Guam Governor Want COFA Nations To Help Cover COFA-Migrants Hospital Bills

Migrants' home nations could be asked to help pay hospital bills

Kevin Kerrigan | The Guam Daily Post Feb 12, 2019 Updated 18 hrs ago
Gov. Lou Leon Guerrero will consider asking the Federated States of Micronesia, the Republic of Marshall Islands and the Republic of Palau to help cover the costs of providing care for their citizens at Guam Memorial Hospital.

The governor mentioned this and other ideas to help provide financial support to GMH during her visit to the government hospital on Monday.

During a meeting with hospital employees, Leon Guerrero suggested one way to help reduce the $30 million shortfall GMH faces every year is to recognize the health insurance coverage the island nations' governments already provide to their citizens. GMH could then file claims for the care the hospital provides to the regional migrants from the island nations who have no insurance.

“When we see that 25 percent of the patients that come here are not paying, we have to look and see what we can do,” Leon Guerrero said.

“Can we talk to the various island nations whose residents are here ... and not able to pay?” asked the governor. “Can we work closely with those leaders in Micronesia to see if we can have a partnership?”

She suggested working in conjunction with the leaders of Micronesia and working out an agreement for GMH to be reimbursed for the millions of dollars in medical care it provides to the regional migrants.

Finding $30M

“We don’t really need to wait for a dedicated funding source to fund the hospital,” said the governor.

“My contention has always been that if the hospital needs $30 million from the government to make sure that our patients and our people are given quality health care, then we need to give the $30 million.”

GMH also needs to be fiscally responsible and cut back waste, the governor said.

The island’s only public hospital needs to be more efficient in collecting its bills and make sure that the bills are accurate, she said. When accurate bills are sent to the health insurance companies, there would be no reason to deny those claims, the governor added.

She said she has been working with the Department of Revenue and Taxation to collect taxes that haven’t been remitted. “We’re also looking at improving the collection process, providing automation and technology so that they can collect the money right away,” she said.

The department has partnered with the Office of the Attorney General “to make sure that we get those funds that have to be collected,” she said. The AG's office is focusing on filing cases against bounced-check issuers and making sure that all businesses are licensed and paying their taxes.

“We’re looking at every area of possibility to improve the revenues of our government and also to decrease the costs,” Leon Guerrero said.


  • this has been a trend for the Guam government to carry the burden result of the compact impact to their government not only in Guam but also in Hawaii, I think this is not fair because the citizen are for the COFA government and the COFA government should take responsibility of their own citizen and work with the compact impacted government. it is a collective responsibility and the COFA must own -up and not look like crooks trying to escape their responsibilities.
  • Perhaps there is reason the USA doesn't refund that hospital's receipts.
  • well, there could be, and given the fact Trump has cut a significant cut to the Medicaid and all entitlement funding in short, "the safety net".? meaning America is not safe any much for #MAGA..
  • Folks,
    In my own opinion and not intruding on anyone's intellect, I agree with the Governor of Guam when she mentioned that COFA should be also responsible for this. All COFA Governments should chip in and help out GMH similar to how Guam, CNMI & Honolulu has helped us. We enter into their islands for work, education and pleasure, why don't our Governments see how we can help out each other instead of playing dump as if we do not know what our citizens have caused.

    Like I said, this is my opinion and I don't mean any disrespect to anyone. We should be fare to our neighboring islands who help the FSM, RMI & the RoP.
  • I kind of agree but I am wondering if Guam or Hawaii get US federal funding to cover extra expenses for new legal immigrants who come to Guam, such as those from the Philippines, S. Korea, etc.? Or, if the governments of the Philippines or S. Korea are being asked to provide funding to their people who have immigrated to the US. If they are, then, it would be fair to ask the FAS governments to pay. If not, then, it seems unfair--since Micronesians are moving to these places legally. Just curious.
  • The problem is, these COFA states are broke so what they need to do is to work with the state of Guam and Hawaii to negotiate the US government to raise the compact impact funding to these states or something or re allocate the health funding in the compact to cover COFA citizens living in the US...I know it not easy but it is the fair thing to do.. in my own opinion..
  • Marc/VisaFree,
    You should read through the Compact of Free Association where it allows COFA citizens go in and out of the US without any visa or any other authorities and vise versa for the US Citizens into COFA States.

