COFA enables residents from the Marshall Islands to live in the United States as a way to compensate the region for U.S. nuclear weapons there in the 1940s and 1950s. Hawaii officials have long said that the amount of money that the federal government provides does not adequately cover the health, education and health care costs associated with the migration.
The U.S. Government Accountability Office estimates that these areas have paid around $1 billion from their own state budgets since 2004 – about $155 million a year – with Hawaii shouldering 62% of the total uncompensated costs.
One bill, similar to legislation she’s introduced in the past, would increase the Compact Impact funding from $30 million to $185 million annually.
The bill is cosponsored by Reps. Tulsi Gabbard, Madeleine Bordallo, D-Gu., and Rep. Eni Faleomavaega, D-A.S.
A second bill, which may have a better chance of passage because it calls for less money, would ease the burden on states by restoring Medicaid coverage for COFA migrants.
That group lost their eligibility as part of welfare reform in 1996. Due to nuclear testing, COFA migrants often have high rates of end stage renal disease or cancer. Hawaii alone pays about $45 million each year in unreimbursed health care costs for this population, a Hanabusa press release said.
Gabbardd, Bordallo, Faleomavaega, as well as Rep. Gregorio Sablan, MP, and Barbara Lee, D-Calif. are co-sponsoring the Medicaid legislation.
“For me, this is a balanced way of living up to our obligations, something we owe to everyone involved,” Hanabusa said. “These bills work together to address the impact of migrants traveling under the Compact of Free Association. COFA migrants deserve coverage under Medicaid, but states must receive adequate funding so that COFA coverage does not come at the expense of existing residents. In all fairness, we needed to increase funds for COFA coverage and give impacted areas access to additional grant funding to ensure that we are not favoring one side of the equation over the other.”
— Kery Murakami