Selected Pre-Hurricane Indicators on the U.S. Virgin Islands, Compared to the 50 States and DC
U.S. Virgin Islands 50 States and DC
Total Population (2017)1 107,268 326,625,791
Demographic and Economic Characteristics
U.S. Citizens2 88% 93%
Over age 653 18% 16%
Below Poverty Level4 22% 14%
Unemployment Rate5 13% 5%
Median Household Income6 $37,254 $57,617
Health Access Indicators
Share Enrolled in Medicaid/CHIP7 22% 24%
Adult Uninsured Rate8 30% 12%
Needed to see a doctor but could not because of cost in the past 12 months9 78% 87%
Routine Check-Up in the past 12 months10 69% 71%
Dental Visit in the past 12 months11 51% 66%
Health Status Indicators12
Adults Reporting Fair/Poor Health 20% 18%
Adults Reporting Diabetes 13% 11%
Adults Reporting Heart Attack/Heart Disease 4% 7%
Adults Reporting Cancer 5% 11%
Adults Reporting Depression 6% 17%
Infant Mortality Rate per 1,000 Live Births 7.9 5.8
Federal Medicaid Rules13
Federal Matching Rate Fixed at 55% Ranges from 50-83% based on state’s per capita income
Federal Funding Capped at $16.8 million in FY16 Uncapped
  • With nearly 110,000 residents, the U.S. Virgin Islands, a U.S. territory, is located in the Caribbean and consists of the islands St. Croix, St. Thomas, and St. John. Virgin Islanders are natural-born U.S. citizens.
  • Although Medicaid and CHIP enrollment rates are similar, adults living in the U.S. Virgin Islands are two and a half times more likely to be uninsured than adults living in the 50 states and DC.14
  • Unlike the 50 states and DC, annual federal Medicaid funding for the U.S. Virgin Islands is capped, meaning once federal funds are exhausted, the island no longer receives federal Medicaid funds during that fiscal year.15 The territory also does not receive payments for uncompensated care (DSH).16
  • On September 6, 2017 Hurricane Irma hit the U.S. Virgin Islands followed by Hurricane Maria less than two weeks later, leaving severe damage to the infrastructure and limiting access to electricity, water, and basic necessities.17 Both hospitals on St. Thomas and St. Croix and the clinic on St. John were destroyed and will have to be rebuilt. In the meantime, dialysis patients and patients with critical medical needs have been airlifted to several mainland states.18
  • Two months after the Hurricanes made landfall, over two thirds of residents remained without power.19
  • The Hurricanes have placed additional pressure on an already strained economy, which relies heavily on tourism. Many hotels in the territory are closed for the 2017-2018 season, resulting in staff layoffs.20,21
Endnotes
  1. The World Factbook, 2017. Washington, DC: Central Intelligence Agency, Accessed November 2017, https://www.cia.gov/library/publications/the-world-factbook/index.html.

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  2. U.S. Virgin Islands Estimates: U.S. Census Bureau; 2010 Census of the Island Areas, Table DP-2; using American FactFinder, http://factfinder.census.gov. 50 States and DC Estimates: U.S. Census Bureau; 2016 American Community Survey 1-Year Estimates, Table S0501; using American FactFinder, http://factfinder.census.gov.

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  3. The World Factbook, 2017. Washington, DC: Central Intelligence Agency, Accessed November 2017, https://www.cia.gov/library/publications/the-world-factbook/index.html.

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  4. U.S. Virgin Island Estimates: U.S. Census Bureau; 2010 Census of the Island Areas, Table DP-3; using American FactFinder, http://factfinder.census.gov. 50 States and DC Estimates: U.S. Census Bureau; 2016 American Community Survey 1-Year Estimates, Table DP03; using American FactFinder, http://factfinder.census.gov.

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  5. The World Factbook, 2017. Washington, DC: Central Intelligence Agency, Accessed November 2017, https://www.cia.gov/library/publications/the-world-factbook/index.html.

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  6. U.S. Virgin Island Estimates: U.S. Census Bureau; 2010 Census of the Island Areas, Table DP-3; using American FactFinder, http://factfinder.census.gov. 50 States and DC Estimates: U.S. Census Bureau; 2016 American Community Survey 1-Year Estimates, Table DP03; using American FactFinder, http://factfinder.census.gov.

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  7. U.S. Virgin Islands Estimates: “Medicaid and CHIP in the U.S. Virgin Islands,” MACPAC, October 2017, https://www.macpac.gov/publication/medicaid-and-chip-in-the-u-s-virgin-islands/. 50 States and DC Estimates: “MACStats: Medicaid and CHIP Data Book,” MACPAC, December 2017, https://www.macpac.gov/wp-content/uploads/2017/12/MACStats-Medicaid-and-CHIP-Data-Book_December-2017.pdf.

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  8. Reported for adults 18 and older. Kaiser Family Foundation analysis of the 2016 Behavioral Risk Factor Surveillance System.

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  9. Ibid.

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  10. Ibid.

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  11. Ibid.

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  12. Infant Mortality Estimates: The World Factbook, 2017. Washington, DC: Central Intelligence Agency, Accessed November 2017, https://www.cia.gov/library/publications/the-world-factbook/index.html. Other Health Status Estimates: Reported for adults 18 and older. Kaiser Family Foundation analysis of the 2016 Behavioral Risk Factor Surveillance System.

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  13. “Medicaid and CHIP in the U.S. Virgin Islands,” MACPAC, October 2017, https://www.macpac.gov/publication/medicaid-and-chip-in-the-u-s-virgin-islands/.

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  14. Reported for adults 18 and older. Kaiser Family Foundation analysis of the 2016 Behavioral Risk Factor Surveillance System.

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  15. The ACA provided the U.S. territories with an additional $7.3 billion in Medicaid funding. The U.S. Virgin Islands received $273.8 million available between July 2011 and September 2019 under Section 2005 and $24.9 million available between July 2011 and December 2019 under Section 1323. “Medicaid and CHIP in the U.S. Virgin Islands,” MACPAC, October 2017, https://www.macpac.gov/publication/medicaid-and-chip-in-the-u-s-virgin-islands/.

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  16. U.S. territories do not receive Disproportionate Share Hospital (DSH) payments that are used in the 50 states and DC to provide supplemental payments to hospitals that service a high share of Medicaid and uninsured patients.

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  17. United States Senate, Committee on Energy and National Resources Hearing, Hurricane Recovery Efforts in Puerto Rico and the U.S. Virgin Islands, November 14, 2017, statement of Kenneth E. Mapp, Governor of U.S. Virgin Islands, https://www.energy.senate.gov/public/index.cfm/files/serve?File_id=A2538A49-2953-4BA1-8C94-0807E62050A5.

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  18. Jeremy W. Peters, “In the Virgin Islands, Hurricane Maria Drowned What Irma Didn’t Destroy,” New York Times (September 27, 2017), https://www.nytimes.com/2017/09/27/us/hurricane-maria-virgin-islands.html.

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  19. Samantha Raphelson, “2 Months After Maria and Irma, U.S. Virgin Islands Remain In The Dark,” NPR (November 14, 2017), https://www.npr.org/2017/11/14/564138720/2-months-after-maria-and-irma-u-s-virgin-islands-remain-in-the-dark.

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  20. “Hotel Property Updates,” VInow, November 27, 2017, http://www.vinow.com/recovery/hotel-property-updates/.

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  21. Richard Pérez-Peña, “After Irma and Maria: How 3 Spots on the U.S. Virgin Islands Are Faring,” New York Times (November 10, 2017), https://www.nytimes.com/2017/11/10/us/virgin-islands-hurricanes.html.

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