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Introduction of the Medicaid Coverage for Citizens of Freely Associated States Act of 2011

Floor Speech

Location: Washington, DC

Ms. HIRONO. Mr. Speaker, I rise today to introduce the Medicaid Coverage for Citizens of Freely Associated States Act of 2011. I would like to thank Congressman Eni Faleomavaega, Congresswoman Colleen Hanabusa, and Congresswoman Madeleine Bordallo for cosponsoring this bill.

Compact Migrants are citizens from Micronesia, the Marshall Islands, and Palau that have migrated to the United States. Citizens from these countries are allowed to freely enter the United States without a visa, criminal background check, or health certification due to agreements signed by the Federal Government.

The 1996 Personal Responsibility and Work Opportunity Act prohibited Federal Medicaid payments for nonimmigrants, a category that includes Compact Migrants. Prior to this specific prohibition, Compact Migrants were covered by Medicaid. Since enactment of the Federal welfare reform law, state and territorial governments have been the sole sources of funding for meeting the social service and public health needs of this ever growing population.

In 2007, Hawaii spent over $37 million to cover the health care costs of the state's Compact Migrant population. Of this amount, $30 million would have been eligible for partial Federal reimbursement through the Medicaid program.

The decision to allow citizens of the Freely Associated States to come to the United States was a Federal decision; however, the cost of that decision has fallen mainly on a handful of states and territories. Most Compact Migrants have settled in the Pacific region, likely because the environments and climates are similar to their home nations. Hawaii is home to 12,215 Compact Migrants; Guam, 18,305; and the Commonwealth of the Northern Marianas Islands, 2,100. Compact Migrants are also on the continental United States, including California, Oregon, Washington, and Arkansas--a state where they have been specifically recruited as laborers. Restoring Medicaid coverage is the only fair way to address the Federal mandate.

Our former colleague and now Governor of Hawaii, Neil Abercrombie, worked with Congressman Eliot Engel and Congresswoman Anna Eshoo on an amendment to provide Medicaid coverage for Compact Migrants during the mark-up of the House health care reform bill by the Energy and Commerce Committee. This amendment was adopted by the Committee by a voice vote.

Regrettably, the Senate health care reform bill did not include comparable language. So today, I am introducing that same, bipartisan supported amendment language as a stand-alone bill.

Restoring the Medicaid eligibility of Compact Migrants is an important issue not only for Hawaii, but also Arkansas, California, Oregon, and Washington as well as the territories of American Samoa, Guam, and the Northern Marianas Islands. I look forward to continuing to work with my colleagues on this important issue.

Mahalo nui loa.


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