Medicaid restored for Pacific Islanders in U.S.

Nearly 25 years ago, with the stroke of a pen, the United States broke its commitment to provide medical care forMarshall Islands residents in the United States.

This past weekend, congressionalnegotiators agreed to reinstate that promise, deliveringMedicaidandChildren’sHealth Insurance Program coverage to tens of thousands of Marshallese andresidents of several other Pacific Island nations living in the United States.

“We are all so overjoyed with tears of joy for this fight thatmany have us have been part of” for decades, said Sheldon Riklon, aMarshallese physician at theUniversity of ArkansasMedical Center’s Northwest Center. “This is an historic legislation thatwe finally right the wrong.”

The health care assistance comes as the COVID-19 pandemic and related job losses have hammered manyMarshallese and Pacific Island communities in the United States, from Washington state to Arkansas.

“The COVID-19 pandemic has shown us the gruesome health injustices ... the rest of the world ignored,” said Melisa Laelan, executive director of Arkansas Coalition of Marshallese, in a statement. “Today we find peace and comfort in knowing that one of our fundamental human rights will finally be restored.”

In 1986, the United States and the Republic of the Marshall Islands signed a bilateral agreement that allowed the Marshallese to enter the United States as “legal non-immigrants” in return for the U. S. military continuing to operate a weapons testing base in theMarshalls. It also provided the Marshallese with Medicaid coverage.

Similar agreements, known as Compacts of Free Association, were signed with the nations of Palau and the Federated States of Micronesia.

Then, in 1996, President Bill Clinton signed the welfare reform bill, which changed the categories of people qualifying for federal aid, including Medicaid — the Marshallese and other compact nation citizens were shut out.

Although the omission of these residents was considered an error, Congress refused to reinstate them — even as some legislators, including Sen. Mazie Hirono andU.S. Rep. Tulsi Gabbard, bothDemocratsfromHawaii, pushed to have them reinstated.

Their efforts, and those of others, have now paid off.

“This bipartisan agreement will unlock new tools to assist the COFA community suffering from unequal access to health care,” said Hirono in an email statement. “By allowing States to enroll COFA citizens in Medicaid, we are upholding the promises we made to our critical national security partners in the Freely Associated States.”

Gabbard noted the bill would also help states such asHawaii, OregonandWashington, which had stepped in to fill that federal void for compact residents.

The Marshallese were “promised support by the federal government due to the damage done to their health and homes from nuclear testing,” said Gabbard, who also pushed to have compact nation children reinstated in the federal school meal programs.

Between 1946 and 1958, the United States detonated 67 nuclear bombs on, in and above the Marshall Islands — vaporizingwhole islands, carving craters into its shallowlagoons and exiling hundreds from their homes.

For decades afterward, theU.S. continued to use the islands to test biological and convention weapons. The U. S. still sends missiles to the islands, andMarshallese who live near the U.S. military base in Kwajalein atoll are accustomed to having to take cover, periodically, fromincoming missiles from California, or otherweapons testing programs.

“This is certainly a great Christmas present for all COFA citizens across the U.S. A huge kommol tata to everyone that played a role in getting us to this historical milestone,” said Eldon Alik, consul general of theRepublic of the Marshall Islands, Arkansas.