May 15, 2006 – A Senate Committee on Health and Hospitals meeting held Monday evening proved less productive than expected, as no vote was taken on a bill mandating employers to provide universal health care coverage to their employees. The bill, which has been languishing in the Senate since last year, will instead come up again at another committee meeting scheduled for June 5.
According to Sen. Craig W. Barshinger, the committee's chairman, the bill had been thoroughly revised since it was first introduced on the floor. However, when the meeting started, senators still had not received the redrafted copy of the bill, which comes as an amendment in the nature of the substitute.
"I am not a happy camper right now," Barshinger said before he called the meeting to order.
Working from the original document, Dr. Jacqueline Hoop-Sinicrope, project manager of the Governor's Health Care Reform Initiative, and Lauritz Mills, director of the V.I. Bureau of Economic Research, detailed the changes that have been made to the bill over the past few months.
Hoop-Sinicrope said the changes came from concerns raised by community members, health care professionals and insurance industry representatives during multiple meetings, forums and Senate hearings.
Prior to the changes, the bill:
–mandates employers working in the private sector who do not currently provide health care coverage for the employees join a multiple employer trust, a self-insured pool that would give unrelated employers the purchasing power of one large entity.
–states that the employer and employee would split the cost of the premiums, 50-50, estimated at $182 a month for a single person during the first year.
–establishes government-funded assistance to low-income workers; the threshold for this had been raised from $16,000- $23,000.
During the meeting, Barshinger said that without changing the principal components of the bill, the new amendment would address many of the concerns posed by the community, while a separate amendment lays out how financial relief would be provided to businesses that can't afford to participate in the health care program.
To tackle this particular concern, Barshinger proposed that such businesses would be able to apply to the Small Business Development Center at the University of the Virgin Islands to participate in an "extreme assistance program" which could cover up to 100 percent of the employer's share of the cost.
Testifying during the meeting, Warren Bush – state director of the SBDC – said such a responsibility would not "burden" the organization, since the SBDC would primarily be conducting assessments to determine what businesses are eligible for extreme assistance.
He said that businesses that have to spend more than 10 percent of their net earnings in order to meet the mandate would automatically qualify.
Other changes in the bill:
–allow employees earning up to $24,000 a year to qualify for the Premium Assistance Program.
–offer coverage to dependents – including spouses, children, siblings and domestic partners.
–require that every multiple employer trust (MET) established have a board of trustees who is responsible to the MET as a fiduciary, and has the authority to administer the health plan.
–extensively define and regulate the METs so that they are able to safeguard against insolvency.
Despite the changes, however, community members said they still have many lingering questions, such as whether the plan would be able to sustain itself during the first year. Additionally, letters distributed during the meeting from various business owners state that the proposed program is too expensive, inflationary, limits the ability of patients to seek off-island care, and provides "exclusionary" financial assistance.
"Personally, I would like to see everyone in the Virgin Islands have health care insurance, but I think this proposal is ill advised," wrote Judith Hinkel, president of Allied Building Cleaning Services Inc.
Correspondence from other organizations, such as the League of Women Voters, expressed similar views, which were all refuted by Hoop-Sinicrope, who said the program would help local hospitals subsidize costs associated with uncompensated care, and would provide up to $1 million in coverage for each employee.
However, Hoop-Sinicrope did not provide any specifics with regards to potential premium increases, re-insurance coverage, and individual and aggregate stop loss amounts. She also did not say whether the bill would need additional changes – instead, when asked, she said she would need time to review the amendment in the nature of a substitute, since it had not been fully drafted by the Legislature's Legal Counsel until the end of Monday's meeting.
Mills said, "There are always going to be people who say that the bill is not perfect. But there are people out there who say that it's something that they want – and we want to work in their best interest."
Present Monday were Barshinger and Sens. Roosevelt C. David, Pedro "Pete" Encarnacion, Louis P. Hill, Norman Jn Baptiste and Usie R. Richards. Sens. Lorraine L. Berry, Adlah "Foncie" Donastorg and Neville James were absent.
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