By Governor Albert Bryan Jr.
In the Virgin Islands, we are no strangers to challenging times. We have faced storms, recessions, energy shortages, setbacks, and a global pandemic that could have broken our spirit. Instead, we turned them into steppingstones to a more resilient future. Today, we face another test of courage—not from the wind or the waves, but from the rising tide of healthcare costs that threaten our government, our seniors, our workforce, and the families who depend on them.
Some hear the words “self-insurance” and think of risk. I hear them and think of responsibility. Responsibility to stop paying more for less. Responsibility to confront a system that drains our budgets, our choices, and our peace of mind. Responsibility to claim control of our future before it slips further away.
Under our current fixed-cost model, the Government of the Virgin Islands is already the plan sponsor. That means the government, and by extension its employees and retirees, already bear the full cost of healthcare. Each year, premiums climb higher, coverage shrinks, and the weight of the system presses harder on families.
The concern that the government may not be able to cover claims under self-insurance is valid, but it is not insurmountable. We are already paying those claims. The only difference is that now we do it through a structure that supports ever-rising premiums sent to insurers far from our shores. The liability exists today. The question is whether we will continue to fund someone else’s profit or secure those same dollars to serve our people.
The solution lies in a simple safeguard: a lock box structure that secures the funds for claims. The money would be reserved and protected, flowing first to pay healthcare costs. We already use this model in our finances. Revenues pledged to bonds, such as the rum excise tax and the gross receipts tax, are set aside to meet obligations before any other expense. If we can guarantee bondholders their payments, we can guarantee our people the coverage they have already paid for. In fact, we do that every two weeks in the form of payroll. Come hell or highwater somehow, we have always managed to pay employees on time. If we have committed to that on time payment, why can’t we commit to this one?
This is not a leap into the unknown. It is simply directing the money we already spend into a system designed for our benefit rather than for the profit margins of distant companies.
We are not alone in this journey. Guam faced the same rising costs and chose to act. They moved to a self-insurance model for their government employees and dependents. They did so carefully, with deliberate safeguards, and they emerged with a system that provides stability, bargaining power, and protection for their people.
The Virgin Islands shares many of Guam’s realities. We are small economies shaped by tourism, federal partnership, and geographic limits. Both of us carry debt that weighs heavily on our size. Yet Guam found a way forward. That same path can open before us, but we must make that leap of faith and choose. We ran on “Change Course Now,” not “Leave Things the Same.” We cannot change unless we are willing to take on risk.
Some argue that our debt-to-GDP ratio is a reason to fear change. I see the opposite. When debt is high, doing nothing is always the riskiest choice. Every dollar spent on bloated premiums is a dollar lost to classrooms, to safe roads, to public safety, to the services that define our community.
Self-insurance does not add to our debt. It is a tool to keep it from deepening. With built-in mechanisms like stop-loss coverage to shield us from catastrophic claims, and with a lock box to ensure the public that funds are protected, we can control costs while preserving financial security.
This should not be reduced to an argument about numbers, but a discussion on affording reliable and affordable health care to our people. It is a promise to people not only in the government but to our ailing hospitals, which depend on getting those dollars to take care of all our people, regardless of their insurance status.
To employees and retirees, it is a matter of dignity. Plans can be shaped to reflect their needs and provide peace of mind.
To taxpayers, it is a matter of fairness. Every dollar spent on healthcare can be directed to serve our community rather than enrich insurers.
To the Virgin Islands as a whole, it is a matter of resilience. A healthier workforce strengthens the services we all rely upon.
I am not calling for reckless leaps. I am calling for deliberate steps, grounded in studies, data, and expert guidance. I am also calling for courage. Fear has never authored progress. Fear does not build schools. Fear does not open businesses. Fear does not keep families secure.
Vision does. Courage does. Innovation does.
The Virgin Islands must evolve to a place where we rise above fear-mongering politics and lead our territory to measurable progress. Self-insurance is not a gamble. It is a proven model already in use across states, territories, and cities. It offers us the power to control a cost that, if left unchecked, will erode our solvency and dim our future.
We owe it to ourselves, to our workers, and to our children to meet this challenge with clarity and conviction. The road ahead divides. One path leads to higher costs and shrinking options. The other leads to control, security, and a system that serves our people first.
For the good of our people, and for the future of these Virgin Islands, it is time to take that step.
###
The post Op-Ed: Why the Virgin Islands Must Take Control of Rising Healthcare Costs appeared first on Government of the United States Virgin Islands.
Government of the United States Virgin Islands
