On Wednesday, the Territory’s Health Reform Implementation Task Force met at Government House to continue to explore opportunities to expand health insurance coverage to all Virgin Islanders, a primary objective of the Patient Protection and Affordable Care Act. 

Convened by Lieutenant Governor Gregory R. Francis, the territory’s Commissioner of Insurance and Chairman of the Virgin Islands Health Reform Implementation Task Force, the meeting was an opportunity to discuss progress underway in implementing key initiatives that are driving healthcare reform in the territory.

Task Force members highlighted a milestone achieved in the territory for women and children’s healthcare coverage, in accordance with various provisions of the Affordable Care Act. For non-grandfathered health insurance plans, women are now able to access preventative health services at medical providers including the Department of Health and the territory’s health centers without paying co-payments, co-insurance or a deductible. Some of these services include birth control pills and other contraceptive methods, breast feeding support and domestic violence counseling. These preventive care services will support and enhance those already provided by the Department of Health, Department of Maternal and Child Healthcare and Children with Special Needs Programs (MCH & CSHCN), which last year received a grant of $500,000 to assist the territory’s healthcare reform initiatives by developing a home visitation program that can improve the health of mother and child. 

Earlier this month the U.S. Department of Health and Human Services issued guidelines to expand preventative health services for women nationwide, paving the way for healthcare coverage expansions in states and territories.

The territory is also exploring the development of a Health Insurance Exchange (HIX)—a marketplace for individuals and small businesses to purchase health insurance. Task Force Coordinator Taetia Phillips-Dorsett, Banking and Insurance Director John McDonald and Attorney Dwayne Henry, Legal Counsel for the Office of the Lieutenant Governor, recently traveled to Puerto Rico to discuss the possibilities of partnering with the commonwealth to build a regional insurance exchange.

Additionally, during Wednesday’s meeting, Paul Ritzma, Executive Director of the Medical Assistance Program (MAP) provided an update on progress to date of the Pharmacy Benefits Management (PBM) Program and the Medicaid Management Information System (MMIS). Attorney Ritzma indicated that preliminary data from the PBM program shows that since its implementation, the MAP program projects a cost savings of between $600,000-$800,000 per quarter as compared to prior years’ prescription expenses. 
Ritzma also recapped his recent meeting with relevant parties in West Virginia regarding the development of an MMIS system that will enable the MAP to process claims faster. The State of West Virginia is also being considered as a potential Health Insurance Exchange partner. Representatives from the Medical Assistance Program and the Virgin Islands Health Insurance Exchange Team continue to engage West Virginia as the territory moves towards purchasing or building IT systems that will address the multiple eligibility screening requirements for territorial programs, including: the HIX, MAP, CHIP, WIC, SNAP (Food Stamps), and TANF (Emergency Assistance) programs.

Francis stated, “I am impressed with the level of local collaboration involving the Departments of Health and Human Services Medical Assistance Program, IT Divisions, and SNAP and TANF programs as we move towards leveraging federal and local resources to meet the healthcare needs of our most vulnerable populations, including the uninsured and the underinsured.” 

Additionally, to meet the demand for individual health coverage in the Virgin Islands, the Task Force has engaged the services of the Economic Development Authority (EDA) to solicit insurance providers writing individual healthcare policies to do business in the Virgin Islands. On Wednesday, Percival Clouden, Chief Executive Officer of the EDA, noted his team has received promising leads in continuing to market the territory to insurance providers. Currently, only a few companies in the territory offer individual policies to consumers. To fulfill the goal of expanding coverage, the territory must have more providers who locally underwrite and offer individual policies until such time as an exchange is established. 

The 14-member task force is comprised of Lieutenant Governor Gregory R. Francis; Attorney General Vincent F. Frazer; Office of Management and Budget Director Debra Gottlieb; Acting Health Commissioner Fern Clarke; Human Services Commissioner Christopher Finch; Division of Personnel Director Kenneth Hermon; Deputy Chief of Staff to the Governor Pamela B. Berkowsky; Schneider Regional Medical Center CEO Alice Taylor; Governor Juan F. Luis Hospital CEO Jeff Nelson; Frederiksted Health Care, Inc. CEO Masserae Sprauve Webster; St. Thomas East End Medical Center Executive Director Wilbur Smith; GESC-Health Insurance Board of Trustees Chairman John Abramson; Virgin Islands Equicare Director Nancy Bass; and the Legislature’s Chairman for the Committee on Health, Hospitals, and Human Services Senator Patrick Sprauve. 

The Task Force will next meet on October 20.