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The Honolulu Advertiser
Posted on: Wednesday, August 26, 2009

'Time running out' for Micronesians


By Will Hoover
Advertiser Staff Writer

Less than a week before the state cuts back on health care benefits in Hawai'i to some 7,500 adult Micronesians who are part of the Compact of Free Association, many of those affected are worried and trying to persuade the state to reconsider.

"What we want to happen is for the governor to postpone this new plan that is going to be effective Sept. 1," said Edlynn Tita Raed, vice president of the Micronesians United. "They let us know about this on Aug. 3. It was short notice. And we don't know if they let our governments back home know."

Of particular concern are services for Micronesians who are on dialysis and chemotherapy, which Raed said will end Monday.

"Time's running out," she said. "People's lives are at stake. They'll die."

"It's not fair," added Alma Coleman, one of a group of Micronesians who met yesterday at a location on School Street to discuss the problem. "It's unconscionable."

Raed and Coleman want the governor to give them more time to notify their governments back home and to work to persuade the federal government to do more.

They're getting an assist from state and federal lawmakers.

Tomorrow state Rep. John Mizuno, chairman of the Human Services Committee, will call on Gov. Linda Lingle and the state Department of Human Services to postpone implementing the new Basic Health Hawaii program.

That plan would save the state $15 million but limits monthly services to 12 outpatient doctor visits, 10 hospital days, six mental health visits, three procedures and emergency medical and dental care, said Mizuno, D-30th, (Kamehameha Heights, Kalihi Valley, Fort Shafter). It does not allow for "life saving" dialysis or chemotherapy treatments.

About 100 Pacific Islanders receive dialysis and another 120 to 160 rely on chemotherapy under the current program, Mizuno said.

Mizuno hopes the Lingle administration will wait to implement the change until legislation introduced by U.S. Rep. Neil Abercrombie, D-Hawai'i, results in federal money to help dialysis and chemotherapy patients from the Pacific Islands.

"Delay this and save these lives and allow the federal government to work on a long-term solution," Mizuno said.

Dr. Kenny Fink, the administrator for Med-QUEST at the state Department of Human Services said he has worked with two dialysis providers in the state to continue free treatments for Micronesians until a permanent solution can be found.

He also said he has been working with the American Cancer Society to assist in temporarily meeting the needs of those Micronesians who need chemotherapy treatments.

Fink said said the Compact of Free Association made between the federal government and the Federated States of Micronesia, the Republic of the Marshall Islands and the Republic of Palau allows for citizens of those nations to travel freely, work and live in the United States.

But he said there is no provision in the compact for medical care. The federal government did allow COFA nation citizens to be eligible for Medicaid, but that ended in 1996.

Since then — even though it was not required — Hawai'i continued to provide the same level of medical assistance to the COFA migrants without receiving any money at all from the federal government, Fink said. No state except Hawai'i offers medical benefits to citizens of COFA nations, he added.

In 2003 Hawai'i began receiving a partial reimbursement — less than 10 percent — from the federal government for the money Hawai'i spends annually on COFA migrants, said Fink. Last year the state's share was more than $100 million, he said.

"All the while we believe that it's the federal government's responsibility to fix this," Fink said. "The state has for more than a decade been funding the federal government's obligation. The state simply can't afford to do this anymore."