Maryland Plans To Provide Affordable, Coordinated Care For Uninsured Residents

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Howard County, Md., officials on Tuesday at a news conferenceunveiled the Healthy Howard program, which aims to provide affordableand coordinated health care to uninsured state residents who are noteligible for state and federal programs, the Baltimore Sun reports (Carson, Baltimore Sun, 10/17).

Tobe eligible for the program, individuals must have lived in the countyfor at least one year and must have been uninsured for a year.Residents also cannot be eligible for state or federal health programsand must have incomes lower than 300% of the federal poverty level.Undocumented immigrants are not eligible for the program.

Residentswith incomes at or below 200% of the poverty level will contribute $50per month for coverage, and those with incomes up to 300% of thepoverty level will contribute $115 per month. The program is expectedto cost $2.8 million in its first year, and residents' contributionswill cover about half of the expenses.

Program beneficiaries will be entitled to at least six physician visits per year at the Chase Brexton Health Services community health clinic, hospital care at Howard County General Hospital,and mental health, substance abuse and diagnostic services. The programalso will offer prescription drugs at $10 per prescription, with drugcosts not to exceed $20 per month (Otto, Washington Post, 10/17).

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Inaddition, beneficiaries will be required to meet with a health coachwho will design a wellness plan. Those who do not follow the plan couldbe put on probation after three months and lose their health benefitsafter six months (Baltimore Sun, 10/17). The county alsowill undertake efforts to enroll those eligible but not participatingin state and federal health care programs (Washington Post, 10/17).

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County health officer Peter Beilenson said that mandatory preventivecare is a fundamental element of the program because, "We feel accessto health care is a right, but it's also a responsibility" (Washington Post,10/17). According to Beilenson, the national health care system is"broken," and the county "decided to step up and be a national modelwhile developing a program to benefit the residents of Howard County."He added, "This is explicitly not insurance and not portable."

Georges Benjamin, executive director of the American Public Health Association,said, "We'll all be watching this experiment," noting, "It's much morecomprehensive than what usually gets done anywhere. From thatperspective, I think it's unique." Some experts doubt that the programwill succeed given a lack of financial investment by the county. UlderTillman, health officer of neighboring Montgomery County, Md., said,"You've got to have an engine that can drive this."

Gerard Anderson, a Johns Hopkins University Bloomberg School of Public Healthprofessor specializing in health care finance, said, "I just don't seehow you cover people without any new money." Howard County ExecutiveKen Ulman said, "Much of this is new. To a certain extent, this is alla leap of faith" (DeFord/Otto, Washington Post, 10/16).

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Reprinted with permission fromkaisernetwork.org.You can view the entire KaiserDaily Health Policy Report, search the archives, andsign up for email delivery at kaisernetwork.org/email. The Kaiser Daily Health Policy Report is published forkaisernetwork.org,a free service of The Henry J. Kaiser Family Foundation.

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