Jan. 18, 2006 – Jacqueline Hoop-Sinicrope, project manager of the Health Care Reform Initiative, testified Wednesday at the Health, Hospitals and Human Services Committee that the proposed program could cut the number of uninsured Virgin Islanders by almost two-thirds and help hospitals secure needed funds.
However, Dr. Anne Treasure, president of the V.I. Medical Society, painted an altogether different picture: "If this measure is passed, not only will it not insure more residents and not bring more funds to the hospitals; it will remove residents from the ranks of the insured and would remove funds from the hospital."
Hoop-Sinicrope said she expected opposition to the proposal and was not that upset by it, but she did take exception to a couple of things in Treasure's testimony.
Treasure made a long statement about a section in the bill requiring any felons involved in the program's organizational structure to notify the government of their criminal record within 30 days.
Hoop-Sinicrope said Treasure seemed to be indicating that someone involved in the project was a felon.
Sen. Roosevelt David, sponsor of the bill, questioned Treasure about this. Treasure said she did not know specifically if there were any felons involved in the potential program but added, "I am concerned; why should they be allowed to run these trusts?"
Treasure also appeared to insinuate that some of the proponents were going to make a great deal of money from the proposal, a remark that both David and Hoop-Sinicrope took exception to. David was passionate in his remarks, saying that his only aim was to help the poor of the territory get the medical coverage they needed.
Sen. Craig W. Barshinger, who recently became chairman of the committee, said the proposed reform would be "landmark legislation that needed much analysis." He said he recognized this proposal was not perfect and added, "The fact is that no decision will be made until everyone has a chance to give input." A similar hearing to the one held on St. Croix is scheduled for Feb. 1 on St. Thomas.
He said the issue's importance was underscored by the number of senators showing up for Wednesday's committee hearing. In all, 14 senators were present; only Sen. Shawn-Michael Malone did not attend.
Lauritz Mills, director of the V.I. Bureau of Economic Research, joined Hoop-Sinicrope in making the initial presentation to the committee. She said, "The cost of health care continues to rise, forcing many of our people to go without health insurance." She added, "Without health insurance they are more likely not to receive the care that is so urgent. And if they are even able to pay for some of their care, they are more likely to go bankrupt. Too many are praying to God not to get sick. We can no longer ignore this basic human need to be secure and to be cared for."
According to Hoop-Sinicrope, there are several components of the proposal that "together provide a comprehensive approach to the goal of increasing the insured rate in the territory."
She said there are presently more than 25,000 uninsured residents in the territory, and that this measure would bring the number down to about 10,000.
A lynchpin of the proposal is the banding together of small businesses under a Multiple Employer Trust to be overseen by a trust administrator from the private sector.
Employment & Business Solutions (EBS) has already acquired an agreement to run such a trust. This raised the ire of Sen. Usie R. Richards, who questioned how movement could be made on this proposal when the enabling legislation had not yet been passed.
Hoop-Sinicrope said EBS would not be receiving any funds from the government but would be allowed a "7 percent sum to manage the operating functions of the trust."
She said the running of a trust fund would be efficient and bring cost savings. She noted that employees in the program would pay a monthly premium of $182 – with the employer paying for half ; a spouse could be added for an additional $182. The first three children on the plan would be an additional $69 each, but there would be no charges for additional children after the first three.
Treasure disagreed with Hoop-Sinicrope on many specifics. While Hoop-Sinicrope said the new insurance would cover pre-existing medical conditions and childbirth costs, Treasure said it would not. Hoop-Sinicrope also said the program would not affect employees who already had coverage from their employers. Again Treasure disagreed, adding, "This is not the legislation that will fix the problem."
Barshinger noted the disagreements but said that the purpose of Wednesday's hearing was solely to gather information and that he did not want to see a debate between the bill's proponents and those opposed.
Benjamin Rivera Jr., executive director of the St. Croix Chamber of Commerce, also testified in opposition to the proposal. "The bill is seriously flawed and should immediately be tabled by this committee and only reconsidered after being redrafted with the input of a carefully selected think tank," he said.
David rejected the idea of a think tank and suggested Chamber members submit to the Senate their suggestions to make the proposal work.
The Chamber then received a severe tongue lashing from Sen. Juan Figueroa-Serville, who said the Chamber acted like a "bully" and only testified on selected issues. He asked where the Chamber was when the Senate was seeking testimony on the Jobs Creation Action last year.
How the plan would be financed was questioned by senators also.
Hoop-Sinicrope testified that the plan was self-funded, with collected premiums paying the cost. She indicated that the monthly pay-in with maximum participation would be $5.2 million. Her estimate of payouts at maximum utilization would be $4.7 million.
She said that there is the potential for high-dollar claims in the early months before a reserve has been built up and that EBS has secured a $1.7 million letter of credit to cover that possibility.
Saying that he wants to keep the door open to other options, Sen. Adlah "Foncie" Donastorg requested the Division of Personnel immediately conduct a study as to the feasibility of permitting private citizens to buy into the V.I. government group plans.
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