Howard Unveiling Its Health Program

By Susan DeFord and Mary Otto
Washington Post Staff Writers
Tuesday, October 16, 2007

Howard County, the third-richest large county in the nation, is embarking today on an ambitious plan to ensure that its 274,000 residents have access to health care.

The plan, which will be detailed at a news conference, will bring together public and private resources in a network designed to offer affordable health care to an estimated 20,000 uninsured children and adults in Howard.

Rather than remake the health-care system, Howard officials are trying to draw the uninsured into existing government-funded programs they already qualify for, particularly Medicaid and the Maryland Children's Health Insurance Program. The plan would fill the gap for those not eligible for the government-funded programs through a mix of private providers and the county's hospital and community health centers.

The proposal targets the working poor whose employers do not offer health insurance. Only Howard County residents will be eligible.

What the county will offer is "explicitly not insurance. Nor is it portable," said Peter Beilenson, the county health officer. He said that of the estimated 20,000 uninsured in the county, about 5,000 are children eligible for but not enrolled in state and federally funded programs. About one-third of the adults will not enroll in any program, Beilenson said. That leaves about 10,000 people ages 19 to 64 the county aims to enroll.

"That's our universe: 10,000 uninsured adults," he said. "We'll offer a wide array of services, from primary to specialty care."

That Howard officials are tackling the seemingly intractable problem of providing affordable health care to the uninsured says much about the national debate over that group.

"There is still a broken system," Beilenson said of the federal government's attempts to provide affordable health care to the uninsured. "We decided to step up and be a national model while developing a program to benefit the residents of Howard County."

Many localities have tried their own approaches to reaching the estimated 47 million Americans without health insurance.

The San Francisco Department of Health provides universal health-care access to the city's estimated 82,000 uninsured. Leaders there stress that the program is not insurance but provides a primary-care physician to each participant.

In Chattanooga, Tenn., the medical community has recruited a network of 600 volunteer physicians and drawn in three hospital systems to provide primary and specialty care. The program reaches about 12 percent of the 38,000 uninsured.

Howard County Executive Ken Ulman (D) believes Howard can serve as a kind of test case because the problems of health care in the county are far more manageable. "Our goal is to be able to provide some initiatives as a model to be able to shape the conversation," Ulman said.

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