Uninsured

A day after the historic vote in Congress to overhaul the nation's health care system, local patients and their advocates cheered the legislation and say they're already looking ahead to the expansion of coverage to 600,000 uninsured Marylanders. While some benefits kick in right away, the provisions that will enable most low and moderate income people to get insurance won't become available until 2014. That has left the states to decide if they will add people to the rolls early or if they will seek to opt out of the federal requirements.

If the Supreme Court has to decide whether it is constitutional for the states or the federal government to force people to buy health insurance, why doesn't it also have to decide whether it's constitutional to force taxpayers to pay to cover the uninsured? Charles H. Webster

A new health center for uninsured and underinsured Howard County residents will be coming to Columbia in July. The center, in the Knoll North Building in Oakland Mills village, will have eight examination rooms. The facility will offer dental care, mental health services and treatment for victims of substance abuse. "This new facility is a major milestone in meeting the health care needs of thousands of ... residents," said Richard Kreig, president and chief executive officer of the Horizon Foundation.

For those who have heart disease, cancer, diabetes or another condition, buying health insurance can be impossible. "I was denied, denied, denied," said Jamie Engels, a 29-year-old Baltimore woman with a kidney disorder, about applying for private coverage after her employer closed its doors and she lost her job and insurance in 2010. After some searching, she found a federally subsidized state program and has a plan she can afford. State officials want to make sure others in Engels' shoes know about the Maryland Health Insurance Plan.

BALTIMORE - The good news is that Maryland is doing a lot better than many other states in the percentage of our children, from birth to age 18, who have health insurance - 94 percent, compared with a national rate of 89 percent. The bad news is that 76,800 children in Maryland are uninsured. And the tragic news is that about 35,000 of these children could have free or low-cost health insurance right now if their parents or guardians would only sign them up. Maryland has made enormous strides in the last few years in taking advantage of new public programs to expand health insurance coverage.

The Help is Here Express bus tour will be at the Carroll Nonprofit Center from 2:30 p.m. to 5:30 p.m. tomorrow at 255 Clifton Blvd., Westminster. The bus offers uninsured Americans help in finding programs that provide free or low-cost prescription medicines. The tour is part of the Partnership for Prescription Assistance, a national effort sponsored by America's pharmaceutical research companies. The bus is staffed by trained specialists who can quickly help low-income, uninsured or underinsured patients get access to more than 475 patient assistance programs, including more than 180 programs that are offered by pharmaceutical companies.

Gov. Martin O'Malley and Baltimore health advocates announced the launch yesterday of a $150,000 advertising campaign designed to let uninsured Baltimoreans know that thousands more of them are eligible for Medicaid. Under a law that went into effect in July, parents with annual incomes up to 116 percent of federal poverty guidelines, or about $20,500 for a family of three, are now eligible for Medicaid. Before the new guidelines were passed, only parents making less than 40 percent of poverty were eligible.

Trying to win state approval of a plan to sell stock to investors, Blue Cross and Blue Shield of Maryland is telling regulators the sale could eventually help fund health care for uninsured Marylanders.But there are no guarantees, company officials acknowledge. And a consumer group cast doubt yesterday on this aspect of the Blue Cross stock plan, saying it wouldn't assure that uninsured Marylanders receive the promised benefits.State Insurance Commissioner Dwight K. Bartlett III is mulling this and other issues raised by the stock plan, which would be a major change for historically nonprofit Blue Cross, the state's largest health insurer with 1.4 million subscribers.

State officials are holding four public hearings in the next two weeks to get input on how the state should expand health coverage to its 168,000 uninsured children, from infants to 18-year-olds.Congress enacted legislation in August to cover more children, but states can design their programs. The expanded coverage must include comprehensive medical and preventive services.Ideas are being solicited from consumers, legislators, advocacy groups and others. The hearings will be held at 7 p.m. on these dates: Western Maryland: Today at Hagerstown Junior college, Building C-11.

