Washington, D.C. – Rep. Tony Cárdenas (CA-29), along with Representatives Amata Coleman Radewagen (R-AS), Tulsi Gabbard (D-HI), Steve Womack (R-AR), Ed Case (D-HI), and Gregorio Sablan (D-MP) have introduced the Covering Our FAS Allies (COFA) Act, which would reinstate Medicaid eligibility for citizens of the freely associated states (FAS) – the Republic of the Marshall Islands, the Federated States of Micronesia, and Palau.
Under the Compacts of Free Association with the FAS member nations, The United States has exclusive military use rights in these island nations that enable critical access in the Asia-Pacific region. In exchange, COFA citizens may enter into the United States to live, work, and study without a visa.
For years, FAS citizens residing in the United States were eligible for federal benefits, including Medicaid, as they were considered “permanently residing under the color of the law”. However, the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA) established comprehensive limitations and requirements on the eligibility of all noncitizens for means-tested federal assistance, including Medicaid.
“Reinstating Medicaid eligibility for FAS citizens residing in the United States is the strategically and morally right thing to do,” Cárdenas said. “The United States has long enjoyed a strategic agreement with island nations that allowed us to have a military presence there that is critical to our national security. We must honor our promise and follow through on our commitment to the people of these countries. We have ignored this problem for too long, and it is time we fixed it.”
“Our Compacts of Free Association with the Federated States of Micronesia and the Republics of Palau and the Marshall Islands are of critical importance to all of our countries, but the burdens of the Compacts fall disproportionately on a very few jurisdictions including Hawai’i,” Case said.
“The unreimbursed costs of the Compacts to the people of Hawai’i are estimated in the hundreds of millions of dollars annually and have materially worsened since Compact residents became ineligible for Medicaid, and Hawai’i assumed much of that burden. It is only fair that Medicaid eligibility be reinstated to ensure Compact residents can continue to access the care they need for themselves and for their families without jurisdictions like Hawai’i being asked to bear a disproportionate burden.”
At least 61,000 FAS citizens reside in the United States, where they are integral members of their communities; they pay federal taxes and serve in the United States military at a rate higher than that of American citizens.
“Many come to the United States because of health care needs – COFA citizens have disproportionately high rates of chronic diseases like obesity and diabetes, as well as high rates of some cancers,” states the press release from Cardenas’ office. “These conditions may be related to contamination from the 67 nuclear weapons tests conducted by the United States in the Marshall Islands between 1946 and 1958. The COFA Act honors our commitment to the citizens of these Island nations and reinstates their Medicaid eligibility that they rightfully deserve.”
FSM President David W. Panuelo welcomed the introduction of the bill, which he said “will help to ensure that FSM citizens who are lawfully residing, working, and paying taxes in the U.S. will be provided with much needed access to medical care and will help to improve existing healthcare disparities for our citizens.”
Medicaid assists U.S. citizens with low incomes in acquiring necessary medical services. Medicaid was once offered to citizens of the FSM, and the Covering Our FAS Allies Act would reinstate these services.
“The FSM National Government is deeply appreciative of the introduction of the Covering Our FAS Allies Act, and looks forward to working with its friends and allies to lobby the rest of the U.S. Government for its swift and bipartisan adoption,” the FSM Information Office stated in a press release.