The Guam Daily Post

12 23Wed11252015


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FAS migrants not covered by federal healthcare package

WHILE President Barack Obama and the Democrats celebrated the hard-fought battle for the passage of the Patient Protection and Affordable Care Act, the government of Guam will continue to shoulder the cost of providing healthcare services to citizens of freely associated states.

FAS migrants are not covered by the new law because they are not U.S. citizens.

FAS include Marshall Islands, Federated States of Micronesia, and Palau.

Although most U.S. citizens from Guam will qualify for Medicaid under the new healthcare reform act, the locally-funded Medically Indigent Program will not be dissolved in the future.

Only U.S. citizens qualify for the federally-funded program and residents from these neighboring islands are not U.S. citizens.

Lobbying effort

When she was on Guam, Congresswoman Madeleine Z. Bordallo said she and her colleagues from the insular areas lobbied with federal officials, in an effort to convince them to expand the eligibility requirements for Medicaid to FAS citizens.

However, the recommendations did not make their way into the consolidated healthcare reform bill.


Senator Frank Aguon Jr. recently returned from a National Conference of State Legislatures to find out first-hand what the concerns are in other jurisdictions regarding the new healthcare reform act.

Aguon said the Department of Health and Human Services already sent a letter to all governors and independent insurance commissioners, asking each jurisdiction to express their interest in participating in the temporary high-risk pool program established by the health insurance reform law.

This program will help provide coverage to people who are uninsured because of pre-existing conditions, said Aguon.

States and territories may choose to participate and decide how to participate in the program. Guam must respond by April 30 to determine whether or not it will establish its own high-risk pool, said Aguon. If Guam doesn’t establish its own high-risk pool, DHHS will implement a coverage program for Guam, said Aguon.

Aguon said he discovered that the high-risk pool program will not take money out of local funds, since the federal government will assume the cost for the initial two years.

The amount of $5 billion has been set aside specifically to fund the pool for the initial two years, said Aguon.

The $5 billion will be available beginning on July 1, until the program ends on January 1, 2014, said Aguon.

By 2012, Guam will be receiving $42 million in Medicaid funding and for the next three years, Aguon said that the federal government will assume the costs for all applicants who qualify for Medicaid under the new guidelines. Breaking down the amount of Medicaid funding for Guam, Guam currently receives $14 million; by 2011 Guam will receive $24 million; by 2012 Guam will receive $42 million and by 2019 Guam will receive $58 million.

“By 2014, Uncle Sam will assume 100 percent of the cost, but after the three years, Uncle Sam will cover 90 percent of that total cost and GovGuam will need to come up with the 10 percent variance,” Aguon said.

Cost reduction

“The overall cost savings could translate to a cost reduction for the entire government of Guam- if we have people transitioning from MIP to Medicaid- that cost is not going to be consumed by the local taxpayers. This means freeing up money that can be used to fund our public health care centers and the Guam Memorial Hospital,” he added.

The current problem with the Medicaid program is that Guam must pay 50 percent in matching funds. For example, Guam receives $14 million in Medicaid funds from the federal government and Guam must come up with $14 million in matching funds.

Over the years, GovGuam at times has not been able to meet its matching funds of 50 percent and money has had to be returned to the federal government, Aguon said.

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