Legislation Required For Maryland's Howard County Program For Uninsured

A Howard County, Md., plan to provide 20,000 uninsured residents with access to health care services will require passage of state legislation because of the program's unique structure, the Washington Post reports. According to draft legislation, the Healthy Howard program would create a "public-private partnership." If the legislation is approved, the program would have a first-year budget of $2.8 million and extend access to care to 2,000 legal county residents. The program would use existing federal programs, local government funds, private donations and user fees to provide primary and specialty care, medications, and lifestyle management, according to county Health Officer Peter Beilenson.

Beneficiaries would pay monthly fees ranging from $50 to $85, which would account for 60% of the program's initial budget. The program also would seek $500,000 from the county in its fiscal year 2009 budget and $700,000 in private funds. According to Beilenson, an important feature of the program is Howard County General Hospital's decision to forgive any existing debt Healthy Howard participants have.

If the Maryland General Assembly approves the bill this session, the program would be delayed until Oct. 1 to give state officials time to write the program's regulations, Beilenson said. He added that Healthy Howard cannot be defined as insurance because it would create major financial burdens, such as a requirement for reserve capital. Maryland Insurance Administration spokesperson Karen Barrow said the agency is reviewing the plan to determine whether it is an insurance program. She said, "I believe this is different from anything we've seen," adding, "Perhaps that's why we're needing to set up special rules for it." She said, "We're certainly interested in working with Healthy Howard and the General Assembly to develop the appropriate regulatory scheme" (DeFord, Washington Post, 2/7).

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