Feb. 25, 2006 – At an informal meeting Saturday, it was determined that the Governor's Health Reform Initiative bill would benefit by being redrafted to address the concerns of the territory's healthcare community. Included in the redrafting may be some incentives such as tax breaks to encourage employers to provide insurance for their employees.
The bill, which seeks to create a mandatory, self-funded healthcare benefits program for employers, has been debated in the Legislature since it was introduced in mid-January (See "Testifiers Clash Over Proposed Health Care Bill" and "Still Plenty of Unanswered Questions about Health Care Initiative".)
While no debating was done at Saturday's meeting, various healthcare representatives still had questions about the bill, including how the government would insure residents who can't afford to pay the $182 monthly premium.
"We can't drive people underground, or put people out of business," said Carl Richardson, a representative from the Health Department. "People are just happy to have a job – there must be something we can do to help them out."
While Richardson proposed that the government kick in to help residents with their monthly rent payments so that they can afford the premiums, Dr. Jacqueline Hoop-Sinicrope, project manager for the program, said the Premium Assistance Program set up in the bill would provide some relief.
Under the initiative, employers would split the $182 monthly premium with employees. If employees can't afford to pay their share, the government will then kick in to pay one-third of the cost through the Premium Assistance Program.
"The coverage that we're proposing will target at least 15,000 uninsured residents throughout the territory," Hoop-Sinicrope said. "And we estimate that 5,000 residents out of the initial 15,000 will be eligible for the Premium Assistance Program – that will cover a large chunk of those employees who really aren't able to pay their premiums."
However, Hoop-Sinicrope added that more measures may be added to the bill during the redrafting process to provide low income residents with further assistance.
When asked how premiums included in the bill would be enforced, Hoop-Sinicrope said she is working with the heads of Labor, Licensing and Consumer Affairs, and the Internal Revenue Bureau to develop specific enforcement provisions which are currently not included in the bill.
Because the plan is self-funded – where premiums are pooled to fund claims – residents questioned what would happen if the program's expenditures exceeded the amount of premiums coming in.
Hoop-Sinicrope said that the program does provide stop loss and aggregate insurance, but also that the government may opt to cut benefits or raise premiums if such a situation occurs.
Richardson said that the purchasing the plan should be optional instead of mandatory. "Unless an employer has a certain number of workers, we shouldn't make businesses pay for the plan if they can't afford it."
Hoop-Sinicrope explained that if the plan were optional, then residents with greater and more immediate healthcare needs would most likely be the only ones buying the insurance, which would eventually cause an increase in premium rates.
"It's adverse selection," she said. "We have to make it mandatory."
When asked, Hoop-Sinicrope said businesses with employee turnover rates would be required to enroll workers who work more than 25 hours a week in the program once they have been employed for 60 days.
Senator Craig W. Barshinger, who organized Saturday's meeting, said the revised bill would be up for a vote in the Health and Hospitals Committee (of which Barshinger is chairman) on March 6.
Barshinger said a public meeting would be held March 1 at the Palms Court Harborview Hotel on St. Thomas, so that other community members could learn about and give their input on the bill.
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