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Monday, December 21, 2020
Congress Restores Medicaid for COFA Citizens after 24 Years
By Selected News Articles @ 10:05 PM :: 3514 Views :: Health Care

Congress to Restore Medicaid for COFA Citizens after 24 Years

Politico: … The wait may be over for tens of thousands of Marshall Islanders after nearly 25 years of seeking to correct an oversight that denied them federal health benefits.

Congressional negotiators on Sunday agreed to allow Marshallese living in the United States to sign up for Medicaid, revising a drafting mistake in the 1996 welfare reform bill that barred the islanders from the program, according to three people with knowledge of the deal….

Democratic lawmakers like Sen. Mazie Hirono and her Hawaii colleagues had spent about two decades trying to restore the islanders’ coverage….

Sunday night’s deal was included in the larger coronavirus relief and year-end funding package that lawmakers also finalized on Sunday. That package still needs to be voted on by both chambers of Congress.

Spokespeople for Senate Minority Leader Chuck Schumer and House Speaker Nancy Pelosi confirmed that the package included the Medicaid fix, which has been estimated to cost about $600 million over a decade….

The deal would apply to islanders covered by the Compact of Free Association, or COFA, which covers citizens of the Marshall Islands, Palau and Micronesia. It was hammered out between the Pacific island nations and the United States in the decades after the U.S. military used the Marshall Islands as a testing site for dozens of nuclear bombs in the 1940s and 1950s. As part of the 1980s-era compact, the islanders were allowed special rights to resettle in the United States — and promised access to Medicaid….

POLITICO in January detailed how the Marshallese and other islanders lost access to Medicaid as part of a 1996 welfare reform package that barred them from signing up for the low-cost health program. While policy analysts have called it a legislative drafting mistake, the policy contributed to high rates of uninsurance, poor health outcomes and chronic disease that went untreated….

islanders also have been disproportionately affected by this year's Covid-19 pandemic….

read … ‘A shining moment’: Congress agrees to restore Medicaid for Pacific Islanders

KUAM: Medicaid could be available to migrant FAS citizens for first time since '96

CB: Congress Poised To Restore Medicaid For Micronesians

SA Editorial: COFA migrants need Medicaid

  *   *   *   *   *

Following Hirono, Schatz Advocacy, Congress Poised to Restore Medicaid Eligibility for Citizens of the Freely Associated States Living in the United States

Covering Our FAS Allies Act, Introduced by Senators Hirono and Schatz, Included in Bipartisan Omnibus Appropriations Legislation Unveiled Today

News Release from Office of Sen Mazie Hirono, Dec 21, 2020

WASHINGTON, D.C. – Senators Mazie K. Hirono (D-Hawaii) and Brian Schatz (D-Hawaii) announced that Congress is poised to restore Medicaid eligibility for citizens of the Federated States of Micronesia, the Republic of the Marshall Islands, and the Republic of Palau – collectively known as the Freely Associated States – living in the United States under the Compacts of Free Association (COFA) as part of the bipartisan omnibus appropriations bill unveiled today. 

If enacted, the legislation would expand health care access for thousands of COFA citizens living and working in Hawaii at a time when the community has experienced a disproportionate number of cases and deaths from COVID-19. It would help states like Hawaii and territories like Guam that have provided tens of millions of dollars in care and services to the COFA community that would otherwise be reimbursable under Medicaid.

“Restoring Medicaid access for COFA citizens has been one of my top priorities since arriving in the Senate in 2013, and this work has become only more urgent as the COFA community in Hawaii and across the country have experienced overwhelming levels of disease and death from COVID-19,” Senator Hirono said. “This bipartisan agreement will unlock new tools to assist the COFA community suffering from unequal access to health care. By allowing States to enroll COFA citizens in Medicaid, we are upholding the promises we made to our critical national security partners in the Freely Associated States, and supporting jurisdictions like Hawaii that have traditionally stepped in to provide health care for the COFA community.”

“For too long, Hawaii has shouldered the costs while COFA residents have struggled to get essential health care, so restoring this funding will help both our state and all COFA citizens,” Senator Schatz said. “This will help our state’s fiscal condition when we need it the most.”

Senator Hirono has been a consistent champion for restoring Medicaid access for COFA citizens during her time in the Senate, and has worked with the Hawaii Congressional Delegation to introduce legislation to do so in the 114th115th, and 116th Congresses. In 2013, she successfully included COFA Medicaid language in the Senate’s bipartisan Comprehensive Immigration Reform bill that passed the Senate in an overwhelming vote, but was ignored by the Republican-controlled House of Representatives. In July, Senator Hirono took to the Senate floor to urge Congress to restore Medicaid eligibility for COFA citizens as a way to assist a community suffering disproportionately during the COVID-19 pandemic.

As a member of the Senate Appropriations Committee, Senator Schatz has fought to protect federal funding to Hawaii for COFA citizens, securing millions every year in Congress’ annual appropriations bill. Last year, when an error at the Department of the Interior revealed an undercount of COFA residents resulted in an underpayment in federal funding for Hawaii, Schatz led calls to restore the funding which helps support services for COFA citizens, including health care, education, and transportation.


FSM: United States Congress Votes to Restore Medicaid Eligibility for FSM Citizens Lawfully Residing in the U.S.

CB: The change could help an estimated 25,000 people in Hawaii.  

SR: Pacific Islanders living in Spokane may finally be able to access health coverage 

NBC: U.S. restores Medicaid for Marshall Islands, exposing longtime injustice, experts say

P: How 100,000 Pacific Islanders got their health care back


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