Washington Post Profiles Access to Free Care in Affluent Maryland County

The Washington Post on July 23 examined a community clinic in Howard County, Md., an "affluent Washington suburb," that provides treatment for uninsured residents, yet "demonstrates how barriers to care exist even" in wealthier regions. The Howard County clinic, formed three years ago through a not-for-profit organization called the Health Alliance for Patients in Need, provides free care to all uninsured county residents who meet certain income eligibility requirements -- a family of four can earn no more than $33,396 per year, or about 190% of the federal poverty level. More than 20 doctors volunteer at the clinic, which treats about 450 patients each year. At $75,500, Howard County has Maryland's highest median household income, but roughly 5% of its residents "live in poverty," and a greater number, including many working poor residents and immigrants, cannot afford health insurance and earn too much to qualify for public health coverage. Gary Milles, the Howard County Medical Center physician who founded the clinic, said that while working at the hospital he noticed that many people did not seek medical care until their conditions became grave. "It seemed like we were seeing more and more of these types of patients. And you'd think: 'This is Howard County. This shouldn't happen here. It's such a wealthy community.' But I asked around, and my colleagues were seeing the same thing," Milles said. While it is uncertain what percentage of the county's population is uninsured, Milles believes that the clinic is "seeing just the tip of the iceberg." The clinic's main funding has come from a $298,000 grant from the philanthropic organization Horizon Foundation that expires at the end of the year, and the Post reports that it is "unclear how the clinic will continue." But Milles says, "We're not going to close. We're not going to let it collapse" (Davenport, Washington Post, 7/23).