COFA Med-Quest Health care program

The Senate Committee on Transportation, International and Intergovernmental Affairs (TIA) today conducted an info briefing to update the legislature on changes to the Hawai‘i Quest program. Chaired by Senator J. Kalani English, the committee also discussed the status of the amendment of the federal health bill that provides Medicaid eligibility to the citizens of the Compact of Free Association (COFA) Nations.

Recent cuts to state health care programs covering citizens of COFA Nations have raised concerns that treatments such as kidney dialysis and chemotherapy will no longer be available. The group Micronesians United recently gathered at the Hawai‘i State Capitol to protest the cuts.

“For those suffering from kidney disease or cancer, this is a true health care crisis,” said Senator English. “It is not sufficient to just say, ‘Well, we’re not going to cover that anymore.’ My colleagues and I want to know about how this decision was made, what the true effects are going to be, and where we are going from here.”

Proposed federal legislation could provide funding to cover treatments for Compact Nation citizens. Currently, Hawai‘i provides health care to Compact Nation citizens without federal matching funds. Under the federal proposal introduced by Congressman Neil Abercrombie, new funding would be provided for Medicaid expenses related to providing health care to Compact Nation Citizens.

A new health care program implemented by the State reduces benefits to citizens of the Compact of Free Association nations. On Tuesday, however, Federal Judge J. Michael Seabright issued a temporary restraining order preventing the state from disenrolling COFA residents from the State-funded health programs in which they were participating prior to August 1, 2009. The order also required the state to re-enroll all COFA residents who were disenrolled based on their status as COFA residents, in the applicable QUEST, QUEST-Net, QUEST-ACE, QexA, SHOTT, or fee-for-service programs.

“Judge Seabright’s decision came at a critical time for those in our community who were about to lose life-saving medical treatments. However, we cannot lose sight of the fact that the judge issued a temporary restraining order, and will hear a motion for a more permanent injunction on October 19,” said Senator English. He added, “It is possible that six weeks from now we will find ourselves in the same situation we were in on Monday, with people wondering how they will pay for their dialysis and chemotherapy.”

The committe also received an update on the status of federal legislation that would increase Medicaid reimbursements to the state, reducing the impact of providing health care services to COFA residents.

A number of COFA dignitaries and experts submitted testimony including:

Federated States of Micronesia (FSM):
Hon. Lorin Robert, Secretary of Foreign Affairs; Hon. Vita Skilling, Secretary of Health and Social Services; His Excellency Yosiwo P. George, FSM Ambassador to the United States; Mr. James Naich, Deputy Chief of Mission, FSM Embassy in Washington, DC; Mr. Akillino H. Susaia, FSM Consul General, State of Hawai‘i; and Mr. Daniel Rescue, FSM Consulate Hawai‘i Staff.

Republic of the Marshall Islands:
Hon. John Silk, Minister of Foreign Affairs; Mr. Noda Lojkar, Consul General, Honolulu, Hawai‘i.

State of Hawai‘i:
Dr. Kenneth Fink, Administrator, MED-QUEST Division, Department of Human Services.

Medical community:
Dr. Neal Palafox, Chair, John A. Burns School of Medicine, Department of Family Medicine & Community Health; Dr. Sheldon Riklon, member, Micronesian Health Advisory Coalition. Organization: Mr. William J. Swain, representing Pa Emman Kabjere.

The Compact of Free Association Nations include the Republic of the Marshall Islands, the Federated States of Micronesia, and the Republic of Palau.