By Tim Bonfield
Enquirer staff writer

In Muskegon, Mich., more than 1,300 previously uninsured people working for 430 day-care centers, beauty salons and other small businesses have coverage now through a program that some say should be tried in Greater Cincinnati.

"We're an old, industrial community. We've lost some of the companies that in the past gave people commercial insurance," says Vondie Woodbury, director of the Muskegon Community Health Project. "But we've been able to help a lot of people working for very small businesses that for the most part have been priced out of offering any commercial insurance."

Muskegon's Access Health is called a "three-share" program that asks employers and workers to contribute monthly payments that are matched by a variety of public funds.

In Michigan, hospitals have agreed to devote federal money they get for providing care to uninsured people. In Cincinnati, some advocates say at least part of the Hamilton County tax levy for indigent care could be used for the same purpose - potentially covering nearly all of the county's 70,000 uninsured residents.

This concept is likely to be studied by a new health care review commission, proposed Thursday by Hamilton County Commissioner Todd Portune. Commissioner Phil Heimlich also supports forming the review group.

The concept is being considered by officials in Butler County, some of whom traveled to Michigan about a month ago to learn more about the program.

"This is an interesting program," says Butler County Commissioner Greg Jolivette. "It's sort of a health co-op, where the employer pays 30 percent, the employee pays 30 percent and the community pays 40 percent."

In Hamilton County, the review commission would re-examine how the county spends more than $200 million a year raised by six health-related special levies. Those levies include taxes for indigent care, senior services, children's services, mental health, mental retardation and the Drake Center.

According to Portune's proposal, the commission would be formed this year, but members would be appointed after the November elections. The group would spend several months next year to develop recommendations.

Much of Portune's proposal discusses using tax levy money to reduce the rising numbers of uninsured people in Hamilton County. It specifically mentions a small-business insurance plan promoted by Trey Daly of the Legal Aid Society of Greater Cincinnati and Keith Melson of the Children's Defense Fund.

"This is one of the ideas that came up during discussions during Cover the Uninsured Week (in May). This is one that I think has a lot of potential," Daly said.

"Three-share" insurance programs have been launched in several areas including Rockford, Ill.; Huntington, W.Va., and Galveston, Texas. Places studying similar ideas include Jacksonville and Osceola, Fla., and Charleston, S.C.

In Muskegon County, about 13,000 of its 172,000 residents are uninsured. Access Health was launched in 1999.

The program costs about $2 million a year. It's available only to employers that haven't offered health benefits for at least a year, and to workers who earn $6 to $12 an hour. Part-time workers are eligible. There are no pre-existing-condition exclusions.

In Butler County, officials are considering using some of the money hospitals get through Ohio's Hospital Care Assurance Program to match funds from employers and workers.

E-mail tbonfield@enquirer.com