Mass Medicaid Terminations in USVI Leaves 16,480 Without Healthcare, Lawmakers Fear Health Crisis

Legislators approve $3 million to address shortfall but express doubts over sufficiency as DHS commissioner reveals significant drop in medicaid enrollment; calls for federal assistance and increased income eligibility thresholds highlighted

  • Tsehai Alfred
  • July 03, 2024

Thousands of Virgin Islands residents have been removed from the Medicaid program as of last month, according to legislative testimony from Department of Human Services Commissioner Averil George. The disclosure prompted concern from lawmakers about health accessibility and costs for residents.

‌“The testimony today is saying there's 21,463 [currently enrolled] that means in the last month 16,480 persons, which is 19% of our population, has lost Medicaid insurance,” noted Senator Ray Fonseca during last week’s Committee of the Whole meeting. The disclosure came during DHS’s request for the 35th Legislature’s Committee of the Whole to appropriate $3 million to “support a shortfall” in local matching funds, and to “support the continued operation of the Medicaid program,” according to Ms. George.

Although the Legislature approved the request, lawmakers including Mr. Fonseca remained worried that the $3 million will not be sufficient to support those who have been removed from the program, likely resulting in a cost to the state.

“Many of them go to the hospital or our health clinics [with] uncompensated care. So guess what? The money still comes out of the general fund,” observed Senator Marvin Blyden. According to Mr. Blyden, when it comes to Medicaid, a “single mother will not qualify if she makes minimum wage,” given that the current maximum income eligibility for an individual is $15,660 a year – $31,932 a year for a family of four.‌

While legislators described low-income eligibility cut-offs, Assistant DHS Commissioner Denelle Baptiste said the decrease in recipients is mostly due to an increase in income. According to the USVI’s Medicaid director Gary Smith, the thousands removed were largely the result of an audit conducted after the territory recorded an increase in Medicaid recipients due to special pandemic-driven benefits. After the COVID-19 pandemic public health emergency ended in June of 2023, members of the program were mandated to recertify recipients, dropping enrollment by 44%.

“We can't ignore what this is going to do to our people who are already suffering,” Senator Marise James said. Mr. Fonseca echoed similar concerns, claiming that those previously under Medicaid will not be able to personally pay for health costs and can likely not pay for insurance given the low Medicaid eligibility rates.

“Even though the director Gary Smith told us that they’re working and now above the eligibility, we know the Medicaid eligibility is the poverty line. They are not going to be able to pay to fix their teeth,”  Mr. Fonseca said.

‌Suggesting solutions to the issue, Mr. Blyden said the Legislature and other governmental agencies should seek available federal funds to cover the costs of uncompensated care and support previous Medicaid recipients in need of health services.

Mr. Fonseca also underscored the need to close the gap. “How can we let our own people go uninsured when they were insured before?” he asked.

Last year, then-DSH Commissioner Kimberly Causey-Gomez estimated that approximately 9,000 Virgin Islanders would be disenrolled from Medicaid due to the cessation of pandemic-era support. At the time, local officials were due to meet with their federal counterparts to review and revise the poverty income threshold which guides who qualifies for Medicaid and similar assistance programs. With the numbers of those dropped almost double original estimates, the need for such revision has become more pressing than ever. It is not clear whether the meeting Ms. Causey-Gomez assured lawmakers was imminent ever occurred, or if it did, whether it produced any results.


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