Congressman Michael San Nicolas pushed for Medicaid parity for Guam during a hearing of the U.S. House of Representatives Committee on Energy and Commerce
Subcommittee on Health Virtual Hearing.
San Nicolas said the only solution equitable for Guam is actual equity and he urged his colleagues to complete the work of P.L. 116-94 by permanently closing the Territorial and Guam Medicaid gap with FMAP levels concurrent with the rest of the country and lifting the Medicaid cap also concurrent with the rest of the country.
P.L. 116-94 only temporarily increased the Federal Medicaid Assistance Percentage (FMAP) for Guam to its current temporary rate of an 83% federal match to a 17% local match. Prior to the enactment of this legislation, Guam’s FMAP was limited to a 55% Federal / 45% local Medicaid matching formula, which San Nicolas said is grossly insufficient for communities like Guam with among the highest per capita poverty levels
in the country.
The sunset of P.L. 116-94 in 2022 would mean a return to Medicaid induced “medical cannibalism” for Guam, San Nicolas said, with lower caps and lower FMAP leaving Guam to fund Medicaid at a higher matching rate with a smaller pool and ultimately picking up 100% of the tab of costs.
“Honorable Members of the Committee, thank you deeply for the temporary reprieve of
P.L. 116-94. Let us now make whole Medicaid for Americans in an American healthcare
system by simply applying to Guam what is applied throughout the rest of America,” San Nicolas concluded.