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Territories secure permanent Federal Medical Assistance Percentage

Updated: Dec 26, 2022

By Pacific Island Times News Staff

The Consolidated Appropriations Act of 2023 released this week by the

U.S. Congress’ House and Senate appropriations committees extended the Medicaid funding for the U.S. territories.

The bill permanently extends the 83 percent enhanced Federal Medical Assistance Percentage (FMAP) for Guam, the Northern Marianas Islands, American Samoa and the U.S. Virgin Islands and 76 percent enhanced FMAP for Puerto Rico for five years until September 30, 2027.

Additionally, the bill creates Medicaid Data System Improvement Payments for Guam, American Samoa, the Northern Marianas Islands and the U.S. Virgin Islands.

These payments will be equal to 100 percent of the qualifying data system improvement expenditures incurred on or after Oct. 1, 2023, up to a total cap of $20 million equitably distributed across the four territories.


“This bill will help us provide greater access to health care and critical health services to those in our community most in need, a hallmark goal of our administration. The increased funding will help us treat more Medicaid recipients and use more innovative approaches to expand Medicaid services,” said Gov. Lou Leon Guerrero. “I want to recognize Speaker Pelosi, Congressman Soto, and Congressman Bilirakis who have been strong allies to the territories and have championed our needs for Medicaid in the Capitol.”

Lt. Gov. Josh Tenorio said securing this permanent funding solution provides hope to Medicaid patients that sufficient funding will be available for their healthcare needs.

In the CNMI, Delegate Gregorio Sablan said the 83 percent federal share for Marianas Medicaid is the highest for any state or territory and has been in place on a temporary basis since 2019.

"Without the extension in today’s fiscal 2023 spending bill the federal share would drop to 55 percent, requiring the Commonwealth to spend an additional $40 million to completely draw down available federal funds," Sablan said. “This is very good news for everyone in our islands and the result of many years of work."

In American Samoa, Congresswoman Uifa’atali Amata said the changes in Mecaid program will allow the American Samoa government to invest even more resources in other areas of healthcare, while also allowing potential healthcare providers more stability as they provide important services to American Samoa.

She noted that the legislation also included an increase of $1 million to American Samoa's operations account at the Department of the Interior.

“This permanent extension of the FMAP to 83 percent is a wonderful victory for the territories and all of us in Congress that shared this priority, as our people can now count on this non-emergency rate of federal support for the long term, rather than year-to-year,” said Amata.

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