    Philippines and Korea are not COFA so for them to come and live in the US would be a different story. We have to also understand and realize that only a small portion of these COFA citizens causing all these problems. Yes, the COFA Government should seriously look into how they can assist Guam and Hawaii on medical expenses and also see how we can also assist in our citizens whom incarcerated on those islands as well?
  • @visafree, cutting aid to medicaid wouldn't have made a difference since the feds have already settled on the amount the federal reimbursement for the medical bill of COFA citizens. Educate thyself and read the COFA agreement which were signed 30 years ago before TRUMP came along. Slow down on the Trump derangement syndrome.
  • I was only thinking outside the box because it looks to me the COFA Governments are stuck in the COFA and it is a living document (treaty) I'm sure there are arears that could be revisited in the cofa to make it work better for the people? if the cofa communities in the US can negotiate and be succeeded what that tells you @ reaper?
  • How do we know the governor is not double dipping? The reason student tuition and health care are so expensive are due to government intervention programs. Universities and hospitals raise their prices because they know government will ultimately foot the bill. Keep the government out of it and they will lower their prices.
  • Talking about compact impact, Guam’s $14.9 Million Share of 2018 Compact Impact Funding to Support Government Operations and School Building Lease Payments, what happened to it?

    Interior Assistant Secretary for Insular Areas Doug Domenech has announced that Guam’s 2018 share of Compact Impact funding, $14.9 million, is being provided to the Government of Guam for costs associated with providing education, public health, and public safety-related services for the residents of the territory. Guam Governor Eddie Calvo has requested the use of $6.7 million towards school building lease payments and $8.2 million towards offsetting government operational costs.

    “I am pleased to allocate these funds to cover the costs of priorities identified by Governor Calvo on behalf of the federal government,” said Assistant Secretary Doug Domenech. “This funding is allocated by Congress to help Guam address impacts on public services by residents who hail from the Federated States of Micronesia, the Republic of the Marshalls, and the Republic of Palau, and ultimately helps bolster public services for the people of Guam.”

    Compact Impact Assistance to Guam for fiscal year 2018 will support the following:

    $6,661,550 for the Guam Department of Education School Leaseback Program. Started in fiscal year 2007, the program was to finance, design, build, maintain, and leaseback four public school facilities: Liguan Elementary School; Adacao Elementary School; Astumbo Middle School; and Okkodo High School. Completed in 2008 and 2009, the schools have been occupied since. Leaseback payments will be completed in 2023.
    $8,245,121 will be available to the Government of Guam as a general operations offset to reimburse costs associated with providing education, public health, and public safety-related services.
    Under the Compacts of Free Association first approved in Public Law 99-239 (1986) and Public Law 99-658 (1994), and later amended in Public Law 108-188 (2003), citizens of the Federated States of Micronesia, the Republic of the Marshall Islands, and the Republic of Palau are legal nonimmigrants allowed, for indefinite periods of time, to live, work, and study in the United States without a visa. The final Compact agreement in 1994 terminated what was then the Trust Territory of the Pacific Islands, providing the U.S. with important strategic denial rights to the western Pacific region between Guam and Hawai‘i. In 1996, under the Personal Responsibility and Work Opportunity Reconciliation Act, nonimmigrants living and working legally in the U.S. under the Compacts were deemed ineligible for federal public benefits. Thus began what has been a rising concern for the Governments of Guam and Hawaii, as U.S. ports of entry in the Pacific, who have directly borne the cost of public services related to migration under the Compacts, often referred to as “Compact Impact”.

    In 2003, the U.S. Congress allocated $30 million annually to Guam, Hawaii, the Northern Mariana Islands, and American Samoa to assist in defraying costs due to increased demands placed on health, educational, social, or public sector services, or infrastructure related to such services due to Compact Impact. The funds are currently distributed using a ratio allocation based on a 2013 U.S. Census Bureau enumeration. Per that enumeration, there are an estimated 17,170 Compact migrants on Guam, roughly ten per cent of Guam’s total population. The U.S. Census Bureau is conducting a new enumeration expected to be completed in 2018.

    Under current law, Compact Impact funding expires in 2023.
  • This is not some issue for that nation, I am saying that if and IF anyone pays for her/his insurance policy there would be no problem..Ladies and Gentlemen buy your health insurance!!!! knuckle heads!
  • I believe most COFA citizens in both Guam and Hawaii have insurance, but a mere small fraction of them do not have.
  • "A small fraction" of Micronesians with a $30 million annual shortage at GMH...??? Either the governor needs to re-examine her hospital's claims or lower their ridiculous prices. Exploiting sick people is just bad taste. Then again, she is a democrat.
  • Yes, when Guam gets a republican governor, he/she can deport all these sick and lazy migrants back to their home islands....then build a seawall to keep them out. Trump will love it. lol
  • The previous governor, Calvo, was a republican and he commuted incarcerated criminal aliens back to their island of origins -- not sick people. He didn't build a seawall for criminal aliens either. Please refrain your fake news, "Facts Matter." You must be down with TDS, because your name is becoming an ironic misnomer.
  • Speaking of facts, who said, "I will build a great wall and Mexico will pay for it."

