top of page
  • Writer's pictureAdmin

Governor says increase in Guam Medicaid enrolment includes FAS

By Pacific Island Times News Staff

Approximately 6,400 freely associated citizens previously enrolled with the locally-funded Medically Indigent Program have been migrated to Medicaid resulting in savings to the government of Guam, Gov. Lou Leon Guerrero said.

"Guam Medicaid increased the program income eligibility guideline and expanded coverage to the citizens of freely associated states increasing our enrollments," the governor said, disputing Congressman Michael San Nicolas' criticism against the "shockingly low" FAS enrollment in the fedeerally-funded program.

In a letter to San Nicolas, the governor said Medicaid enrolment increased by 2,454 -- from 43,238 in 2020 to 45,692 in 2021.

She said the increase comprised 436 Medicaid recipients eligible "through the increased income eligibility and the difference of 2,018 through the expanded coverage" to the citizens of Palau, Federated States of Micronesia and Marshall Islands, which are affiliated with the United States through the Compacts of Free Association.

Read related story

"Spreading misinformation and false allegations regarding our administration’s purported failure to enroll eligible members of our community in Medicaid, or in any other federal program the government of Guam administers, is irresponsible, divisive, and, frankly, disappointing," Leon Guerrero told San Nicolas.

In 1996, FAS citizens were removed from the Medicaid program. Their eligibility to the program was restored in H.R.4821, the “Covering our FAS Allies Act,” and as a clause in the Public Law 118-260, or the Consolidated Appropriations Act of 2021. It went into effect on Dec. 20, 2022.

As a result, Guam Medicaid's coverage has expanded to include FAS citizens through State Plan Amendment and mandated by PL 116-260 Consolidated Appropriations Act.

The Consolidated Appropriations Act of 2021 provided Guam Medicaid $127 million in lieu of the $19.2 million capped funding under the Social Security Act. It also increased the Federal Medical Assistance Percentage (FMAP) from 55 percent to 83 percent, reducing the required local match funding from 45 percent to 17 percent, which expired on Dec. 30, 2021.

The U.S. Health and Human Services Covid-19 public health emergency also provided an additional 6.2 percent, increasing Guam's FMAP from 83 percent to 89.2 percent, and increasing payment rates for inpatient and outpatient hospital services, physician services, home health services, clinic services and other practitioners' services during public health emergency period.

"With this funding, Guam Medicaid continued to provide timely payments to providers with no delays due to the unavailability of the local match, and increasing our provider participation that we continue to receive new provider enrollment," the governor said.


The governor said Guam Medicaid also increased the program income eligibility guideline reducing the uninsured population.

"Guam Medicaid is currently amending the state plan to increase the income eligibility of this group from 100 percent FPL to 150 percent FPL to be equitable with the other Medicaid groups' recent increased income eligibility guideline that was in effect Jan. 1, 2021," she said.

"Moreover, revising the hospital reimbursement rates to boost hospitals revenue and our economy, and adjusting the eyeglasses reimbursement rate to help Medicaid recipients defray the cost of eyeglass frame and lens in conjunction with adjusting the elderly and disabled income eligibility guideline for equitability of Medicaid groups," the governor added.

Subscribe to

our digital

monthly edition


bottom of page