A $1 million federally funded study has come up with severaloptions to extend health insurance coverage to the nearly 25 percentof Virgin Islanders living without it.
The project, funded with a State Planning Grant from the U.S.Department of Health and Human Services to the V.I. EconomicResearch Bureau, initially surveyed the territory's uninsured and isnow looking toward developing options that would increase theiraccess to health insurance.
'We will be looking at long-term strategies,' said Lauritz Mills,director of the Economic Research Bureau.
Although the numbers are better than officials expected, thepercentage of people living without health insurance in theterritory far exceeds the national average, with 24.1 percentreporting they had no insurance at the time of the survey, comparedwith a 17 percent average for the nation as a whole.
The figure for residents who had no health coverage the entireyear is more bleak: 21 percent in the territory, compared with 12.2percent across the nation.
The study came up with three options to increase the number ofinsured in the territory:
- Expand health insurance access to small employers with group-purchasing arrangements or possibly a buy-in to the governmentemployee plan.
Survey results indicated that some of the residents more likelynot to have insurance were those who were self-employed or employedby firms with fewer than 10 workers.
The project report says that some level of local governmentsupport would be required for this option, such as premiumsubsidies, tax credits or legislation changes to enable unrelatedbusiness firms to pool their purchasing power with insuranceunderwriters.
Developing a buy-in provision for small employers into thegovernment employee insurance program is another possibility underthis option, although it would require a way to project annualparticipation and assess the degree of risk.
'Nothing in this option assumes that coverage is given for freeto employees or employers. It is designed to find the marginaldollar which will encourage small firms and their employees topurchase health insurance,' the report states.
- Increase individual access to health insurance.
This option is potentially more costly than any program thatdeals directly with employers, according to the report.
One of the possibilities under this option is developing high-risk pools for people who cannot get insurance in other ways. Thecost of coverage in this sort of pool is more expensive because ittends to attract people who are sicker.
Another possibility is to enable individuals to buy into thegovernment employee health insurance program, although the logisticsfor this would be more complex than private-employer participationin the plan.
The final possibility under this option is a health-center prepayplan, where the East End and Frederiksted health centers wouldmarket prepaid service plans for preventive care to small employers.
- Develop a public/private universal coverage program.
This option would bring every person in the territory with anykind of health insurance into a single pool, thereby reducing costs.
'Some of these options have worked in other states,' Mills said.'I am sure that one of these options, or a combination, would workfor us.'
Mills said more studies and number-crunching will be done on theoptions, and an advisory group that comprises a cross-section of thecommunity, from health leaders to members of the AmericanAssociation of Retired Persons, will weigh the results and design aproposal that works for the Virgin Islands.
The findings will be presented to government leaders.
'All we are going to do is recommend. What is done is anothermatter,' Mills said. 'Ultimately, government officials will decidewhich, if any, option we will take.'
