Micronesian community members marched from Kalihi to the federal building in Honolulu on Wednesday to rally for migrant health care and ask Hawaii's congressional delegation to redouble its efforts to reinstate Medicaid payments.

The 9th U.S. Circuit Court of Appeals ruled earlier this month that the state has no obligation to offer paid health care benefits to Micronesian migrants covered under the Compact of Free Association, which allows Palau, Marshall Islands and Federated States of Micronesia citizens to live and work in the United States.

The ruling alarmed Micronesians and their advocates.

"Just as a human being, that's scary," said Josie Howard, a 44-year-old University of Hawaii graduate student from Chuuk. "When I heard that, it (was) scary because I do not want myself, my sister, my brothers, my mother, you know, my family, to one day go without insurance."

Ignacia Terno, 65, also of Chuuk, said she could lose her diabetes, high blood pressure and kidney medicines and other health care if Hawaii takes advantage of the ruling.

"Without the medical insurance, we're all dead," she said. "The adults and the kids would be having (a) hard, hard time."

The Rev. David Gierlach of St. Elizabeth's Episcopal Church on King Street, who helped organize the event, said more than 200 marchers walked for more than an hour from the Kalihi church to Ala Moana Boulevard and Halekauwila Street, where they lined up to wave signs and shaka at passing cars.

"I have parishioners who have the need for organ transplants, people in their 30s who will die if they don't get them, and it sounds like organ transplants are one of the first things to be stopped," he said. "So for the churches this was a pastoral concern, and Holy Week seemed to be the best time to bring attention to this matter."

In 1996, Congress cut health care funding for COFA migrants as part of welfare reform. Hawaii continued paying for full coverage for COFA migrants until 2009 when the state then tried to roll out a reduced-benefits health care plan. A federal judge twice stopped the plan from moving forward, but those rulings were overturned when the 9th Circuit ruled in favor of the state.

A week after the ruling came down, the state attorney general said Hawaii will continue to provide health benefits for Micronesian migrants until a lawsuit on the issue is resolved.

Honolulu attorney Paul Alston, who served as co-counsel representing the migrants, said earlier this month he plans to ask the 9th Circuit panel to rehear the case or possibly request the entire 9th Circuit to weigh in.

Howard said she is worried that Hawaii might revert to the Basic Health Hawaii plan proposed in 2009 and 2010 because it "was very limited, especially for people who are suffering from nuclear testing and … unhealthy diet due to globalized menu and things like that."

U.S. Sen. Mazie Hirono, the Senate's only immigrant, worked to include language in the chamber's immigration reform bill — introduced a year ago Wednesday — that would restore Medicaid eligibility for COFA migrants. The bill passed the Senate in June but has not yet been vetted by the House. On the House side, U.S. Rep. Colleen Hana­busa also introduced a measure last year to restore Medicaid for compact migrants.

Hirono released a statement Wednesday calling for the House to act on immigration reform.

"Each day House Republicans fail to act, families are suffering and are kept apart," Hirono said in the statement. "It is past time for the House to take action on immigration reform."

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