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GRMC exec says Guam needs to get all Compact migrants to switch to Medicaid

By Mar-Vic Cagurangan

There are 2,000 migrants from freely associated states living on Guam who are still under the Medically Indigent Program and getting them to switch to the federally-funded Medicaid will allow the government of Guam to gain more savings, according to Eric Plinske, vice president for corporate affairs at Guam Regional Medical City.

He recommended that additional savings be used to cover more uninsured patients on Guam.

More than 8,000 FAS citizens have so far migrated to Medicaid since the federal government restored their eligibility for the health care program with 100 percent coverage in 2020.

Eric Plinske

“We have a large population of our residency from those islands and the challenge we have is to let them know they have access to Medicaid right now,” Plinske said.

Migrants from the Compact of Free Association nations-- the Federated States of Micronesia, Palau and the Marshall Islands-- were inadvertently removed from the Medicaid program in 1996.

Their eligibility to the program was restored through H.R.4821, titled the “Covering our FAS Allies Act,” and as a clause in the Consolidated Appropriations Act of 2021, which went into effect on Dec. 20, 2020.

According to the governor’s office, Guam Medicaid's coverage has since expanded to include FAS citizens.

Prior to Medicaid reinstatement, Plinske said "many of the COFA citizens were either under MIP or uninsured."


Medicaid coverage for FAS citizens, however, does not apply in their home states, thus necessitating travel to any U.S. jurisdiction to be able to avail of the program.

“That's why we want the feds to put more money into their home islands to beef up their health care so they don’t need to travel to get their health care,” Plinske said.

He said no data are currently available at the hospital level to determine the number of FAS citizens who flew into Guam for medical care under the Medicaid program.

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.

The law also increased the Federal Medical Assistance Percentage from 55 percent to 83 percent, reducing the required local match funding from 45 percent to 17 percent, which expired on Dec. 30, 2021.

While the local match requirement bears on Medicaid expenditures for U.S. citizens, the costs incurred on FAS migrants' medical care are fully shouldered by federal funds.

The MIP program, on the other hand, is fully financed through local funds.


Plinske said GovGuam annually spent $15 million on MIP coverage for COFA migrants prior to the Medicaid reinstatement.

Getting the rest of the FAS migrants on Medicaid will free up the cost for GovGuam.

He said the second quarter report from the Department of Public Health and Social Services showed that the amount of MIP claims has plunged to only $2 million since the passage of the “Covering our FAS Allies Act.

However, he advised the government against cutting the MIP allotment.

Instead, he recommended that GovGuam expand the eligibility criteria to capture more of the uninsured segment of the Guam population.

“Keep the $15 million level to cover everybody else so that we don’t have an uninsured population,” he said.

GovGuam’s recently signed fiscal 2023 budget appropriates $8.5 million for MIP.

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