For the approximately 60,000 Montgomery County residents who do not qualify for federal or state health care coverage or a subsidized health insurance plan under the Affordable Care Act, a group of local foundations is working to create a streamlined enrollment system for the county’s own health care access program, Montgomery Cares.
Founded in 2005, Montgomery Cares is a public-private partnership between the county’s Department of Health and Human Services, 12 health care clinics, the five county hospitals and the Primary Care Coalition that provides health care to the county’s uninsured low-income residents.
While each participating clinic has screened and enrolled participants in the Montgomery Cares program since its inception, there has not been a centralized, consistent process for enrollment, said Hillery Tsumba, manager of communications and development for the Primary Care Coalition.
Montgomery Cares currently serves about 30,000 residents, but up to 60,000 may not qualify for federal or state coverage, or a plan through the new federal medical insurance law, leaving a gap of about 30,000 people, she said.
Through $35,000 in donations from a group of foundations — including $5,000 from the county health and human services agency — Montgomery Cares will soon have that centralized enrollment system and with it, the means to reach more residents and to assess whether any residents may qualify for other services, such as Medicaid, she said.
For participants, the new process will also mean less hassle when it comes time to see a doctor, said Councilman George L. Leventhal (D-At Large) of Takoma Park, chairman of the council’s Health and Human Services Committee.
“In the very near term, there will be no resident of Montgomery County that does not have health care coverage,” Leventhal said. “Our goal is that we have uniformly high-quality health care in Montgomery County, whether you are enrolled in a Cadillac-quality private-pay plan or whether you are receiving care through a community health clinic.”
Maryland struggled last year to deploy its online health insurance exchange under the Affordable Care Act, leaving many unable to enroll.
As the partners of Montgomery Cares prepare to create and implement their own exchange, of sorts, Tsumba said they are paying close attention to the past and the future of Maryland’s exchange.
“We are keeping our ear to ground,” she said. “All the information and lessons learned should be taken into account. All of these things are very much connected and so the important thing here is streamlining the system.”
Montgomery Cares’ exchange is targeted for implementation in fiscal 2016, but at present it has not yet even been designed, she said. Design is expected by October.
Details of the system remain up in the air, such as whether the program will continue to operate without charging participants a premium. Right now, all participants pay only copays, which can vary depending on the clinic where they are served and the services provided, Tsumba said.
“Because we are still in the design phase, the inclination is not toward a premium, but everything is going to be considered in the interest of due diligence,” she noted.