Many in the Virgin Islands have been closely following the national health care debates. We have heard about the House bill, the Senate bill, Senator Baucus’ bill and we have heard about President Obama’s commitments. By now, many people are confused about what is included in which version of each bill, and most of us have gotten lost in the maze of the debates. To make things even more confusing, more than 560 amendments have been registered just prior to the Senate Finance Committee’s mark up.
The current ‘mark up’ in the Senate Finance Committee is a reconciliation process where all of the bills under consideration are boiled down into one massive bill that includes the amendments that were voted on for inclusion.
Getting to the reconciliation process is a critical stage. Within the next few weeks we will know if health care reform is going to happen. The basic concept which formed the foundation for this reform was to ensure that every American has access to quality and affordable health care. What still remains uncertain is whether Virgin Islanders will be included in all aspects of the reform.
In many of the original bills, Virgin Islanders were completely left out of the health care exchange. The exchange is part of the ‘public option’ for the uninsured. Participation in the exchange is critical. Exclusion from the exchange will be devastating for the Virgin Islands, Puerto Rico and other US territories. Without inclusion in the exchange, Virgin Islanders will be faced with serious disparities in how we are treated in the health care system. We will continue to have limitations on benefits and subsidies from the federal government.
The Virgin Islands already suffer the pitfalls that come with a cap on our Medicaid program, and continue to be faced with disparities that undermine the social intent of critical public programs. Thus far, draft bills will bring improvements to the Medicaid cap situation.
The ideal situation for the territories goes beyond mere inclusion in the exchange. The ultimate goal is parity or equal treatment in all health care policy. Fortunately, there are several amendments and one recent addition to the Senate Finance Committee’s mark up that can help us partially achieve our parity goal.
The Schumer-Menendez-Bingaman Amendment #C8 to Title I, Subtitle B amendment could serve as our parity cornerstone. This amendment would include Puerto Rico and the Territories in all aspects of Title I of the bill, the insurance market reforms, the health care exchanges, the coverage affordability provisions, and the shared responsibility provisions.
AARP is closely monitoring the mark up process and the amendments related to the territories. Virgin Islanders are urged to visit the AARP VI website for updates.