    (Hint: His name rhymes with rump and he is a republican.)
  • If you cannot figure it out yourself, ask any of his deranged followers who believed his lies and voted for him. TDS
  • The Trump derangement syndrome is showing again. Ain't the Guam gov a Democrat? Blaming Trump for what a Democrat is doing.
  • @visafree, you do not make sense at all. You cited a non factual reason as to why the this is a trump fault by saying its because Medicaid was cut when the amount that the federal government covered and reimbursed the states and territories was set in stone 30 years ago. We shouldn't let TDS/Trump Derangement Syndrome get the best of us or cloud our judgment.

    @FactsMatters, those being deported were deported because they committed violent crimes in Guam and agreed to get deported if their sentences were reduced. Lets not spread fake news and make it appears as if those COFA migrants were deported for no reaso. Majority of the Micronesian community in Guam agree with the deportation but want the deportees to do their time in jail in Guam before being deported. Micronesians like Vid Ratioor who is running for government office in Chuuk said it well when he said "let them do their time in Guam and then deport them back here\FSM"

    As for the wall Democrats now offer money for 55 miles of border wall/fences. 102 miles of wall already up plus tue 30 miles thats going up in Texas plus thia 55 miles that Democrat are offering is 190 miles of 30 feets oc concrete and steel aka the Border wall. 800 more miles to go. Little by little the wall is going up. lol

    The Democrat Governor of Guam is looking for a excuse to raise taxes.
  • I hope Trump accept the latest democrats offer of 1 and a half billion for wall and then declare national emergency which will bring another 7 billion for the wall. All in all the total will be 8 billion for the wall. Democrats will try to halt it in the courts but in the end like travel ban it will be declared legal then it will be build.
  • It will be another illegal act pulled by the dictaror in the Whitehouse. Declaring a national emergency to build a wall is unconstitutional and shows again why Trump is a dictator.
  • How is it illegal when Congress, the body that makes and enact law gave that power to the executive branch decades ago? Can Trumps declare a national emergency to build a wall? Yes. Legal experts say the act gives the president the power to declare a national emergency. But the act does not require presidents to prove a crisis exists to declare an emergency — it's at their sole discretion.

    National Emergencies Act of 1976

    Graham who was against Trump few years ago is now advising the President to do it. Declare emergency to get funds for the wall and build it.
  • How is it illegal when Congress, the body that makes and enact law gave that power to the executive branch decades ago? Can Trumps declare a national emergency to build a wall? Yes. Legal experts say the act gives the president the power to declare a national emergency. But the act does not require presidents to prove a crisis exists to declare an emergency — it's at their sole discretion.

    National Emergencies Act of 1976

    Graham who was against Trump few years ago is now advising the President to do it. Declare emergency to get funds for the wall and build it.
  • Trump is being urged to accept the latest democrat offer of 1 and a half billion that will get 55 miles of wall build and declare a national emergency at the same time along with accepting the deal. 2 things done at the same time.
  • of course its a fact, Trump has cut a significant cut to all entitlements including Medicaid, Hud, and the rest of the safety net that was created to help the poor and the low income wager, and now he is looking at emergency disaster funding too so that he can build his promise stupid wall? This dude is a communist socialist maniac, oh btw he is doing all these just to distract the public from what is now being delivered to public view about his former campaign manager Manafort being a Russian agent after Court Judge found him a lying to Muller investigation.. This President is like a candle in the wind when it comes down to the far right conservative media and the republican leader Mitch Mac Donald is just a puppet..
  • You Trump supporter in here are bunch of IDIOTS!!!
  • Don't you love that Trump derangement syndrome? Blaming him for the federal reimbursements to the state's and territories that was settled 30 years ago. Communist socialist maniac. Hmmm.....That communist socialist maniac is against free healthcare and the green deal that the real communist socialist are
  • STOP IT!!!! I was hoping to be educated with the issue from governor of guam. can we hear more from her plans on this issue and what Guam legislative have to say? its a developing story here....
Sign In or Register to comment.