‘A shining moment’: U.S. Congress agrees to restore Medicaid for FSM, RMI, and ROP citizens

December 20, 2020

Congress plans to restore Medicaid access for citizens from Palau, the Marshall Islands and the Federated States of Micronesia living in the U.S., Politico reported Sunday. The change would help thousands of Pacific Islanders who have been hit hard by the coronavirus pandemic.

image U.S. Sen. Mazie Hirono (D-HI) has been a major supporter of Medicaid restoration for COFA migrants.

Congressional leaders confirmed to Politico Sunday that the change will be included in the omnibus spending bill.

Citizens of the three Pacific nations live in the U.S. through treaties known as the Compacts of Free Association that give the U.S. strategic control over the western Pacific Ocean. But Congress stripped the migrant community of access to Medicaid in the 1996 Welfare Reform Act.

That decision had major implications: even before the pandemic, Hawaii residents from Palau, the Marshall Islands and the Federated States of Micronesia struggled to access health care due to high costs.

The pandemic has laid bare major health inequities. In Hawaii, non-Hawaiian Pacific Islanders have the highest rates of COVID-19 infections, hospitalizations and deaths. Other states have seen similar trends. In Arkansas, Politico reported: “The local Marshallese were more than 71 times more likely to be infected by Covid-19 than the white population, 96 times more likely to be hospitalized and 65 times more likely to die.”

After Congress stripped Pacific Islander migrants of their access to Medicaid, Hawaii continued to provide it through state-funded MedQuest until Gov. Linda Lingle’s administration stopped doing so to save money.

MedQuest access was briefly restored after a class action lawsuit. But when the state won its appeal, Gov. David Ige’s administration pushed migrants onto Obamacare in 2015. A University of Hawaii study found that decision correlated with a sharp increase in mortality in Hawaii’s Micronesian community.

When reached by phone Sunday, Hawaii resident Josie Howard said she was crying tears of joy. Howard, who migrated from Chuuk decades ago, co-founded the community organization We Are Oceania in reaction to the lack of access to health care for her people.

“I think this is the best Christmas gift our community has ever got but it would not be possible without the push and the fight of Hawaii leadership,” she said,
crediting Sens. Mazie Hirono and Brian Schatz and Rep. Ed Case. “I want to deeply thank them from the bottom of our heart on behalf of our community.”

She noted the community has been waiting for more than two decades, and in the meantime her co-founder and fellow advocate Jojo Peter died. “I began to lose hope that this may not happen anytime soon,” she said.



  • Migrants to Guam from Compact of Free Association nations will be covered by Medicaid under a federal plan up for a vote by lawmakers, according to Guam Del. Michael San Nicolas.

    "For the first time since 1996, COFA migrants are slated to qualify in the upcoming vote on federal government funding for Medicaid coverage, which is at over 80% for Guam since we had the formula adjusted earlier in the year," San Nicolas said Monday.

    The formula adjustment and the COFA coverage "combined are huge for Guam, as it transfers Guam (Medically Indigent Program) cost centers to Medicaid, and has the costs covered over 80% federally, compared to Guam absorbing it at 100% locally," San Nicolas stated.

    The development comes as lawmakers in Washington prepare to debate and vote on a federal COVID-19 relief package.

    "More updates will be forthcoming over the next 24 to 48 hours, including on relief and stimulus packages," San Nicolas stated.

  • many many thanks to Congresswoman from Hawaii and all who support the passage of the bill..from the bottom of our hearts!
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