Micronesian migrants living in Hawaii under the Compact of Free Association are no longer covered by the state for Medicaid, but they are being enrolled for health insurance through the Hawaii Health Connector. This will save the state an estimated $27 million dollars.
In this legislative session, Hawaii lawmakers also introduced a pair of bills that would require the state to cover the costs of premiums, copays and deductibles to help low-income migrants. The Senate health committee advanced SB1327 in mid-February.
Reverend David J. Gierlach, the Rector at St. Elizabeth’s Episcopal Church, is sympathetic to the cause because a quarter of his congregation is Micronesian. He tells me this is a good move for several reasons.
"First, the needed care will probably be provided through emergency rooms which is horrifically expensive, thus burdening the entire community with unnecessarily high medical costs. Second, our nation caused many of the problems for which this population seeks relief and we have a moral obligation to address them.
Third, this really is a federal responsibility that should not be the obligation of a small state like ours, thus the need to reform the law that excludes them from Medicaid," says Gierlach.
In the 1940s and 1950s the US government used Micronesia and the Marshall Islands as the primary above ground nuclear testing site. The Federation of American Scientists reports the following regarding those tests:
Summary of 66 Nuclear Tests over Marshall Islands (1946-1958):
43 at Enewetak Atoll
23 at Bikini Atoll
Largest Hydrogen Bomb “Bravo” on March 1, 1954: 15 Megatons
Equivalent to 1,000 Hiroshima Bombs
Total of 66 Bombings: Equivalent to 7,200 Hiroshima Bombs in total or
600 Hiroshima Bombs per year or 1.6 Hiroshima Bombs per day over 12-year Nuclear Testing Program
In order to engage in these tests, whole populations were relocated off of ancestral islands, the culture was transformed from a subsistence diet to one based on rice and canned meat, and disease associated with the radiation and poor diet is endemic. Since then, the US military continues to have free reign throughout these islands and the adjoining ocean.
In exchange, people from this area are permitted to enter the US without visas and to work in the US. However, in the 1996 Welfare reform act, this population was barred from receiving Medicaid benefits, meaning that treatments such as dialysis and radiation treatment for cancer is not funded unless the state where the person resides agrees to fund it. Hawaii did fund this gap in coverage until the Lingle administration decided to reduce the permitted health care coverage.
There are an estimated 7,500 migrants affected by the health insurance changes. SB1327 seeks an estimated $8 million to cover the additional health care costs.
The bill has support from large medical entities like Hawaii Medical Services Association, the state's largest insurance company, and The Queen's Health Systems.