNBC show Billion Dollar Buyer, made his fortune buying up struggling restaurants after growing up peeling shrimp in his father's seafood restaurant in Galveston. He's now CEO and 100 percent owner of Landry's, the restaurant group based in Houston that has also purchased chains like McCormick & Schmick's, and here in SF, McCormick & Kuleto's Seafood Restaurant.

After November's election, and amidst the current debates about the GOP's healthcare plan, he's eager to voice his distaste for San Francisco's healthcare law, given how it's affected the multiple bottom lines of his SF restaurants — though the healthcare surcharge, which he still keeps as a separate bill item, probably isn't discouraging tourists from eating at his tourist-focused restaurants. And neither is mediocre food.

As he told Forbes a couple years back, it's not really about the food. ""You can put the greatest seafood restaurant next to an average steak house in an urban area, and that steak house will do more business than the seafood place. If you go to the water, you can put an average seafood place next to the greatest steak house, and people are going to eat seafood."

But it seems like Fertitta may may be behind the times when it comes to the discussions that many restaurateurs have had here about whether or not to keep grumpily pointing out the Healthy SF surcharge — something they began doing when the law took effect nearly a decade ago, and which many of said they should stop doing and just roll the costs into their prices as of about seven years ago.

"Do you realize, all the restaurants in San Francisco, we all have an added charge?" says Fertitta to CNBC. "We have a 3% or 4% or 5% add-on to the menu because they make us give all our employees full healthcare. We can't afford to do it."

All restaurants definitely do not put that added charge on their bills anymore, and the city never required that. And while different corners of the restaurant industry here may be struggling with their margins, the industry has managed not to collapse in the decade since they began having to provide health benefits.

As the Business Times notes, Fertitta is hoping the president appoints "the right people to the National Labor Relations Board," though he acknowledges that they can't change mandates made by individual cities and states.

At least in San Francisco we can rest assured our city leaders are battle-ready, organizing their troops and laying out strategies for fending off the destructive flanks of Donald Trump's approaching armies.

The Board of Supervisors has created a new committee specifically dedicated to dealing with the various fallout from policy decisions made by the incoming Trump Administration, and first up on the agenda may be the expansion of San Francisco's pioneering, decade-old public healthcare program, Healthy SF. It was suggested in the weeks following the election that our city was uniquely well equipped to deal with the possibility that the Affordable Care Act, a.k.a. Obamacare, would be repealed by Trump and a Republican led Congress, because unlike most localities across the country we have our own program for insuring low-income individuals and those otherwise uninsured that launched three years before the ACA.

"A repeal vote will start us down the path... to chaos in the insurance market and declines in coverage," said Mayor Ed Lee at a rally on Sunday at City Hall that drew thousands of people to protest Congress's impending action on the ACA. As ABC 7 reported, another march in defense of the ACA here in SF is scheduled for February 1.

But some, like SF's Republican Hispanic Assembly chair Leo Lacayo, say "It's a done deal," and Congress will now "take six months to design a new program that will work for the entire country."

The new Board committee to deal with such matters is called the Federal Select Committee, and as the SF Public Press reports, it's chaired by Supervisor Malia Cohen, and she's joined by two new supes, District 8's Jeff Sheehy and District 1's Sandra Fewer. Their job will be to anticipate local needs created by such things as the ACA repeal — which is still not a done deal, and Republicans have yet to propose anything to replace it — and any crackdown on SF's Sanctuary City policy, which could include the cutting off of federal funding to the city. As reported earlier, that could spell a $478 million hole in the city budget, and threaten a large portion of the $915 million a year we get from the state which is derived from federal funds.

Expanding the rolls of Healthy SF will come at a cost, too. Enrollment in the program reached a peak of about 54,000 people in the 2010-2011 fiscal year, as the Department of Public Health tells SF Public Press. That's now down to about 14,000 people six years later, largely due to the expansion of the state's Medi-Cal program, and to those getting insurance via Covered California under Obamacare. In that time the cost to the city for Healthy SF has gone from about $150 million to $44 million, meaning that re-expanding the program — which could include loosening eligibility requirements — would mean needing to find another $100 million in the city budget, at the least.

