[Congressional Record Volume 167, Number 6 (Monday, January 11, 2021)]
[Extensions of Remarks]
[Page E25]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




          INTRODUCTION OF THE INSULAR AREA MEDICAID PARITY ACT

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                  HON. GREGORIO KILILI CAMACHO SABLAN

                    of the northern mariana islands

                    in the house of representatives

                        Monday, January 11, 2021

  Mr. SABLAN. Madam Speaker, President-elect Biden has pledged to 
address the healthcare disparity in minority communities that the 
coronavirus pandemic has laid bare. One longstanding disparity is that 
our national Medicaid program does not reach all Americans with full 
coverage.
  The Northern Mariana Islands, American Samoa, Guam, Puerto Rico, and 
the U.S. Virgin Islands are subject to a hard, statutory limit on 
federal Medicaid support, unlike the states and the District of 
Columbia. This cap means that preventative care and treatment for the 
poorest Americans in the insular areas will always be less available 
than for Americans elsewhere.
  The final Obama-Biden administration budget proposal, for fiscal year 
2017, addressed this systemic inequity by proposing an alignment of 
insular area Medicaid programs with the rest of the nation, first by 
removing the cap on Medicaid funding, so that it would no longer 
operate as a block grant in any insular area.
  Congress has also acknowledged this inequity. We acted to provide 
more Medicaid funding for the insular areas by substantially lifting 
the cap through P.L. 116-94, Further Consolidated Appropriations Act of 
2020. Provisions in P.L. 116-127, the Families First Coronavirus 
Response Act created equity between the states and the insular areas 
with respect to the increase in the federal-local match for Medicaid. 
Families First, also, provided additional federal dollars for the 
insular area Medicaid programs. But our actions were temporary. These 
funding increases expire at the end of fiscal year 2021.
  Now, Congress must act again. And in doing so, we must create an 
enduring policy that safeguards the health of the poorest Americans in 
our insular areas.
  To achieve that goal, I am introducing the Insular Area Medicaid 
Parity Act. My bill aligns with President-elect Biden's pledge to 
address healthcare disparities in minority communities by repealing the 
arbitrary cap on Medicaid for Americans in the insular areas.
  By repealing the cap, we will be doing more than just ensuring there 
are sufficient resources to face the coronavirus crisis. We will be 
setting up the healthcare systems in the insular areas to respond to 
the next public health challenge, whatever it may be. Most important of 
all, we will ensure that day-after-day and year-by-year those with the 
smallest incomes and no access to other insurance receive the care that 
will keep them healthy and help ward off debilitating disease.
  We will, also, be providing a level of certainty to healthcare 
providers--in the public and private sector--that will encourage 
investment in the health industry in the insular areas, which by any 
measure lags the rest of the nation. And by doing so we will create a 
virtuous cycle of rising quality of care powered by rising access that 
will benefit all at every income level.
  The pandemic has brought home this truth: none of us can truly remain 
well, while some of us are ill. Now it is time for Congress to fully 
commit to making sure the poorest in the insular areas are treated 
equitably.
  I thank my colleagues who joined me in introducing this legislation--
Chairman McGovern, Chairwoman Velazquez, Chairwoman DeLauro, Chairman 
Nadler, Mr. Cleaver II, Mr. San Nicolas, Ms. Radewagen, Mr. Espaillat, 
Ms. Lee, Ms. Moore, Mr. Cardenas, Ms. Bonamici, Mr. Sires, Ms. 
Barragan, Mr. Garcia, Mr. Hastings, Mr. Carson, Mr. Case, Ms. Clarke, 
Ms. Jackson Lee, Ms. Napolitano, Ms. Norton, Ms. Meng, Mr. Castro, Mr. 
Butterfield, Mr. Trone, Ms. Ocasio-Cortez, Ms. Gonzalez-Colon, Ms. 
Kelly, and Ms. Chu.

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