Hawaii needs more federal funding for COFA migrants

Today, Representative John Mizuno held an informational briefing to review the human services issues related to migrants living in Hawaii under the Compact of Free Association (COFA), which defines the relationship between the U.S. and the Republic of the Marshall Islands, the Federated States of Micronesia and the Republic of Palau.

The issue: the inadequacy of federal government funding to pay for COFA migrants’ medical and social services costs.

It was reported in a 2007 Department of the Attorney General study that the cost of providing all state services to COFA migrants was about $100 million a year. The Department of Human Services alone expended $52 million in COFA services in 2010. This year the state received only $11.2 million in grant funds.

Governor Neil Abercrombie is appealing a case that reinstated Med-QUEST for migrant immigrants this past January. The former administration placed COFA migrants in a program called Basic Health Hawaii, a less-costly, less-comprehensive health insurance program. A spokeswoman for the governor, however, has said that the administration will appeal "but has no intention to continue Basic Health Hawaii,” reported the online news publication Civil Beat.

Lawmakers and panelists discussed possible solutions to address the high costs to the state.

"The briefing was informative, however we have much to do as we seek to ensure essential healthcare for the Pacific Islanders while securing our fair share in costs from the federal government," said Rep. Mizuno.

They ideas discussed include:

1.) Seek an amendment of COFA to include greater reimbursement from the federal government.
2.) Work with state, federal, and private agencies for support and funding to invest in dialysis and chemotherapy centers in the Marshall Islands, the Federated States of Micronesia, and the Republic of Palau to allow proper healthcare treatment services for their citizens.
3.) Liberty Dialysis, one of two medical center providers of dialysis services in Hawaii, has indicated their willingness to continue dialysis treatment coverage to COFA citizens if the state no longer pays for such coverage. Not certain how long Liberty Dialysis could sustain such services without pay.
4.) Continue talks with federal medical centers and the U.S. Department of Interior on the possibility of federal hospitals accepting COFA citizens for dialysis and chemotherapy treatment.
5.) Work with the home state government of Marshall Islands, the Federated State of Micronesia, and the Republic of Palau on funding options for their citizens in Hawaii.
6.) Work with the state's administration and the Hawaii's congressional delegation on reducing costs and greater funding from the federal government.