February 27, 2019

Hirono Continues Advocacy to Restore Medicaid Eligibility for FAS Citizens

Discusses Economic Impact of Lost Medicaid Eligibility with Governors of Guam and the Commonwealth of the Northern Mariana Islands During Senate Energy and Natural Resources Committee Hearing

WASHINGTON, D.C. – Senator Mazie K. Hirono continued her longstanding advocacy to restore Medicaid eligibility for Freely Associated States (FAS) citizens living in the United States with the governors of Guam and the Commonwealth of the Northern Mariana Islands (CNMI) during a Senate Energy and Natural Resources Committee hearing to examine the state of U.S. Territories today.

Under the Compacts of Free Association (COFA) – a critical national security partnership in the Indo-Pacific Region – citizens of the Republic of the Marshall Islands, the Federated States of Micronesia, and the Republic of Palau are allowed to live and work in the United States as legal non-immigrants. However, the so-called “welfare reform” law cut off FAS citizens from accessing Medicaid and most other federal benefits.

From Senator Hirono’s Questioning:

“While most COFA citizens reside in Guam and Hawaii, CNMI as well as states like Arkansas, Oregon, and Washington also have high populations of COFA citizens. Now one of the issues we have involves COFA citizens’ for Medicaid. Back in 1996, when the so called welfare reform was enacted, eligibility for COFA citizens for a number of programs, social welfare programs including Medicaid was, in my view having done the research, inadvertently eliminated.

“Since then, the territories and states like Hawaii, they’ve have had to bear the expense for the care of COFA migrants. In 2014 alone, the state of Hawaii was estimated to have spent over $163 million for social services, healthcare and other services for COFA citizens residing in Hawaii, with 40 percent of that going to healthcare.  I know that you face similar concerns in Guam, having visited. Could you comment on the challenges that you face in dealing with the fiscal cost of COFA citizens coming to Guam and would you support legislation that restores Medicaid eligibility for COFA migrants? I would ask this of Governor Torres also. Also anyone that wishes to comment.”

Senator Hirono is a consistent advocate for restoring Medicaid eligibility for FAS citizens. Senator Hirono led efforts by Hawaii’s Congressional Delegation to introduce similar legislation during her service in the House and Senate. In 2013, Senator Hirono included an amendment that would have restored FAS citizen access to Medicaid in the Senate’s comprehensive immigration reform bill.

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