Howard Health Initiative Ready to Enroll Uninsured

Howard County Executive Ken Ulman, center, said the county is well suited to attempting such a program.
Howard County Executive Ken Ulman, center, said the county is well suited to attempting such a program. (By Katherine Frey -- The Washington Post)
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By Lori Aratani
Washington Post Staff Writer
Tuesday, September 30, 2008

Howard County will launch an ambitious effort this week to offer medical coverage to uninsured residents for as little as $50 a month and already has 1,200 county residents lined up to enroll.

County officials said they developed the Healthy Howard initiative to give legal residents access to a doctor, to reduce crowds in emergency rooms and to lower health-care costs for everyone. The effort comes as jurisdictions across the nation look for ways to address the growing population of people without health insurance.

"Yes, we're stepping out on a limb, but our feeling is we can't continue to wait for our national government to get its act together," said County Executive Ken Ulman (D). "The state is making progress in covering more uninsured, but there still will be a gap. We want to create a model that may help improve the system and the way we approach the uninsured."

For one month, beginning tomorrow, county residents can sign up for the program, which will provide as many as six visits a year to primary-care doctors (women will receive an additional OB/GYN visit under the program), free in-patient hospital care, mental health care, discount prescriptions and other services that would probably cost thousands of dollars if participants had to pay out of pocket. Those enrolled will also be assigned coaches to help them work out personal health plans.

The county and private foundations will pitch in money, and local doctors will provide free or reduced cost services to help keep fees within reach for those currently uninsured.

Officials said they expect most of the participants to be working adults who make too much to qualify for state and federal programs but not enough to afford care. A single person with an income at or below 200 percent of the federal poverty level would pay about $50 a month; a couple with a family income up to 300 percent of the poverty level would pay about $115. For an additional $1.65 a month, they can also buy coverage for basic dental care.

Most children are expected to be covered by state and federal programs, officials said.

The program has been a priority for Ulman, who announced its formation last October. Ulman, elected county executive in 2006, has said Howard is ideally situated to undertake such an effort because of its progressive politics, its relatively small number of uninsured residents and its status as one of the wealthiest jurisdictions in the country.

In its first year, Healthy Howard will be open to 2,200 of the estimated 15,000 Howard adults who lack health coverage, officials said. They said many of the participants are likely to be people who have jobs but lack insurance. They are careful to note that the $2.8 million program does not provide insurance and cannot be used outside county limits.

"This is access, not insurance," said Peter Beilenson, the county's health officer.

The program is open to legal residents of the county who have been uninsured for at least a year, a requirement designed to prevent companies from dumping insured patients into the county's pool.

Doctor visits will not begin until January. Beilenson said if applicants exceed available spots, a lottery will be held. Officials hope to add up to 2,000 enrollees a year thereafter, but they said the number will depend on how the program works in its first year.

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