Many clients have asked if and how the Affordable Care Act (“Obama Care”) affects the citizens and employers of the Territory.
Simple answer, it doesn’t.
The Affordable Care Act is designed in three parts: market reform, which includes guaranteed issue, adjusted community rating, and prohibitions against preexisting condition exclusions and other consumer protections intended to address problems that have been identified in the individual insurance market. Full application of the Affordable Care Act relies on the definition of the word “state.” If “state” is defined to include the Territories, then the Act applies. However, if “state” is defined narrowly to include the fifty (50) states and the District of Columbia, the then the Act does not apply. The ACA does not define the Territory as a State.
Following passage of the Affordable Care Act, Governor John deJong Jr. created a task force to provide guidance and recommendations regarding initiatives to implement the Act. The task forces concluded that the disjointed application of the Act’s provisions to the territories and its insufficient allocation of the federal funds significantly limits the Virgin Islands’ opportunity to expand health care coverage to uninsured Virgin Islanders. Final recommendation to the Governor was to utilize the funding provided under the law to expand Medicaid instead of establishing an Exchange.