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IN THE STATES: New Coverage Plan Directs People To Old Plans

We have good news and bad news for the uninsured. The good news is many people going without insurance may already be eligible for enrollment in a public plan. The bad news is many people have no idea these plans exist.

The Washington Post, in an update on the initiative to provide coverage to some of the estimated 15,000 uninsured residents of Howard County, Maryland, reports on some unexpected results. The community initially expressed strong interest in the program but by the end of January, only 109 of its 2,200 spots were filled.

Why? Much to the surprise of officials leading the Healthy Howard Initiative, 1,500 of the Howard residents who expressed early interest in the program were already eligible for other federal, state and nonprofit health insurance programs. After Healthy Howard officials had sorted through all the applications and directed people towards the plans they were already eligible for, Howard County had cut the number of uninsured without changing the parameters of any of their previously existing programs.

State officials in Maryland are optimistic. Peter Beilenson, the county's health officer, told The Washington Post, "There are now more than a thousand people getting care who didn't have it before. We've cut by 10 percent the number of uninsured people with very little added cost, so from that perspective, it's been a tremendous success."

As we've noted previously, underutilization of existing options for health coverage isn't unique to Howard County. According to a report by the National Institute for Health Care Management, 12 million uninsured Americans under the age of 65 are eligible for federal or state health care plans but have not enrolled. Researchers have found that there are many reasons why people don't enroll in public health programs—they don't think they need coverage, they don't have the money, or they simply don't know the program exists.

Other states attempting coverage initiatives have run into similar problems. An Arkansas program that extends coverage to small businesses has enrolled only 5,000 people despite a potential capacity of 50,000, and in Massachusetts, 167,000 people face financial penalties because they haven't enrolled in a health insurance plan.

Howard County is planning to fight against these factors and expand enrollment in health insurance plans through an outreach campaign targeted at young people and small business.

In the coming months, the economic recession will most likely increase the number of the uninsured, even in relatively affluent places like Howard County. With so many people uninsured, it's important that everyone knows the health care coverage options available to them. If we are to be effective, outreach must go hand-in-hand with expansion.