Island Medicaid funding dilemma tackled at US House hearing   


Local Medicaid Chief Sandra King Young argued the problem started in Washington and affects all the territories.

Washington, D.C. – The focus at a Congressional hearing this week was American Samoa’s inability to spend down its Obamacare Medicaid that expires in 2019.  But the bigger issue was Washington’s failure to address overall medical funding needs in the islands.

Three territorial lawmakers, including American Samoa’s Aumua Amata Radewagen, wanted to know why American Samoa, which House Resources members visited this year, has failed to spend down more than $150 million in Obamacare Medicaid at LBJ Hospital. That money expires in 2019 if not expended.

Radewagen stated, “We are talking about the health of our people. I mean, I have tears in my eyes. When I go to that hospital, people cannot get the services they need and they have to struggle to find extra money they don’t have to try to go up to Honolulu. This has been going on for years.”

But local Medicaid Chief Sandra King Young argued the problem started in Washington and affects all the territories.

Young stated, “When the 2011 ACA was passed, there was really no relevant consideration with the situation in the territories. For example, we can barely spend this down, because we have one hospital. But CNMI needs more money, because they have dozens and dozens of providers. Guam needs more money; Puerto Rico needs more money and we have a problem spending our money.”

Island governors and representatives in Congress wrote health subcommittee lawmakers recently to ask for more Medicaid and Children’s Health Insurance Program funding.

Specifically, they asked that all Obamacare Medicaid for the territories be available until fully spent that the annual 55 percent Medicaid island cap be replaced with the higher 80 percent or more state cap and that island hospitals be allowed to receive Disproportionate Share Hospital funds to offset uncompensated patient costs.

Island officials say the cost of Medicaid services in the territories is increasing, forcing the islands to spend more of their own scarce resources, without getting matching funds. They argue getting the same level of help as the states, based on similar, lower per capita incomes, would greatly improve medical care in the US islands.