Introduction of the Ensuring Medicaid Continuity for the Insular Areas Act of 2024

Floor Speech

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Mr. SABLAN. Mr. Speaker, today, I introduce the Ensuring Medicaid Continuity for the Insular Areas Act of 2014, which would protect access to health insurance for our most vulnerable Americans in the territories. Specifically, my legislation would authorize the redistribution of unused Medicaid block grant funding to address shortfalls in the Northern Mariana Islands, Guam, American Samoa, and the U.S. Virgin Islands.

Medicaid programs in the U.S. territories are subject to a statutory cap, denying them the open-ended federal funding enjoyed by Medicaid programs in the states. Block grant programs, however, are inherently ill-equipped to respond to emergencies due to their fixed funding structure. This disparity most recently became pronounced during the COVID-19 public health emergency.

Congress knows well the challenges associated with block grant programs. That's why we designed contingency measures for other block grant programs, such as the Children's Health Insurance Program (CHIP). In the event of a funding shortfall, states and territory CHIP programs have access to multiple contingency measures to protect and sustain access to healthcare services. Territory Medicaid programs face similar funding challenges as CHIP due to their shared block grant structure yet lack equivalent contingency measures.

My bill, the Ensuring Medicaid Continuity for the Insular Areas Act of 2024, fixes this critical gap in our Nation's health safety net for Americans in the territories. Under terms set out by my legislation, territory Medicaid programs--like CHIP programs--would be better equipped to address emergencies through the redistribution of unused territory Medicaid allotment funds to shortfall territories.

This bipartisan legislation presents a common-sense, budget-neutral solution, establishing a long overdue fail-safe for Medicaid in the territories. The well-being of our citizens and the care to which they have access to, regardless of their geographic location, must be our top priority.

The gentleman from Guam, Mr. Moylan, and the gentlelady from American Samoa, Ms. Radewagen, are original cosponsors of the bill. I urge my colleagues to support this vital legislation and uphold our commitment to providing equitable health insurance coverage for all Americans.

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