Howard County's health access plan for the uninsured will need another infusion of $500,000 in county funding next fiscal year, though county health officer Dr. Peter L. Beilenson said that in addition to his budget request, he has some new private grants and is seeking more.
"We think we're OK asking for level funding," Beilenson said after speaking to a lunchtime gathering of the Association of Community Services on Wednesday at the Owen Brown Interfaith Center in Columbia. Beilenson was referring to past support for the program — a key initiative of County Executive Ken Ulman's — from three of the five County Council members. His new request represents the third fiscal year he's asked for $500,000 from county government.
The program has served 1,200 people and has about 720 enrolled now, according to Executive Director Liddy Garcia-Bunuel, just under the maximum 750 that funding would support. Beilenson said many who enroll leave after an average of 10 months when they get past a period of unemployment or become eligible for insurance. Healthy Howard is not insurance and serves Howard residents only while they are in the county.
Of the 10,000 Howard residents screened via Healthy Howard's electronic application program, 6,500 have been found eligible for existing federal and state health care programs.
Beilenson said the program has received three private grants from CareFirst, Kaiser and Aetna insurance companies totaling $244,000 that he's using to pay for health coaches. That's a key part of the experimental health access program, intended to prevent illness and improve residents' daily health habits as a way of cutting costs and reducing medical crises. He said surveys have shown emergency room visits are down for program members, although they come into the program with more bad habits, such as smoking, and receive less routine testing than people with insurance.
Public funding of the coaches has come under fire from County Councilman Greg Fox, a Fulton Republican who has also argued that the program has failed to attract enough members to make it worth taxpayer support. Identifying those eligible for existing programs could have been achieved with a public education program, he said. Ellicott City Democrat Courtney Watson joined Fox last year in voting against continued funding for Healthy Howard, arguing that private grants, perhaps from the health-focused Horizon Foundation, should pay those costs. They were outvoted.
"They obviously haven't received the memo on the economy and the [county] budget situation," Fox said Thursday, reacting to Beilenson's request. County officials expect their toughest budget year for fiscal 2012, with the extent of state cuts to schools and other aid unclear and local revenues nearly flat.
Democrats Calvin Ball, who is this year's council chairman, Jen Terrasa and Mary Kay Sigaty have reaffirmed their support for the program.
"Not only do I think it's the right thing to do, but I believe it serves as a cost-effective bridge until implementation of the federal health care plan," Terrasa said. Sigaty has repeatedly said she feels health care is a right and not a privilege.
At the lunch, Beilenson praised Fox for pushing for more public outreach and said the program is doing that.
Horizon President and CEO Richard M. Krieg said later that the foundation recently gave Healthy Howard about $5,000 for a hardship fund to help people enrolled but temporarily unable to pay the monthly premiums of $50 to $115. In addition, he said, the foundation is evaluating two larger grant requests for a total of about $175,000 to pay for specific medical treatments not covered by the plan, such as colonoscopy tests, and to pay for a new study of the need for the program.
Healthy Howard was launched in late 2008 as a way to provide low-cost health care to county residents who could not afford health insurance. When the new federal health care reform law takes full effect in 2014 and requires everyone to have insurance, Garcia-Bunuel said, Healthy Howard will go out of business. The plan, she said, is to stop enrolling new members in July 2013, meaning funding for two more years of full operations will be needed.
Beilenson said he is still working to plan a conversion of the program to a regional health insurance co-op that would give working families an affordable, lower-cost option when insurance becomes mandatory. Beilenson said some families would likely not be able to afford insurance, even with federal subsidies, and could be forced to pay a $2,100 penalty and still have no coverage.