In an effort to raise the standard of health care in U.S. territories, Delegate to Congress Donna Christian Christensen and other representatives met Monday with White House officials to remove the cap on the amount of federal dollars given for the Medicaid program.
To ensure that the Medicaid cap issue is a priority as the Clinton administration negotiates the fiscal year 2001 budget with Congress, Christensen and Delegate Robert Underwood of Guam met with the director of the White House’s Office of Management and Budget Jack Lew. The meeting follows a request of Clinton by the leaders of the five U.S. territories to increase by 20 percent the federal government’s share of Medicaid payments. Christensen also introduced a bill last month that seeks to lift the Medicaid cap entirely and change the federal-local match formula.
Christensen’s bill aims to increase the amount the federal government covers for Medicaid from the current 50 percent to 77 percent. Medicaid is for the most part the only way elderly, low-income and disabled people receive medical care in the U.S. and its territories. However, territories like the Virgin Islands, Guam, American Samoa and Puerto Rico receive limited funding because they don’t directly contribute to the program in federal taxes.
In the Virgin Islands, there are some 15,000 people eligible for Medicaid, according to V.I. Department of Health statistics. Christensen and others who support lifting the cap, which currently stands at $670 per eligible person compared to $3,300 per person on the mainland, argue that it would mean better health care for residents of the territories and free up local dollars for other pressing purposes.
Additionally, Christensen said hospitals in the V.I. provide more than 60 percent of the care to uninsured or medicaid insured persons, "which greatly impacts their ability to meet their bottom line," she said.
On the mainland, said Christensen, hospitals that provide the same services to people at or below the poverty line would receive additional federal funding. Furthermore, stateside federal/local match formulas are based on average income, where the territories is split 50-50.
"I think we got a very favorable hearing, but it is unlikely that the full cap would be lifted this year because of the cost," Christensen said. "I am hopeful, however, that we would be able to make a big stride toward getting it lifted in the near future with an increase this year."
What will make the request a challenge is convincing Congress to lift the cap for all territories, which includes Puerto Rico and its 3.8 million residents.
Groups such as V.I. Find, Lutheran Social Services and the University of the Virgin Islands have come together to form a lobbying group, the Medicaid Task Force.
