The territory has applied for a million-dollar grant from the U.S. Department of Health and Human Services to explore establishing an American Health Benefit Exchange in the Virgin Islands, Gov. John de Jongh Jr. said Tuesday.
Under the Affordable Care Act, a federal health reform law enacted in 2010, territories may choose to establish an exchange, a marketplace for insurance companies to offer “qualified health plans” including a set of benefits determined by the federal government.
Territories and states establishing an exchange must provide assistance with premiums and other cost-sharing (such as co-payments and deductibles) to low-income individuals.
If the territory determines that an exchange is feasible, the exchange could make affordable health insurance plans available to a portion of the territory’s estimated 33,000 uninsured residents.
"The Virgin Islands struggles with a health care system that is not able to meet all our residents’ needs," de Jongh said. "Approximately 29 percent of Virgin Islanders have no health insurance, and my administration is keenly aware of the challenges this group faces. My administration supports the innovative tools provided in the Affordable Care Act to cover the uninsured, and to move the Virgin Islands toward parity with U.S. States in health care policy.”
The federal law also includes a “Small Business Health Options Program” designed to help small businesses sponsor health insurance for their employees on the exchange.
The exchange would begin operating in January 2014.
DeJongh said that the federal government is providing grants for states and territories to plan an exchange and that the U.S. Virgin Islands has sought $1 million in federal funding. The government intends to use the funds to examine the feasibility of an exchange in the Virgin Islands.
“The decision is more complicated for territories than for states, because federal law provides some funding advantages to states in setting up an exchange that are not provided to territories," he said. "For example, the Virgin Islands would receive an estimated $30 million over a five-year period in federal funding to provide exchange subsidies for low-income persons, whereas states will receive federal support that is not capped.
The governor established the Healthcare Reform Implementation Task Force in June 2010. Under the leadership of Lt. Gov. Gregory Francis, the task force has been examining how to implement the federal law in the Virgin Islands.
“The task force, under my direction, will take a thorough look at whether an exchange is feasible, and if so, how we can design it to provide the most help to individuals and small businesses in the Virgin Islands,” Francis said. “The territory intends to use the federal health reform effort to strive toward the goal of making affordable health care available to every Virgin Islander.”
