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FLOOR 10/30/2025-SPECIAL ORDERED TO THE FLOOR BILL NO. 36-0203 Thirty-Sixth Legislature of the Virgin Islands October 30, 2025 A resolution petitioning the Congress of the United States to amend federal law to include the Virgin Islands as full participants in the Affordable Care Act PROPOSED BY: Senator Kurt A. Vialet WHEREAS, the federal government of the United States has entered a shutdown due to 1 disagreements in Congress over spending priorities, particularly the extension of health-care 2 subsidies and tax credits under the Affordable Care Act (“ACA”); and 3 WHEREAS, this shutdown underscores the fundamental importance of affordable 4 health care and the critical role that subsidies and tax credits play in ensuring that citizens and 5 residents across the nation have access to necessary medical coverage; and 6 WHEREAS, the irony of the current situation is that, while the federal government is 7 paralyzed over policies related to the continuation of health-care benefits for Americans, the 8 Virgin Islands and other U.S. territories are not fully included in or eligible for those same 9 benefits under the ACA; and 10 WHEREAS, further compounding this irony is the fact that the federal government 11 shutdown stemming from disputes over programs from which the Virgin Islands are excluded, 12 disrupts and delays essential federal services and funding upon which the territory depends; 13 and 14 2 WHEREAS, this inequitable arrangement results in Virgin Islanders being adversely 1 affected by federal policy decisions and shutdowns tied to programs they cannot benefit from, 2 illustrating the urgent need for comprehensive inclusion in national health care initiatives; and 3 WHEREAS, Virgin Islanders are American citizens who, despite their citizenship, 4 remain excluded from the full participation in the nation's health reform law, including access 5 to health insurance marketplaces, premium tax credits, and cost-sharing reductions available to 6 residents of the fifty states and the District of Columbia; and 7 WHEREAS, Virgin Islands residents proudly serve in uniform at rates comparable to or 8 above many states, contributing to the defense and security of the United States through the 9 Armed Forces and the Virgin Islands National Guard, yet remain excluded from certain federal 10 benefits and protections, including those provided under the ACA; and 11 WHEREAS, the Virgin Islands also hosts U.S. military personnel and operations as part 12 of a multi-service anti-drug and counter-narcotics mission in the Caribbean, demonstrating the 13 Territory's strategic importance to national security and its integral role in protecting the 14 nation's borders and combating transnational crime; and 15 WHEREAS, this exclusion has contributed to disproportionately higher rates of 16 uninsured individuals, limited access to affordable health insurance options, and greater 17 financial barriers to care for Virgin Islands residents; and 18 WHEREAS, without access to premium tax credits or cost-sharing reductions, health 19 insurance coverage is often unaffordable for working families; and 20 WHEREAS, the Government of the Virgin Islands must shoulder a disproportionate 21 share of the cost for public health programs due to limited federal funding and capped Medicaid 22 allocations, unlike states that receive open-ended federal matching support; and 23 WHEREAS, this inequity leads to delayed care, adverse health outcomes, and higher 24 uncompensated care costs for hospitals and the local government; and 25 3 WHEREAS, inclusion under the ACA would stabilize the Virgin Islands’ health care 1 system, improve health outcomes, expand access to preventive services, and reduce the strain 2 on public health resources; and 3 WHEREAS, equitable inclusion would also promote economic stability by fostering a 4 healthier population, increased workforce productivity, reducing uncompensated care costs for 5 the territorial hospitals, attracting greater investment in the territory's health sector, and 6 alleviating local fiscal pressure; and 7 WHEREAS, extending ACA eligibility to the Virgin Islands would align with the 8 principles of fairness, equality, and full citizenship for all Americans, ensuring that residents 9 of the Virgin Islands are not left behind in national health care policy; and 10 WHEREAS, the Legislature of the Virgin Islands recognizes that the ongoing exclusion 11 of the territory from the ACA is inconsistent with the federal government's stated commitment 12 to equity and inclusion across U.S. jurisdictions; Now, Therefore, 13 Be it resolved by the Legislature of the Virgin Islands: 14 SECTION 1. The Legislature of the Virgin Islands petitions the Congress of the United 15 States to amend federal law to include the Virgin Islands as full participants in the Affordable 16 Care Act, with access to the same subsidies, tax credits, and marketplace options available to 17 residents of the fifty states and the District of Columbia. 18 SECTION 2. The Legislature of the Virgin Islands urges the President of the United 19 States and the United States Department of Health and Human Services to take all 20 administrative and legislative actions necessary to ensure equitable treatment for the residents 21 of the Virgin Islands in all federal health programs. 22 SECTION 3. The President of the Legislature of the Virgin Islands shall forward 23 certified copies of this resolution to the President of the United States, the Vice President of 24 the United States, the Speaker of the House of Representatives, the Majority and Minority 25 4 Leaders of the United States Senate, the Virgin Islands Delegate to Congress, and the Secretary 1 of the United States Department of Health and Human Services. 2 BILL SUMMARY 3 This Resolution requests for the Congress of the United States to amend federal law to 4 include the Virgin Islands as full participants in the Affordable Care Act. 5 BR25-0898/October 30, 2025/GC 6