Nestled between Washington and Baltimore, Howard County, Maryland is a pretty affluent place. It too, however, has its share of uninsured people. And through its "Healthy Howard Access Plan" initiative, it decided to do something about them. With a mix of county and foundation funding, and free or reduced services by local doctors, the county aimed to provide up to 2,200 people with a low-cost health plan that included as many as six annual primary care visits, hospital care, discount drugs, and mental health. Most of the beneficiaries were expected to be working adults who make too much to qualify for state and federal programs, but not enough to pay for insurance.

That's not exactly how it turned out. The Washington Post reported that out of the 1,100 people who have attended information session so far, most turned out to be eligible for existing state, federal or nonprofit health programs.

"This is a tremendous indictment of how badly the health-care system is set up," Howard County Health Officer Peter Beilenson told the newspaper. "These people have been going without health insurance, yet they were eligible for an existing program all along."

About 850 county residents have been referred to other programs; 44 so far have signed up for Healthy Howard, although that number is expected to rise as outreach continues.

Nationally, experts estimate that about one in four of uninsured people—roughly 12 million—are eligible for some kind of public health insurance program but either don't realize it, or are put off by the paperwork or stigma. Howard County is using a one-stop electronic system that matches people with appropriate programs.

As the number of uninsured rise along with unemployment, effective outreach will be even more important. It is quite likely that the new Congress will include Medicaid money for states in the next stimulus package, and expand the SCHIP program for poor kids. Let's hope that people get the help that's available to them, rather than unnecessarily adding to the number of uninsured, creating both more strain on families and individuals and on the political system that's trying to solve a problem that's plenty big already.