Over since Congress abandoned its responsibility to provide Medicaid to Pacific islanders, Hawaii has been saddled with the bill — hundreds of millions of dollars in medical costs for migrants who have the right to live and work in the U.S.
A proposal to remedy this problem is included in the comprehensive immigration bill before the U.S. Senate. It deserves strong congressional support, along with other amendments that relate to Hawaii.
The bipartisan Gang of Eight senators who put together the immigration reform package last month were offered 301 amendments from members of the Senate Judiciary Committee, of which 92 were approved, mostly technical. Among the more substantive was Sen. Mazie Hirono's amendment to reverse the elements of a mistake made 17 years ago by Congress, a mistake it has been reluctant to correct.
More than 50,000 people — nearly one-fourth of the populations of the Republic of Palau, the Republic of the Marshall Islands and the Federated States of Micronesia — have moved to the U.S., including 13,231 in Hawaii and at least 10,000 in Arkansas.
Their education and medical care cost Hawaii $114.9 million in 2010, up from $32 million in 2002, according to Gov. Neil Abercrombie. The state Department of Human Services spent $42.7 million on Medicaid-related benefits to the Pacific migrants — $26.4 million of it on services for able-bodied adults, $14.1 million for the aged, blind and disabled and $2.2 million for children and pregnant women. Restoration of Medicaid eligibility would cut the state expenditure in half, according to the department.
Those expenses should have been paid by the federal government under the 1985 Compact of Free Association Act, as compensation for past U.S. nuclear testing and defense uses, but a 1996 welfare reform law erased the migrants' eligibility for Medicaid. In 2010, a federal judge ordered Hawaii's government to restore life-saving health care to low-income migrants. Many Pacific islanders migrate to Hawaii mainly to receive that health care.
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