Advocates for Oregon’s substantial Pacific Islander community believe they have a legislative solution to a situation that has left many of their poorest members without health insurance and shut out of the health reforms of the Affordable Care Act.
A proposed amendment to House Bill 2522 would create a special program within the Oregon Insurance Division that provides private health insurance sold on the exchange to people who were born in the South Pacific. Their islands were damaged by United States military and atomic testing and are covered by the Compact of Free Association treaties.
The program would work similar to the defunct Family Health Insurance Assistance Program, which gave low-income families a chance to buy private insurance with state help in the days before federal health reform. Loyd Henion, the board secretary for the COFA Alliance National Network, said for $2 million, the state could receive an 80 percent federal match to help pay the premiums, deductibles and copayments for islanders whose income is below 138 percent of the federal poverty level.
Oregon has the fifth-largest population from these islands of any state, numbering around 9,000 people and centered in the Salem area. Henion said about 1,200 would become eligible for insurance under this program.
It’s unclear if the islanders will be able to find that kind of money in the 2015-2017 budget. Like other marginalized groups, they have no representation in the Legislature. Their population, though large compared to other states, is still relatively small compared to Oregon’s other ethnic groups and is concentrated near Salem, leaving few legislators with a COFA constituency.
Henion said that budget co-chairman Rep. Peter Buckley, D-Ashland, was sympathetic to their plight, but Sen. Alan Bates, D-Medford, informed Henion on Monday that it may be hard to find the dollars to support the program.
Kianna Angelo, who was born on the Marshall Islands but grew up in Vancouver, Wash., said that hydrogen bomb testing near the islands left the residents of the COFA islands with exposure to radiation many times higher than survivors of the bombings of Hiroshima and Nagasaki.
“You’ve heard the injustice and suffering of islanders from nuclear testing. Many are also climate refugees,” said John Mullin of Oregon Law Center, noting that rising ocean levels caused by carbon dioxide pollution threatens the islands.
Unlike true immigrants, who may receive Medicaid after five years, the dubiously named federal Personal Responsibility and Work Opportunity Act of 1996 stripped the islanders of ever being able to receive Medicaid, the state and federal healthcare program for the poor.
An earlier proposal would have included state revenue to make the Oregon Health Plan available to these immigrants, but since Oregon would receive no federal match, the price tag would be four times the amount in the proposed private insurance program.
Quirky federal laws do make the population eligible for subsidized insurance even as they are not eligible for Medicaid. The problem for those below or near poverty is that they cannot afford the consumer share. The amendment to HB 2522 would have the state pay this portion. Similar to Oregon’s other low-income residents, they would receive healthcare at no cost to them or at a loss to the healthcare system.