The start of Howard County's innovative health access plan for the uninsured will be pushed back three months to Oct. 1 because state legislation is needed to distinguish the program from insurance.
Howard County health officer Dr. Peter L. Beilenson said the legislation is necessary to ensure that the Healthy Howard program, which is to be operated by a private, nonprofit corporation, would not be required to have a multimillion-dollar reserve fund that insurance companies must have.
"We didn't want to start the program with [state insurance officials] declaring it insurance," Beilenson said. Howard officials have maintained since announcing the plan last year that it is not insurance.
"It doesn't fit into any particular hole," said Aaron Greenfield, chief of staff for County Executive Ken Ulman, at a county delegation meeting this week.
The program would use a combination of existing health programs and public and private donations and services to let about 20,000 uninsured residents get comprehensive medical care for a small fee. In the first year, Beilenson estimated about 2,000 people might sign up. The services would be available only within the county.
Karen Barrow, spokeswoman for state insurance Commissioner Ralph S. Tyler, said, "We are continuing to gather information to make a final determination as to whether this program is insurance." The proposed legislation would let the program, and any others like it, operate without following state insurance regulations.
"It creates what could be a public-private partnership that the commissioner can regulate," Greenfield said.
The bill, which Del. Shane Pendergrass described for Howard delegation members Wednesday, would allow the commissioner to "grant a waiver from full insurance regulations," Beilenson said. Although it is statewide legislation, the bill would describe the Healthy Howard program, which could be replicated in other local jurisdictions. Pendergrass said she might sponsor it if it comes too late for the insurance commissioner to do that. She urged her fellow Howard County legislators to be co-sponsors.
"There's no reason to think it's controversial. It's to make sure there's no question the insurance administration won't have a problem with us when it starts," Beilenson said.
Any bill must be approved by the General Assembly and Gov. Martin O'Malley. Beilenson said it would take effect June 1, if approved, but the state would need more time to write regulations.
Beilenson said he would begin enrolling people for medical care July 1 and start treating patients Oct. 1.