Howard County Pilots Easier, Web-Based Health Insurance Application

By Jessica Harper, Capital News Service

Howard County Executive Ken Ulman attended a health care conference in Phoenix three years ago to learn more about improving coverage options for his constituents, a trip that ended up yielding an ideal solution to his district's health insurance woes.

"This California company had a 'one-e-app' that streamlined all their health care programs into one form," said Ulman. "So I thought, 'Let's do this ourselves.'"

Ulman's decision triggered the implementation of Door to HealthCare, a one-stop, web application designed to help mostly low-income residents navigate the county's health care labyrinths.

Residents who can use the electronic application generally include people under age 65 or families of four, who are 300 percent below the federal poverty level and make a maximum of $66,000 a year. Applicants must be U.S. citizens. Undocumented residents qualify for emergency care only, and that's usually if they are pregnant. Seniors on Medicare are disqualified.

With Door to HealthCare, applicants work from a kiosk—either alone or with an assistant—at the Howard County Health Department, where they input personal data about their income level, health insurance status and family make-up. The web application returns a list of available services based on the data.

The application process takes 10 to 15 minutes to complete for individuals and 45 minutes to one hour for a family of six.

The county's Health Department is the pilot site for the program, which has federal government approval. The department collaborates with community-based nonprofit Healthy Howard on the venture, which costs Maryland $500,000 and the county $12,000.

Lena Hershkovitz, a Door to HealthCare enrollment manager, said online applications are convenient because they allow people to apply for multiple health care services at one location. "It cuts out the guesswork," said Hershkovitz. "Clients can talk to real people (the assistants) and get immediate answers to their questions rather than mailing an application and having to wait to hear back."

Health department assistants are often bilingual, speaking either Korean or Spanish in addition to English—a plus given that Korean and Spanish communities, Hershkovitz said, comprise sizable populations in Howard County. The program can also switch between English and Spanish.

Dr. Peter Beilenson, the county's health officer, said the department's client pool has quadrupled as a result of the new application. "The response has been huge," Beilenson said. "We saw about 150 to 170 people each month before implementing the program. That number is now at 693."

Of Howard County's 281,000 residents, about 20,000 are uninsured, Beilenson said, including several thousand children.

The county's median household income exceeds $100,000, but Beilenson said working-class families still exist in the well-to-do area and are hit especially hard by a lack of coverage. Ulman agreed. Even the wealthiest counties, he said, have working-class residents. And despite its distinction as the third-richest area in the nation, Howard County lags in making health care accessible to all of its residents, a barrier the county leadership aims to bridge with Door to HealthCare.

"The restaurant and real estate industries are not set up for health care benefits," said Ulman. "Farmers can buy insurance through co-ops, but unless you work for the government, it's hard to find an affordable health care package."

And health care woes, Ulman said, stretch across economic lines. "Sometimes it's worse in higher income areas because there's this stigma (about needing to ask for help)," he said.

Accessibility aside, Ulman said Door to HealthCare's simplicity is its greatest asset. "This is not reinventing the wheel. We're not recreating programs; we're just linking existing ones together," he said. "This app makes government more efficient and user friendly."