City leaders join the fight for retired SF firefighter's cancer care coverage

SAN FRANCISCO, Calif. - The community is rallying around a retired San Francisco firefighter battling cancer after his family said his treatment has been denied.

City leaders, who are demanding answers from Blue Shield of California, hosted a rally on the steps of City Hall on Friday.

Ken Jones served the city of San Francisco as a firefighter for 17 years, retiring over a decade ago.

His wife, Helen Horvath, also a retired firefighter, said Jones was diagnosed with lung cancer last year.

"I know that metastatic lung cancer is not going to be cured, but we hope to have more time with Ken and more time where he's feeling good," said Horvath.

Horvath said Jones has been fighting the terminal illness for the better part of a year.

Cancer treatment ‘doesn’t meet guidelines' for insurance

She said when they showed up for his doctor’s appointment at UCSF last week, they learned insurance wasn’t covering a $47,000 treatment.

"The doctor discovered last Wednesday when we were there for treatment that Blue Shield had denied it and we weren't aware," said Horvath.

The disease is attributed to his exposure to toxins on the job. The San Francisco Firefighters Cancer Prevention Foundation said 65% of firefighters will be diagnosed with cancer in their lifetime. 

Horvath said she expected the city-provided Medicare Advantage Plan to take care of everything.

"Blue Shield felt that they didn't specifically match the cancer treatment guidelines," she said.

In a statement by Blue Shield of California, a spokesperson told us they could not comment on individual cases, but said clinical coverage is based on specific evidence-based guidelines established by the centers for Medicare and Medicaid services.

The spokesperson wrote, "We are committed to supporting our members with compassion and working with their doctors to help them access care and resources."

SF city leaders say it's happened before

On Friday, Mayor Daniel Lurie and Supervisors Matt Dorsey and Connie Chan joined the firefighters union and advocacy groups sending this message to the insurance company.

"We will go after you," Chan said.

"The mayor of San Francisco, the Board of Supervisors have our firefighters back, we will get to the bottom of this," said Mayor Lurie.

The Supervisors said after hearing Jones’ story, they’ve learned of three other firefighters who’ve been denied or delayed coverage. Two of those were eventually covered, but only after extensive advocacy, they said.

They argued denying coverage to firefighters is a moral failure and have begun the fight to help Jones.

Dorsey said they wrote a letter to the city's Health Services System to inquire about whether Blue Shield had a pattern of inappropriately denying or delaying coverage to employees and retirees.

"The outreach budget chair Chan and I are undertaking with our city workforce and retirees seeks to ask whether Blue Shield is engaging in post claim underwriting practices to deny care and treatment," he said.

Jones, who was unable to attend the rally at City Hall because he was receiving treatment at UCSF, was represented by his wife and daughter, Rachel Jones, and dozens of firefighters.

"This is not just about my father, this is about Medicare Advantage Plans being allowed to delay medically necessary care behind closed doors without transparency, without accountability and without consequences," said Rachel Jones.

The city began its contract with Blue Shield in June 2024, replacing their existing deal with United Healthcare. Supervisor Dorsey made it clear during the rally that it’s a switch they regret.

What you can do:

In order to determine whether the denied coverage is part of a broader pattern, the supervisors are asking retirees and employees to report issues in health care coverage.

The family has a GoFundMe to cover expenses, which has raised more than $50,000.