[Congressional Record (Bound Edition), Volume 159 (2013), Part 10]
[House]
[Pages 15062-15063]
[From the U.S. Government Publishing Office, www.gpo.gov]




   THE AFFORDABLE CARE ACT AND THE IMPACT ON THE U.S. VIRGIN ISLANDS

  The SPEAKER pro tempore. The Chair recognizes the gentlewoman from 
the Virgin Islands (Mrs. Christensen) for 5 minutes.
  Mrs. CHRISTENSEN. Mr. Speaker, Tuesday was a bittersweet day. It was 
an unfortunate day because of the government shutdown, but it was a 
good day because of the millions of Americans who live in the States 
and Washington D.C., who finally had the opportunity to leave the ranks 
of the uninsured when they logged in or called the toll-free number and 
enrolled in affordable quality health care coverage through the health 
insurance marketplaces.

[[Page 15063]]

  However, October 1 was bittersweet for other reasons for me, and I 
rise today as a Congresswoman from the United States Virgin Islands 
because on October 1 my constituents, who are also Americans, were 
largely left out in the cold on this key part of the law.
  As a member of the Health Subcommittee of Energy and Commerce, I was 
at the table and an active participant in the drafting, negotiation, 
and amending of the Affordable Care Act, and I am proud that I was. But 
it was and remains sadly clear that one of the U.S. Virgin Islands and 
the other territories' biggest public health and health care challenges 
when it comes to Federal policies is benign neglect. Despite our 
efforts, still too many people, well intentioned, just don't 
acknowledge that, for example, across nearly every health indicator, 
from HIV/AIDS, cancer, heart disease and obesity prevalence, to rates 
of uninsurance and health care provider shortages, the U.S. Virgin 
Islands often are worse off than the national average.
  So I, working in close collaboration with leadership and my 
territorial colleagues, the Black, Hispanic, Asian and Progressive 
Caucuses, worked tirelessly to ensure that the more than 4 million 
Americans who live in U.S. territories, as well as our collective 
health care systems, would enjoy the positive benefits of health care 
reform.
  The great news is that we were in very large part successful. Today, 
Virgin Islanders and other persons in the territories are included in 
the consumer protections that make it illegal for a health plan to deny 
health coverage because of a preexisting disease or to rescind or deny 
coverage when someone gets sick and to impose lifetime dollar limits on 
essential benefits.
  Today, U.S. Virgin Islanders can keep their children on their health 
plans until the child is 26 years of age. Because of The Affordable 
Care Act, today seniors in the U.S. Virgin Islands receive free annual 
wellness visits and free preventive care. They receive Medicare 
prescription drug rebate checks and meaningful help covering the cost 
of their prescription drugs. In the U.S. Virgin Islands because of the 
Affordable Care Act, our community health centers and community health 
workers are strengthened and better equipped to serve as medical homes.
  But the devil is in the details. You see, the sad reality is that 
just because U.S. Virgin Islanders are included in the law and eligible 
for these great benefits does not mean that the law has been 
implemented in a manner that allows them all benefits or to fully 
experience the positive impact the Affordable Care Act was intended to 
have on every American.
  The law gave the Governor in the U.S. Virgin Islands a choice between 
two options, and all the territories: one, to establish a health 
insurance exchange, either separately or in partnership with a State 
that was also setting up a State-based exchange; or, two, to use the 
funds that would have gone towards the exchange to expand our Medicaid 
program.
  The Governor, based on advice of a task force and consultants, opted 
for option number two. And so amid all of the information that is being 
promulgated about the opening up of enrollment for the exchanges, 
wonderful news for many Americans, my constituents and those in the 
other territories feel very much left out and unfairly treated. To add 
insult to injury, there are no individual policies being written and 
the industry is blaming it, I think unfairly and not rightly, on the 
Affordable Care Act.
  It is important to remember that because of the Affordable Care Act 
there is a very significant increase, though in the hundreds of 
millions of dollars, in funding for the Medicaid program and the 
Governor can establish a local poverty level that could significantly 
increase Medicaid eligibility. The robust increase in funding for 
Medicaid can allow for thousands of Virgin Islanders to be newly 
eligible for meaningful health insurance coverage under that program. 
Unfortunately, although the House passed a provision that would have 
changed the match, it did not make it through the Senate, so the match 
is set so high that it is difficult for us and the other territories to 
fully utilize the increased funding.
  As a physician who practiced for more than 20 years before coming to 
Congress, I know what happens to someone's health and wellness, as well 
as personal finances, when they do not have health insurance coverage. 
It is catastrophic. That is why I requested meetings with Secretary 
Sebelius to explore how and whether the moneys that could have been 
used to establish a health insurance exchange can instead be used for 
making health care reform a reality for those who are uninsured but 
make too much to qualify for Medicaid.
  So there is a small but distinct window of opportunity to work with 
the Secretary and our Governor to think outside the box, to identify 
meaningful and thoughtful solutions to the unique health care 
challenges facing the Americans in the U.S. Virgin Islands. Some will 
require legislation, and I ask for the support of my colleagues on 
that; but also please let us pass a clean CR to keep our government 
open and provide services to Americans wherever we live in this great 
country.

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