Supreme Court Will Determine Fate of Howard County Health Program
‘I think it’s one of the most innovative programs in the state.’ – Kathy Westcoat, president of the Baltimore-based Healthcare Access Maryland
The fate of a unique program in Howard County that has aimed to reduce the number of uninsured residents largely rests in the hands of the Supreme Court, scheduled to make a historic decision Thursday on whether to uphold federal health care legislation that would require all U.S. citizens to buy health insurance.
The Healthy Howard Health Plan is part of a nonprofit organization that has provided health services to 1,700 uninsured residents since it starting enrolling people in 2008. It has come under the national spotlight for its attempts to bridge the gap on a local level between insured and uninsured residents.
If the Supreme Court upholds President Obama’s health care law in its entirety, the Healthy Howard Health Plan would shut down in January of 2014, Howard County health officials said.
If the bill is overturned, Howard County Health Officer Dr. Peter Beilenson and at least one other state health advocate said aspects of the plan, which Beilenson said is unlike any other efforts in the region or country, could be scaled statewide.
“We’ve talked to some legislators [about taking it statewide], but we are waiting for a decision,” Beilenson told Patch this week.
Greg Fox, the lone Republican who sits on the Howard County Council, has been critical of aspects of the program, which receives $500,000 in county money yearly; he said he opposes any moves to expand it.
“It’s very misleading, the whole program,” Fox said, saying that the program only provides access in Howard County.
“You've got to be careful about the whole thing,” he added. “People are paying for something that may not provide them for what they need and provide a false sense of security.”
Here’s how the Healthy Howard Health Plan works, according to its website and Beilenson: Eligible residents who earn too much to qualify for Medicaid, but not enough to afford health insurance, can enroll by paying a monthly fee.
That fee, which the website says goes as low as $50, would give the enrollee access to health services, including doctor visits, emergency room treatment, prescription medicine at a low cost or free, as well as a personal health coach.
The plan is not health insurance, according to the website, and also only provides health care access in Howard County to Howard County residents.
There is a cap of about 750 residents at one time to receive health services under the plan, Beilenson said. Right now the program is serving 809 residents, with a waiting list of more than 125, he added.
Kathy Westcoat, president of the Baltimore-based Healthcare Access Maryland, a nonprofit agency that helps residents get health insurance through federal programs, is among those who say parts of Healthy Howard could be replicated if the federal law is struck down.
“I think it’s one of the most innovative programs in the state, and I think if the Affordable Care Act is struck down, people will look to that program and look at its success,” she said.
Beilenson said the percentage of uninsured Howard County residents went from 12.1 percent in 2007 to 8.1 percent in 2009, one year after the Healthy Howard Health Plan started.
Nationally, 16.3 percent of Americans are uninsured, according to the Kaiser Family Foundation. In Maryland, 13 percent were uninsured from 2009 to 2010, according to the foundation.
In addition to the 1,700 that have enrolled in the health plan, about 7,000 others in the past 18 months have been enrolled in other health insurance programs for which they are eligible through work done by the program, Beilenson said.
Beilenson also said he supports the federal health care law.
“This bill is much better than the status quo,” he said. "I hope they uphold the bill. It covers a lot of people. It does a lot for insurance reform in pre-existing conditions.”
The Supreme Court’s decision will include a ruling on the constitutionality of the law's “individual mandate” requiring all U.S. citizens to buy health insurance.
Opponents of the mandate say it’s an unprecedented exercise of congressional power—requiring people to buy something—and could be expanded to cars to help the auto industry, or even broccoli.
Delegate Justin Ready, R-Carroll County, said he supports the repeal of the federal law.
"There are areas of common ground that the American people agree with on issues like tort reform, pre-existing conditions, eliminating needless mandates and regulations, and giving individuals more control over their care," Ready said.
"Obamacare does not do most of those things, and even the things it does reform properly are not done in the most efficient way," Ready said.
Obama has argued that the commerce clause in the Constitution allows Congress to regulate health care, and that expanding coverage would lower costs, according to the Economist, which summarizes both the supporting and opposing arguments to the issues that have been debated at the high court.
With reporting from Westminster Patch Editor Kym Byrnes