[Congressional Record Volume 148, Number 53 (Thursday, May 2, 2002)]
[Extensions of Remarks]
[Page E674]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                    AMERICAN SAMOA MEDICAID PROGRAM

                                 ______
                                 

                       HON. ENI F.H. FALEOMAVAEGA

                           of american samoa

                    in the house of representatives

                         Wednesday, May 1, 2002

  Mr. FALEOMAVAEGA. Mr. Speaker, I rise today to introduce a bill to 
provide American Samoa with treatment under the medicaid program 
similar to that provided to States.
  American Samoa receives only about $3 million annually in medicaid 
reimbursement. Each year, American Samoa's expenditures exceed its 
federal fiscal ceiling. For example, in FY 2000, Medicaid expenditures 
were $4,909,677, or $1,709,677 over ceiling. Although Congress adjusts 
the federal fiscal ceiling annually for the states based on the 
percentage change in the medical care component of the consumer price 
index for the preceding year ending in March, this adjustment has very 
little relation to the needs of American Samoa.
  The fact of the matter is American Samoa pays a higher federal match 
than 40 other states yet the per capita income in American Samoa is 
less that $4,500 per year. More than 56% of the population lives below 
the poverty level. All on-island heath care is provided by the LBJ 
Tropical Medical Center.
  Construction of the LBJ medical center was completed in 1967. The in-
patient wards have not been renovated since this time. The patient 
wards have no air conditioning. Bathroom and washroom facilities are 
inadequate and many of these wards do not even meet fire safety codes 
and ADA standards and requirements.
  In order to meet fire safety codes and ADA standards, the LBJ 
Tropical Medical Center is in need of upgrading or installing 
restrooms, medical air, medical vacuums, piped oxygen, proper lighting, 
a nurse call system, a fire sprinkler system, and sufficient electrical 
outlets for medical equipment.
  However, the LBJ Tropical Medical Center does not operate at a profit 
and is consistently strapped for funds because every year medicaid 
expenditures exceed the federal fiscal ceiling. Mr. Speaker, I am not 
asking for millions of dollars to address the inequity that currently 
exists in the way we provide for the medicaid needs of American Samoa.
  I am simply asking that the federal ceiling for American Samoa be 
raised to $10 million. I am also asking that the calculations used to 
determine the federal match for the states be applied to American 
Samoa. Currently, our federal match is fixed at 50%. Year after year 
we're at 50% with no thought or review or consideration by Congress to 
adjust this match to more adequately address our needs.
  Mr. Speaker, it is time for the U.S. Congress to take this issue 
seriously. The bill I have put forth is a fair and reasonable approach 
to provide for the health care needs of low-income residents in 
American Samoa. I urge my colleagues to support this bill.

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