SEVENTY years ago, Guam was a war-torn island and our people were struggling to rebuild broken lives even as their eyes squinted through the glare of hard-fought liberation. Yesterday, we were picking through the rubble of yet another super-typhoon that had destroyed our fragile economic infrastructure, leaving every single Guamanian, rich or poor, on the doorsteps of the Third World.

Today, more than 40,000 Guamanians – nearly one-third of our entire population – cannot afford to buy medicine or take care of their sick children and are poor enough to qualify for federal welfare. Grandiose plans for economic growth and private sector expansion will be fruitless if our people, especially our most needy families, cannot take advantage of the opportunities before us.

Last week, the Guam Medical Association convened a discussion of the recent U.S. Supreme Court ruling on the Patient Affordability Care Act (aka Obamacare) and its impact on Guam. Meeting with island policymakers and health insurance executives, the GMA doctors learned that the governor of Guam’s office thinks Obamacare may be an injustice to our territory.

Gov. Calvo’s chief policy advisor Arthur Clark said, "With the passage of Obamacare, the federal government will pay 100 percent of Medicaid costs for every single state that opts in for three years. And the qualifications for Medicaid rises for those Americans at 100 percent of the national poverty level to 133 percent. That means millions more will have access to Medicaid. That all sounds really good except Guam and the territories won't get that 100 percent gift. As a matter of fact, our matching requirement will remain at 45 percent until the year 2019. No one knows what will happen after that. As for the states that will get 100 percent for three years, they will only end up matching 10 percent after that."

Medicaid is a health subsidy program for indigent individuals and families. The federal and state governments share Medicaid costs. Gov. Calvo’s office pointed out that states with similar poverty levels as Guam like West Virginia, Texas and Mississippi are currently only required to match 20 percent of the federal contribution in Medicaid funding. Meanwhile, Guam and the other U.S. territories have to put up 45 percent of the federal Medicaid match.

Although possibly inequitable, Obamacare did provide $6.3 billion in additional funding for Medicaid in the territories from Fiscal Year 2011 through FY2019, and increased the territories’ Federal Medical Assistance Percentage from 50 percent to 55 percent. Guam’s Medicaid funding doubled to more than $25 million in Fiscal Year 2011 and will nearly double again to $42 million in 2012. 

Medicaid assistance to Guam will continue to rise for the rest of the decade, reaching approximately $58 million by 2019. Adjusting for inflation, this represents a tripling of federal Medicaid assistance to Guam.

As Delegate Madeleine Bordallo's Guam District Office director Joaquin Perez said, Medicaid is going to be the largest insurance policy on this island. A large segment of Guam’s uninsured population will migrate over to Medicaid. That number will likely be about 44,000 people. If Guam taxpayers budget the “low” national average for Medicaid spending at $1,000 per Medicaid member per year, maximum local funding would be approximately $19.8 million. This local investment would allow up to $42 million in matching federal funds to strengthen Guam’s healthcare system.

Today, our island's people are struggling to pay for cancer medicines and to deal with catastrophic disease. You can see family members begging for money on the side of the streets while their dying loved one waits for a kidney transplant or lifesaving heart surgery. As Gov. Calvo calls for $43 million in government cutbacks and islandwide worker layoffs, the need for egalitarian economic pain has never been more necessary.

New senators like Dennis Rodriguez, Chris Duenas, Mana Silva, Aline Yamashita and Tony Ada must now have the moral fortitude to take back the $65 million in gross receipt tax exemptions to hotels, banks and insurance companies. Devoid of any socio-economic benefit, GRT exemptions are a legacy of the "Me-First" attitude of previous Guam politicians. Hopefully, our young senators will act soon. Otherwise, please vote carefully for someone else this November. Have a nice day.