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COFA Islander Health Plan Clears House Health With Gov. Brown’s Backing

The state has developed a plan that will pick up the healthcare tab for low-income Pacific Islanders who’ve been free to come to the United States because of military involvement around their home islands, but in a cruel injustice, cannot get access to Medicaid, unlike other legal longtime immigrants.
February 2, 2016

Oregon’s House Health Committee quickly and unanimously passed its first bill of the session on Monday, asking the state to set up a health insurance assistance program for a group of Pacific Islanders who are legal residents of the state but prohibited by federal law from receiving Medicaid.

Both Rep. Bill Kennemer, R-Canby, and Rep. Alissa Keny-Guyer, D-Portland, complained that many of the islanders have resettled in Oregon only to be denied real access to healthcare.

“What’s a really unfortunate circumstance is we ruined their homeland, and for 10,000 years nobody can live there,” said Rep. Brian Clem, D-Salem, referring to Bikini Island, which was nuked by the U.S. military to test the hydrogen bomb. The site was likely chosen because, from the American Cold War perspective of the 1950s, the islands were seen as expendable.

Gov. Kate Brown also sent her healthcare advisor to the hearing to express her support for HB 4071: “She really thinks this will fix an inequity right now for people,” said Jeremy Vanderhey.

House Bill 4071 establishes a program within the Department of Consumer & Business Services that will cover the out-of-pocket costs low-income islanders face when they use their health insurance, which they can purchase on the exchange with a heavily subsidized premium.

Despite a subsidized premium, people from this group living below 138 percent of poverty could not afford to actually use their health plans. But with 90 percent of the costs paid by the federal government, the state can implement this program and cover all the out-of-pocket costs as if they had the Oregon Health Plan.

The islanders affected are citizens of three island groups: the Federated States of Micronesia, the Marshall Islands and Palau. Decades of heavy military involvement since World War II led the United States to sign the Compact of Free Association with these island nations, allowing them to come and live in the U.S., but since they are not citizens nor technically immigrants, they cannot receive Medicaid.

Lahaina Phillip, a Portland healthcare interpreter who grew up on the island of Chuk, said the American occupation of their islands has greatly altered their diet, leaving them dependent on unhealthy canned food, which then leads to high rates of diabetes and high blood pressure. She told the Lund Report a primitive healthcare system on the islands leads many older islanders to come to the States.

“They come here to get healthcare and then find out they are not eligible,” said Phillip, whose mother would qualify for the program. “They have to wait for some charity to help them.”

While the islanders await the passage of this bill, nonprofit Project Access Now, using charity dollars from Portland-area hospitals, has been picking up the tab for some islanders who live in the tri-county metro region.

HB 4071 now must face another hurdle -- labyrinthine passage through the fickle House Committee on Ways & Means, which holds the purse strings for the $1.8 million that the state estimates the program would cost.

But the bill has momentum, including the backing of Gov. Brown, a remarkable turn of events after this population languished for years almost invisibly but in plain sight, particularly in Salem, the state’s most diverse major city.

The COFA Alliance National Network, led by Loyd Henion and David Anitok, devised the solution behind HB 4071 in the waning days of the 2015 session. The concept of a premium assistance program and the plight of the islanders were highlighted in a series of Lund Report articles and Sen. Alan Bates, D-Ashland, who co-chairs a critical budget subcommittee, vowed last session to make it a top priority for this year. He was joined in support by Rep. Andy Olson, R-Albany, who then sponsored HB 4071 with Rep. Dan Rayfield, D-Corvallis.