[Congressional Record (Bound Edition), Volume 149 (2003), Part 3]
[Extensions of Remarks]
[Page 3699]
[From the U.S. Government Publishing Office, www.gpo.gov]




  ELIMINATION OF CAP ON MEDICAID PAYMENTS TO THE U.S. TERRITORIES AND 
                             COMMONWEALTHS

                                 ______
                                 

                       HON. DONNA M. CHRISTENSEN

                         of the virgin islands

                    in the house of representatives

                       Tuesday, February 11, 2003

  Mrs. CHRISTENSEN. Mr. Speaker, I rise today to re-introduce 
legislation which continues to be the highest health care priority for 
the more than 4 million residents of our country's off-shore areas--the 
elimination of the cap on Medicaid payments to the U.S. Territories and 
Commonwealths.
  Mr. Speaker and my colleagues, it saddens me as a physician, to 
report to you once again that our fellow indigent Americans living in 
American Samoa, Guam, Puerto Rico and the Virgin Islands who qualify 
for Medicaid, receive less than adequate health care because the amount 
of federal Medicaid dollars we receive falls far short of meeting their 
needs. Because we face depressed economies with high unemployment 
rates, as well as, a growing indigent population, the ever-increasing 
cost of health care coupled with the federal cap means that our local 
governments have to bear a significantly greater cost of the Medicaid 
program than their counterparts in the states. This means, that for the 
bare bones Medicaid program in the Virgin Islands, the federal 
government contributed only $5.59 million of the $14,394 in fiscal year 
2000 total cost of the program. In Guam, the local government spent 
three times more than the $5.4 million they received from the federal 
government to run their Medicaid program also in fiscal year 2000.
  Mr. Speaker, this is my fourth term as a member of the House of 
Representatives. Every year I have been here, fighting to eliminate the 
cap on Medicaid for the insular areas has never been far from my focus.
  Since becoming Chair of the Congressional Black Caucus Health 
Braintrust, I have garnered the support of my fellow Caucus members in 
calling attention to this problem and have made lifting the Medicaid 
cap for the off-shore areas a central item in the CBC's overall health 
care agenda. I thank my colleagues for the support they have given me 
on this issue.
  In 1997, we were successful with the help of the previous 
administration to secure important increases in our cap for which we 
were grateful but that was almost five years ago and the problems have 
gotten worse not better.
  It is time that our country ends this inequity and, in this one 
area--health care--treat all Americans alike, whether they live in a 
state or not. We must end the practice of residents of the territories 
and commonwealths having to leave their homes to seek more and better 
health care services on the mainland, often splitting-up families all 
because our Medicaid program is under-funded and our local governments 
can't afford to pay the difference.
  Mr. Speaker President Bush recently announced a proposal to modify 
and improve the way Medicaid works in the states. My colleagues from 
the off-shore areas and I look forward to working with the President, 
Health and Human Services Secretary Tommy Thompson as well as every 
member of this body to impress upon all of you the urgent need to end 
this unequal treatment of health care funding for the American citizens 
living in the territories and Commonwealths.
  I urge my colleagues to join my cosponsors and I in supporting this 
bill. All Americans deserve the same health care program that their 
government provides, regardless of where in the country they happen to 
live.

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