Local health department insurance bill moving through Senate

April 04--A proposed bill that would have insurers cover trips to local health departments aims to increase access to health care in rural counties.

House Bill 1132 would require insurers, nonprofit health service plans, and health maintenance organizations that use a provider panel to make sure that all enrollees can access local health departments and covered services through those departments. Some carriers already contract with local providers, so the proposal would expand and require that coverage.

The Frederick County Health Department covers patients using Medicare and Medicaid, as well as uninsured low-income patients, according to Dr. Barbara A. Brookmyer, county health officer.

Frederick Delegate Karen Lewis Young (D-District 3A) became the bill's sponsor after the original sponsor, Delegate Joseline A. Pena-Melnyk (D-Prince George's), suggested Lewis Young take the lead to free Pena-Melnyk to work on other legislation. Lewis Young sits on several health subcommittees and represents a rural county, so it seemed like a good fit, Lewis Young said.

She testified briefly in support of the bill before the Senate Finance Committee on Tuesday.

The idea for the bill came, Lewis Young said, out of a need to bolster behavioral health services in rural areas. The Frederick County Health Department has only one psychologist on staff, Brookmyer said, citing difficulties in recruiting for more positions.

Brookmyer said she didn't believe the bill would have a substantial impact on the Frederick County Health Department, but it would be very important in places where the local health department is the only service provider.

She gave the example of rabies vaccination. While Frederick Memorial Hospital now provides the treatment, there was a time when only the health department offered the vaccinations, Brookmyer said. If a family using private insurance had been exposed to an animal with rabies, they may have had to leave the county for in-network treatment or be treated locally and pay out of pocket. With a cost of around $6,000 per person, the rabies vaccination would be prohibitively expensive, she said.

The measure could increase revenue and expenses for local health organizations, according to analysis from the Department of Legislative Services. Revenue statewide might increase as much as $1.8 million for behavioral health services, which would be spent to provide further health care services.

The department reported that it was likely local health services would hire more providers to handle an increased volume of patients.

If the bill were to pass, group model HMOs would be exempt from the requirement.

The proposal passed the House unanimously last month and a cross-filed Senate version unanimously passed a few days later, so as long as Lewis Young's measure makes it to the Senate floor before the end of the 2018 General Assembly on Monday, it stands a good chance of heading to the governor for his signature.

Follow Kelsi Loos on Twitter: @KelsiLoos.

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