[Congressional Record (Bound Edition), Volume 157 (2011), Part 3]
[Extensions of Remarks]
[Page 3859]
[From the U.S. Government Publishing Office, www.gpo.gov]




INTRODUCTION OF THE MEDICAID COVERAGE FOR CITIZENS OF FREELY ASSOCIATED 
                           STATES ACT OF 2011

                                 ______
                                 

                          HON. MAZIE K. HIRONO

                               of hawaii

                    in the house of representatives

                         Friday, March 11, 2011

  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.

                          ____________________