The Healthy Howard health access plan is "a signature issue for the county executive and a signature issue for me," health officer Dr. Peter L. Beilenson told the County Council during a review of expenses for the program last week.
It could be the program that helps establish County Executive Ken Ulman's political claim to fame for future campaigns - if it works.
Preparations for the program, intended to provide access to affordable health care for the county's uninsured residents, are continuing on schedule, Beilenson told the council. Legislation allowing the state insurance commissioner to regulate the program is due to be signed by Gov. Martin O'Malley this week, a new executive director, David Allan Minges, has been hired, and many programmatic details are being worked out.
"It's a massive undertaking," Beilenson said.
Potential critics are poised in the event that the county's share of expenses outpaces projections or if there are other stumbles. Councilman Greg Fox, a Fulton Republican, and Council Chairman Courtney Watson, an Ellicott City Democrat, voiced concern about that possibility to Beilenson.
But Beilenson - dubbed the "mastermind" of the program by Fox - said private fundraising is going well, meaning the $500,000 in the fiscal 2009 county budget to help fund its start should be sufficient, particularly with the start date pushed back three months until Oct. 1.
"It's very likely we will not come back for more than [the current] $500,000," Beilenson told the council.
Watson, worried about the effects of slowing revenue growth, warned Beilenson anyway. "Don't necessarily look at us for $3 [million] to $4 million in four years," she said.
Fox questioned Beilenson and County Solicitor Margaret Ann Nolan closely on potential liability to the county from the program. But both said that because Healthy Howard is to be a separate nonprofit organization, the county should be safe.
"As a not-for-profit, I don't have a problem with it," Fox said.
Earlier, as Beilenson described an online enrollment feature, Fox raised another fear that some have expressed - that illegal immigrants will be able to sign up, boosting program costs. "So they can apply online before they come to the U.S.?" he quipped.
But Beilenson said applicants must be in the county to use the online process. Only county residents who are citizens who have been without health insurance for a year are eligible.
Ulman and Beilenson are looking beyond the first year's $2.8 million budget for the program, especially concentrating on private donations.
The program already has $556,000 in pledges, most of which comes from the Horizon Foundation, and Beilenson said he is pursuing another $500,000 or more from other foundations. The county's contribution is vital, however, he said, to give donors confidence that the county supports the program.
Beilenson and Ulman said Horizon's $500,000 pledge is key to more private grants.
"It's another critical piece," Ulman said. "This [Horizon grant] puts us one major step toward starting enrollment."
That ability to raise private money will be increasingly critical, both officials said, as the program's first-year results are studied and enrollment grows beyond the first 2,000 people planned to be enrolled.
"We're really being very careful to study this first year," the county executive said. "Our plan is to scale this up."
Once first-year results are analyzed, the information can be used for similar programs in other places, they said.
"Everywhere I go, interest is so strong in this," Ulman said. "A lot of people want to see where this goes."