Even if lawmakers can agree on how to overhaul the nation's health care system, the hope of universal coverage could crumble if individuals can't afford their share.
Take Howard County. Less than five months into an innovative program to give low-income people access to medical care for as little as $50 a month, nearly one in 10 participants is at risk of being cut off because they can no longer afford the cost.
Howard officials say their fledgling program, called the Healthy Howard Access Plan, provides a cautionary lesson for federal policymakers battling over how to re-imagine the nation's health care system and extend insurance to some 47 million Americans. While the major congressional proposals would require that nearly everyone have insurance or pay a penalty, low-income people could qualify for subsidies to help cover the cost of premiums. But lawmakers are wrangling over who would get financial help - and how much.
If the subsidies fall short, millions of Americans could continue to struggle without health insurance, say advocates for the uninsured. Besides, if people in Howard County - among the richest localities in the nation - can't manage $50 a month, how could those struggling elsewhere afford the plans under consideration in Washington that would require a much higher out-of-pocket cost?
Dr. Peter Beilenson, Howard County's health officer, said higher government subsidies are crucial to making health care affordable to all. "I'm totally for universal health care, but these are working people who are asking themselves, 'How in the world can I afford this?' The bottom line is there will be insurance reform and, I think, a modest expansion. But unless the subsidies are significantly ramped up to deal with real-life families, it's not going to be even close to universal coverage."
Today, as premiums skyrocket, many uninsured people say they would be unable to purchase coverage without substantial subsidies.
Jean Barnett tried pricing insurance, but threw up her hands when she discovered the cost: $186 a month. The 47-year-old from Baltimore has been uninsured since being laid off from her job at an addiction counseling center in February, where she made about $400 a week.
Barnett pays $90 for 30 pills to manage her high blood pressure, but can no longer afford the Lipitor she took for years to keep her cholesterol in check. She is eyeing proposals in Congress closely with hopes that she may one day be able to afford insurance.
