[Congressional Record (Bound Edition), Volume 146 (2000), Part 13]
[House]
[Pages 18819-18820]
[From the U.S. Government Publishing Office, www.gpo.gov]



                       FIX 96/FIX THE TERRITORIES

  The SPEAKER pro tempore. Under a previous order of the House, the 
gentleman from Guam (Mr. Underwood) is recognized for 5 minutes.
  Mr. UNDERWOOD. Madam Speaker, I rise to the floor today to talk about 
an issue in the context of the appropriations struggles that we are 
having, and that is to bring a modicum of fairness and justice to the 
people, American citizens, of the U.S. territories.
  It is ironic that there are many proposals around today which I 
endorse which will restore some of the benefits that have been taken 
away since 1996 for legal residents, not U.S. citizens of the United 
States, including some access to health care.
  At the same time that we are doing this, health care for U.S. 
citizens in the territories like my home island of Guam are severely 
hampered by the fact that Medicaid assistance to the territories is 
capped at certain amounts; for Guam it is $5.4 million. Moreover, the 
match between the local government and the Federal Government is fixed 
at 50/50.
  Madam Speaker, what this means essentially is that if the government 
of Guam is to participate in the Medicaid program, which it currently 
does and for this past year it did and spent some $14 million in 
Medicaid, the actual share that the government of Guam paid is not at 
50/50, but is somewhere along the line of 70/30. And as a consequence, 
the people of Guam, the resources are taxed to a greater extent than is 
to be expected.
  The territories, especially Guam, have not shared in the economic 
boom that has occurred. In the 1990s, we have not shared in the 
economic boom that the U.S. mainland has enjoyed; and as a consequence, 
with double digit unemployment and the fact that the numbers of low-
income people and people eligible for Medicaid has dramatically 
increased, not only due to poor economic statistics, but immigration 
from

[[Page 18820]]

surrounding islands, under compacts of free association agreements with 
the United States. As a consequence, the people of Guam have to share a 
much bigger burden than the average citizen in the U.S. mainland for 
the provision of medical care for the indigent and the low-income.
  What we proposed, and I think all of the representatives of the 
territories, I know all the governors of the insular areas as well, 
have proposed that either the caps be lifted or the cost-sharing 
arrangement be altered. Preferably, we could do both.
  But at a minimum, we need to provide relief to these insular areas, 
and the way that we can do it is to secure within the context of the 
current appropriations process a little bit of increase in the caps, 
not to raise the cap entirely, but at least to raise the dollar amount 
on the cap, not to eliminate caps, but to at least raise the dollar 
amount on the caps.
  We have raised this issue; I have personally raised it with the 
President in a meeting on Tuesday. We have raised this issue with a 
number of White House officials. We raised this issue with leaders here 
in Congress. And although it is perhaps a little bit late in the game, 
it is important that if we think that health care access should be 
extended to all people who live in the United States, regardless of 
their ability to pay and regardless of their legal status at a minimum, 
U.S. citizens in the territories should be included.
  So we hope that in the context of the negotiations and the 
discussions over Medicaid payments, that there will be increases 
lifting, not eliminating, the caps, but at a minimum at least lifting 
the caps for Guam and American Samoa and Puerto Rico, the U.S. Virgin 
Islands and the Northern Marianas.

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