Vann R. Newkirk II: This is definitely an interesting time to visit Washington.
Kenneth Mapp: It's been a very interesting time to visit Washington since January 21, I believe. But in a storm there's some quiet corners and you can actually get some work done. My meetings with the congressional leadership have been going well. Every six to nine weeks I come to Washington and meet with Congress about specific issues that related to the Virgin Islands and our agenda.
Newkirk: What's at the top of your list of issues?
Mapp: A lot of things are near the top of my list. In an insular area, coming out of a recession, there are just a lot of things to deal with. Economic growth, federal relations, and infrastructure development, to start. One of our big issues is fiscal stability, and getting away from borrowing working capital every fiscal year.
When I was here in the National Governors Association meeting in February, most of the governors, regardless of which side of politics they were on, remained concerned about what the federal approach would be to health-care reform. There are fixes for us that can take place under the current Affordable Care Act. I'm not sure that throwing it out and trying to start from scratch is the best way.
Newkirk: What kind of fixes?
Mapp: I had 22,000 folks on the expanded Medicaid program when I entered office and now we've qualified another 19,000. So about 40 percent of my 100,000 population will depend on it. While there need to be improvements to the law, that's a significant number of people in a single jurisdiction.
Newkirk: How did you manage that increase of the Medicaid population?
Mapp: We requested an increase in the federal poverty level, by moving the minimum qualifying income up. The poverty level was at $8,100, and we selected the federal poverty level of $11,770, and that opens up another 19,000 people.
Newkirk: What’s the structure of health care in your territory?
Mapp: In the Virgin Islands, we've long had universal health-care. For decades we grappled with this issue of making sure there's money for the hospitals, because we have a law that says the hospitals—the only hospitals in the Virgin Islands are public—cannot deny benefits or services because of a person's inability to pay. That's not just for emergency services, that's not just for a person who fell off a ladder and needs sutures—it's everything.
Just take a pregnant mother who ends up with a premature birth, and that premie baby needs intensive care. If it's unavailable on the Virgin Islands, the hospitals have to put that mother and baby on an air ambulance and fly them to the mainland to a facility where they can be cared for. When public hospitals make those decisions, the government of the Virgin Islands foots that bill. We've had instances where people have been transferred to mainland facilities, and when it was all finished the bill was over $600,000. That comes directly out of the treasury. So if you relate that back to an expanded Medicaid program, any ceding of expense to the federal government is a reduction of costs for the Virgin Islands.