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Mr. AKAKA. Mr. President, I rise today to introduce the Medicaid Restoration for Citizens of Freely Associated States Act of 2011. This bill would reinstate eligibility for critical federal health benefits for citizens of certain Pacific Island nations who have been invited by the federal government to live in the United States, but for whom the costs of services have fallen to individual states, Hawaii in particular. I would like to thank Senators Inouye and Bingaman for joining me in introducing this bill.
The Freely Associated States - the Republic of the Marshall Islands, the Federated States of Micronesia, and the Republic of Palau - are island nations that have a unique political relationship with the United States.
At the end of World War II, the United Nations established the "Trust Territory of the Pacific Islands," which was administered by the United States between 1947 and 1986. It included the islands that now make up the FAS nations, as well as other Pacific islands liberated from Japan after World War II.
This U.S. Trusteeship presented the federal government with new strategic and military opportunities, allowing the United States to establish military bases and station forces in the Trust Territory and close off areas for security reasons. It also bestowed upon the United States the responsibility to promote economic development and self-reliance for the territory.
In the 1980s, the United States entered into a new phase in its relationship with the FAS through the Compact of Free Association and the Palau Compact of Free Association. The Compacts allow FAS citizens to freely enter, reside, and work in the United States and authorize their participation in certain federal programs.
As a part of the Compacts, FAS citizens were extended Medicaid eligibility.
Unfortunately, when the Personal Responsibility and Work Opportunity Act of 1996 was enacted, FAS citizens lost many of their public benefits, including Medicaid coverage.
Subsequently, state and territorial governments have been the sole sources of funding for meeting the social service and public health needs of this ever growing population. And FAS migrants to Hawaii often arrive with serious medical needs, requiring costly health care services such as dialysis and chemotherapy.
These costs will continue to rise, even as the state's resources are increasingly constrained.
Restoration of Medicaid eligibility for these individuals is crucial for states where many FAS citizens reside. In the Pacific, this includes Hawaii, Guam, and the Northern Marianas Islands. In the continental U.S., this includes California, Oregon, Washington, and Arkansas. Health care providers that operate in areas with high rates of uninsured are having difficulties meeting the health care needs of their communities. Uninsured FAS citizens who seek health care services contribute to the uncompensated costs that are creating an ever-greater burden on health care providers.
I ask my colleagues for their support of the Medicaid Restoration for Citizens of Freely Associated States Act of 2011. The decision to allow citizens of the Freely Associated States to come to the United States was a federal decision, with national benefits.
That we also accept the cost of that decision is a matter of fairness and responsibility.
Thank you, Mr. President. I ask that the full text of this bill be printed in the Record immediately following my remarks.
Introduction of the Medicaid Restoration for Citizens of Freely Associated States Act of 2011
Floor Statement of Senator Daniel K. Akaka
Tue, August 2, 2011
Mr. AKAKA. Mr. President, I rise today to introduce the Medicaid Restoration for Citizens of Freely Associated States Act of 2011. This bill would reinstate eligibility for critical federal health benefits for citizens of certain Pacific Island nations who have been invited by the federal government to live in the United States, but for whom the costs of services have fallen to individual states, Hawaii in particular. I would like to thank Senators Inouye and Bingaman for joining me in introducing this bill.
The Freely Associated States - the Republic of the Marshall Islands, the Federated States of Micronesia, and the Republic of Palau - are island nations that have a unique political relationship with the United States.
At the end of World War II, the United Nations established the "Trust Territory of the Pacific Islands," which was administered by the United States between 1947 and 1986. It included the islands that now make up the FAS nations, as well as other Pacific islands liberated from Japan after World War II.
This U.S. Trusteeship presented the federal government with new strategic and military opportunities, allowing the United States to establish military bases and station forces in the Trust Territory and close off areas for security reasons. It also bestowed upon the United States the responsibility to promote economic development and self-reliance for the territory.
In the 1980s, the United States entered into a new phase in its relationship with the FAS through the Compact of Free Association and the Palau Compact of Free Association. The Compacts allow FAS citizens to freely enter, reside, and work in the United States and authorize their participation in certain federal programs.
As a part of the Compacts, FAS citizens were extended Medicaid eligibility.
Unfortunately, when the Personal Responsibility and Work Opportunity Act of 1996 was enacted, FAS citizens lost many of their public benefits, including Medicaid coverage.
Subsequently, state and territorial governments have been the sole sources of funding for meeting the social service and public health needs of this ever growing population. And FAS migrants to Hawaii often arrive with serious medical needs, requiring costly health care services such as dialysis and chemotherapy.
These costs will continue to rise, even as the state's resources are increasingly constrained.
Restoration of Medicaid eligibility for these individuals is crucial for states where many FAS citizens reside. In the Pacific, this includes Hawaii, Guam, and the Northern Marianas Islands. In the continental U.S., this includes California, Oregon, Washington, and Arkansas. Health care providers that operate in areas with high rates of uninsured are having difficulties meeting the health care needs of their communities. Uninsured FAS citizens who seek health care services contribute to the uncompensated costs that are creating an ever-greater burden on health care providers.
I ask my colleagues for their support of the Medicaid Restoration for Citizens of Freely Associated States Act of 2011. The decision to allow citizens of the Freely Associated States to come to the United States was a federal decision, with national benefits.
That we also accept the cost of that decision is a matter of fairness and responsibility.
Thank you, Mr. President. I ask that the full text of this bill be printed in the Record immediately following my remarks.
