Howard County's highly praised attempt to provide low-cost, preventive medical care for uninsured residents is off to a slower than expected start.
Only about 200 people have joined since enrollment in Healthy Howard began last Oct. 1, county health officer Dr. Peter L. Beilenson said, falling short of the admittedly ambitious goal he set of signing up 2,000 members in the program's first year.
"Enrollment is not where I hoped it would be," Beilenson admitted under critical questioning at a recent county council budget hearing. He did note, however, that another 250 applications, many representing entire families, are being processed.
The program is under close scrutiny for how successfully it addresses on a local level one of the most persistent problems facing the nation: how to provide health care for the uninsured, who number 50 million across the country and more than 700,000 in Maryland.
As the Obama administration tackles national health care reform, Howard's effort to provide coverage for every uninsured resident who wants health services will provide a glimpse into what works - or doesn't.
The program is also a signature initiative for County Executive Ken Ulman, a Democrat, and Beilenson, the former Baltimore City health officer who ran unsuccessfully for Congress in 2006, and could figure into any future ambitions of both.
Beilenson said the major roadblock to signing up more clients is lack of awareness. "I think it's very clear people just don't know about it," he said.
Another factor, officials said, is a reluctance of some residents to pay even a small monthly charge for coverage during a time of economic uncertainty.
The sluggish start to enrollment provided an opportunity for the program's chief critic, County Councilman Greg Fox, a Republican, to question whether there is a demand for it and if it merits a second $500,000 infusion of county funding for the coming fiscal year.
"The bottom line is, they're down to enrolling 20 or 25 a month, not 150 a month, and that's going to drop off, not increase," Fox said.
Fox is pushing to cut in half the county's contribution in the fiscal 2010 budget, which the County Council will vote on Wednesday. Supporters of the program say it needs both time and continued funding to succeed.
Patients in the program only began seeing doctors in January, they noted.
