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Charlotte Amalie
Thursday, August 18, 2022
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Territories to Be Included In Final Health Care Reform Bill

The U.S. House of Representatives’ final reconciliation health care reform bill is complete Thursday and it includes the U.S. Virgin Islands and other territories, Delegate Donna Christensen said Thursday.
The news the 4-million-plus U.S. citizens living in the territories are included is something of a relief after recent concerns about the direction negotiations were taking. The original House bill passed last year included the territories, but the Senate version did not. To avoid a Republican filibuster and allow a simple majority vote, the House must pass a reconciliation bill that fairly closely follows the Senate version.
When President Barack Obama offered his suggested route to reconciling the House and Senate bills this February, his relatively brief proposal made no mention of the territories, leaving open the possibility the final reform package would leave territorial citizens not only without the benefits of reform, but possibly worse off than before.
But after numerous meetings over the past two weeks with the leadership in the House, Senate and with Obama, the territories are in the bill, Christensen said in a statement Thursday.
“The bill that was released today – while not perfect – will play a significant role in improving the health care of the American men, women and children living in the U.S. territories,” Christensen said. “Not only will the U.S. Virgin Islands receive an enormous infusion of new Medicaid dollars, but we also have access to the health insurance exchange.”
During the negotiation process, Christensen said she and the other delegates scored an additional success by ensuring the territories will not have restrictions on how to use the new Medicaid funds.
During a conference call with reporters Thursday, Gov. John deJongh Jr. said he is thrilled by the apparent final version. DeJongh said the legislation would deliver more than $300 million to the territory over the next nine years, up to $40 million of which the territory could use for the uninsured – “those who do not qualify for Medicaid,” he said. (For more on the deJongh conference call, see "DeJongh Reports head and Allies from D.C. Trip".)
“It really begins to create a pathway to parity for the Virgin Islands’ healthcare,” deJongh said, adding that the legislation would effectively and finally lift the notorious Medicaid cap. DeJongh is Washington, D.C., to testify on the proposed V.I. constitution currently before Congress.
According to the Congressional Budget Office, this reconciliation bill will result in 30 million more U.S. citizens becoming insured and will reduce the U.S. budget deficit by $138 billion between now and 2019. Savings should be much larger in the decade following–as much as $1.2 trillion. But CBO only gave tentative ranges for the second decade, qualified with the caveat that predictions so far in the future are extremely difficult to make with precision.
The bill’s text was placed online this afternoon at the website for the House Rules Committee. Bills must be placed online 72 hours in advance of a vote and the House vote may occur sometime Sunday afternoon. After that, the Senate takes up the same bill for a last up-or-down vote. Republican opponents may at that time make a final attempt to attach numerous amendments in an effort to slow down or derail the process. But under Senate reconciliation rules, there is a time limit for all amendments to a reconciliation bill, so unless a significant number of Democrats reverse course and work against the bill on either the House or Senate votes, or unless the Senate Parliamentarian raises an unexpected objection, passage of a health care reform bill is now very likely.

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