Gov. John deJongh Jr. called on Delegate to Congress Donna Christensen to renew her efforts to provide parity to the territories and commonwealths on federal Medicaid caps, according to a statement issued Monday by Government House.
The news release was issued following a weekend broadcast interview in which the governor noted that the Virgin Islands was the first territory to announce its decision to go with Medicaid expansion instead of setting up an insurance exchange under the Affordable Care Act. At the same time, he noted, there are drawbacks to Medicaid in the territories, and he urged the delegate to continue pressing to have those addressed.
"She should approach Secretary Kathleen Sebelius of the U.S. Department of Health and Human Services and President Barack Obama to ensure full coverage of the territories by the ACA," deJongh said. "We need their cooperation to surmount this long-term problem of the lack of adequate government subsidies. Access and affordability are very important concerns, but parity and equity are more important. This is a federal and congressional issue that exposes some major flaws of the ACA."
Under the Patient Protection and Affordable Care Act, as modified by the Supreme Court, the Virgin Islands could have opted for an "unaffordable" health insurance exchange, but instead pursued expanding Medicaid program eligibility as a way to provide health insurance to more Virgin Islanders, the governor said. But that would have proven far more costly than the USVI could have managed.
"Based on two years of research and deliberation by the Health Reform Taskforce set up in 2010, I made the decision that the right course of action for the territory was to expand Medicaid eligibility," deJongh said. "An analysis of the Affordable Care Act showed that many mandates were not applicable to the Virgin Islands and that implementing a health insurance exchange would have cost us over $250 million, with only $24 million supplied by the federal government."
As a result of that analysis, deJongh decided the best strategy for the territory was to expand Medicaid coverage by raising the income eligibility rate, which began Aug. 1 with the coverage of pregnant women and children, the governor said.
The expanded program was moved from the Department of Health to the Department of Human Services and a streamlined enrollment system was devised and implemented.
"Human Services Commissioner Chris Finch and his team are continuing to explore different models of coverage for additional eligibility groups. We are attempting to shift as many of the uninsured onto Medicaid as possible and allowable," deJongh said.
