Health plan costs questioned

The Baltimore Sun

Howard County Executive Ken Ulman's much ballyhooed health access plan has been widely praised, but two County Council members raised questions yesterday about the plan's eventual costs.

The five-member council will vote in May on the next county budget, which Ulman said will include a request for $500,000 in local tax revenue for the Healthy Howard plan's first year of operation. The rest of the plan's first-year cost of $2.8 million is expected to be covered by $700,000 in privately raised donations and $1.6 million in fees from the estimated 2,000 uninsured residents who will be enrolled.

The eventual goal is to enroll up to 12,000 uninsured adults in the program, and Councilman Greg Fox, a western county Republican, and Councilwoman Courtney Watson, an Ellicott City Democrat, said they don't know what the eventual costs will be.

"If we need $700,000 for 2,000 people, will we [eventually] need $5 million a year?" Fox asked. He wondered if that much in donations could be raised annually in the future.

Similarly, will the county government contribution to what will technically be a private nonprofit organization also have to increase over time?

"We'll have to get a better idea of the expansion of the county budget before we move too far into this program," Fox said at a county Chamber of Commerce breakfast panel discussion in Marriottsville yesterday attended by about 220 people.

Watson also said she wants to know more.

"We don't have all the information on this," she said, noting that the plan would not require participation by any businesses, and could help small businesses that cannot afford to provide employee health care.

"Is the plan affordable?" she asked. "The issue is long-term affordability."

Dr. Peter L. Beilenson, the county's health officer, said later that he is working to reduce the costs for prescription medicines and specialty care, but "the whole point of the 2,000 in the first year is so we can answer [cost questions] before expanding. The first year is a pilot."

Beilenson said, "It looks very promising" that nearly all prescription drugs, budgeted to cost $693,000 in the first year, may come free for people with incomes lower than three times the federal poverty level. Negotiations are under way with specialty medical providers, which were budgeted to cost another $185,000 the first year.

If large enough discounts can be worked out, Beilenson said, the need for donations could be cut in half.

At the chamber breakfast, Fox praised another aspect of the program, in which up to 5,000 uninsured children would be enrolled in existing programs, such as the federally funded SCHIP program for lower-income families.

"We don't have a lot of details," Fox said. "I'm not sure how it will be run or operated."

Council Chairman Calvin Ball, an east Columbia Democrat, was also on the panel. He described the Healthy Howard program as "innovative" and "a wonderful opportunity."

After the meeting, Ball said, "You have to weigh the cost of things with the benefits. Access to affordable health care is extremely important."

Councilwoman Mary Kay Sigaty, a west Columbia Democrat who also attended the breakfast, said she "certainly will be needing to pay attention to the budget. ... But the program is such a positive for the county. You're balancing the potential [benefit] to the cost."

The discussion, moderated by WBAL-TV's Jayne Miller, covered a wide range of issues, focusing mostly on the current special session of the General Assembly.

Two of Howard's state senators, Democrat Edward J. Kasemeyer, vice chairman of the senate Budget and Tax Committee, and Republican Allan H. Kittleman, also participated.

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