The ACA was enacted in 2010, however the state insurance exchanges set up under the law as well as the tax credits and penalties associated with it didn't come into being until January 2014, just three years ago. Healthy SF came into being in 2006, and in addition to providing access to healthcare to individuals regardless of employment or income, it requires employers in the city with 20 or more employees to provide health insurance or, at the very least, flexible spending accounts for healthcare. The law has been a sticking point for the restaurant industry in particular, which took to adding Healthy SF surcharges to checks to try to disown the line item as out of their hands — a practice that has largely gone away as the costs have been rolled into menu prices.

As enrollment in the ACA was taking place, Mayor Lee contemplated doing away with the Healthy SF program, promising a task force of business leaders and others to discuss it, but that never materialized, perhaps as enrollment in the program continued declining.

Now, those enrolled in Healthy SF tend to be the poorest of city residents, according to the program's most recent annual report. Most are between the ages of 24 and 44, living at or below the poverty line, and concentrated in the Mission, Excelsior, and Bayview neighborhoods. Also, Healthy SF has always provided coverage to undocumented immigrants, which most other programs do not.

And we should be glad that the program was not dissolved for this very, unforeseen reason — universal healthcare still doesn't exist, and the idea of healthcare being a human right is not settled law in this country. Good luck to the Republicans in coming up with a more affordable, more politically expedient version of the ACA, but in the meantime, we're good.

Previously: Typically Attuned To Difference, Board Of Supervisors Focuses On Similarities In Wake Of Democalypse

Next year, monthly premium rates in California will go up by 13.2 percent on average, the result of two insurers who have requested steep rate increases. As CBS5 and the AP report, officials at Covered California, the state's insurance exchange, announced the hikes would be much higher than the four percent increases of the last two years. The Business Times notes that here in San Francisco, rates will be even greater than the state average at 14.8 percent.

Covered California provides health insurance through 11 insurers who compete for 1.4 million enrollees, those who don't receive coverage through government funded Medicare and Medi-Cal or from an employer. And this year, Anthem Blue Cross and blue Shield asked for increases: Blue cross one of 16 percent and Blue Shield one of 19 percent. Factoring in other insurers who asked for lower rate increases, the average increase is just above 13 percent.

Why ask for the increases? More people were expected to use the exchange than actually did. However, Covered California points out that the rate of uninsured Californians is half what it was just before the Affordable Care Act went into effect.

"Shopping is going to be more important this year than ever," said Covered California Executive Director Peter Lee. "We have a competitive marketplace... Health plans that raise their rates do so at their peril.”

Federal prosecutors are investigating the possibility that Theranos, Inc., a blood testing startup once valued at $9 billion, misled its investors with regard to its proprietary pin-prick blood sample technology.

That was the word from the Wall Street Journal, which was echoed in a company statement to business partners published by the Business Times that also indicated the involvement of the SEC.

"Investigations by the SEC and the U.S. Attorney's Office, which began following the publication of certain news articles, are focused on requesting documents and ongoing, in addition to the CMS inspection," Theranos wrote. "The company continues to work closely with regulators and is cooperating fully with all investigations. "

Theranos has an active partnership with Walgreens in Arizona, a state where the Palo Alto-based Theranos has another lab. Now, Walgreens Boots Alliance and the New York State Department of Health have received subpoenas: Prosecutors want documents and testimony as to how the company was marketing itself and its technology. The investigation may or may not lead to an indictment and is in its early stages according to anonymous sources to the Journal.

"I feel devastated that we did not catch and fix these issues faster," Elizabeth Holmes said in an interview with Today that coincidentally aired yesterday before the news of the criminal investigation broke. "I'm the founder and CEO of this company, anything that happens in this company is my responsibility at the end of the day."

According to a letter from the Centers for Medicare and Medicaid Services. Holmes faces a two-year ban from the blood testing industry if problems aren't resolved at its Newark, California lab, which could also be shut down.

Previously: CEO Of Healthcare Startup Theranos Faces 2-Year Ban From Blood Testing Biz