Baltimore health officials are promoting a new community outreach program that helps uninsured residents better understand their options for obtaining health care. The Baltimore City Access to Care Program started two months ago with a $1 million grant and has outpaced initial projections, said Health Commissioner Dr. Peter L. Beilenson. He said 852 appointments have been made at community health centers, more than half of which were kept. About a quarter of the city's population goes without health insurance over the course of a year, well above the national average, Beilenson said.

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.

Congratulations to Doug Mainwaring for having saved $100,000 in health care costs by opting to "self insure" and for being in a position to spend that amount in the future ( "Health reform unfair to self-insured businessman," Jan. 18). I am sure that will be a great comfort to the millions of working stiffs in this country who earn half that much or less each year. More to the point, Mr. Mainwaring's argument suffers from the classic economic fallacy, "past performance predicts future performance.

Andy Harris probably learned a lesson from the flap caused by his questions about the health care benefits he'll enjoy as a congressman in a supposedly confidential briefing — but likely not the right one. Mr. Harris, a Republican and a physician who was elected this month to represent Maryland's 1st District, will surely chalk this one up as a painful object lesson in the "gotcha" culture of Washington, where reporters were eager to pounce on...

National health care reform is expected to save Maryland $829 million over the next decade and provide coverage to nearly 350,000 people — reducing the number of uninsured in the state by half, according to a report released by state officials Monday. The savings will be achieved by supplanting state spending with increased federal funding for health care programs for those who can't afford it, according to the report from the Maryland Health Care Reform Coordinating Council, which was convened a day after the 2,000-page federal legislation was signed into law in March.

A day after the historic vote in Congress to overhaul the nation's health care system, local patients and their advocates cheered the legislation and say they're already looking ahead to the expansion of coverage to 600,000 uninsured Marylanders. While some benefits kick in right away, the provisions that will enable most low and moderate income people to get insurance won't become available until 2014. That has left the states to decide if they will add people to the rolls early or if they will seek to opt out of the federal requirements.

While legislation calling for the creation of exchanges where the uninsured can easily shop for health coverage has been stalled in Congress and isn't expected this year in the Maryland General Assembly, insurance agents and brokers are girding for the debate. Major insurance trade groups in Maryland say the state doesn't need a new program, like the one Massachusetts created ahead of federal reform to help provide universal coverage there. Maryland's private sector is equipped to inform and absorb the state's uninsured on its own, according to a report to be released today by the National Association of Insurance and Financial Advisors of Maryland and the Maryland Association of Health Underwriters.

The state's hospital rate-setting commission yesterday approved a plan to spread the $400 million-a-year cost of caring for the uninsured more evenly among all hospitals in the state, a move that should better position urban hospitals to compete for managed-care business.The Health Services Cost Review Commission voted to increase the rates for all hospitals by three-quarters of 1 percent, to create a fund for the hospitals that provide a disproportionate amount of care for Marylanders who lack health insurance.

WASHINGTON -- Legislation that would double the excise tax on handguns and earmark the proceeds for a fund to help pay for the treatment of uninsured gunshot victims may reach the House floor months earlier than expected.A House Ways and Means panel yesterday considered attaching the measure, sponsored by Rep. Mel Reynolds, D-Ill., to a miscellaneous tax bill that could be put to a House vote within a couple of weeks. The action puts the bill on a fast track for approval by circumventing the usual committee hearings that can delay legislation.

It's not just uninsured patients who rack up steep medical bills. Even if you have insurance, you might not realize that your coverage is inadequate until you're sick and overwhelmed by co-payments and other health costs. "Medical costs are the single largest contributor to people declaring bankruptcy," often including those who already have insurance, said Ron Pollack, executive director of Families USA, an advocacy group. To help consumers avoid getting buried under hospital bills, Families USA recently published a handbook, "Your Medical Bills: A Consumers Guide to Coping with Medical Debt," which is available online at www.familiesusa.