by Rev. Joseph Santos-Lyons

Over the last three years, APANO has taken a more serious role in supporting the Micronesian communities fight for healthcare access.  We’ve done this in partnership with a range of community partners led by the COFA Alliance National Network (CANN), Micronesian Islander Community of Oregon and the Oregon Marshallese Community, three emerging organizations we have the honor of fiscally sponsoring.

Micronesian residents, citizens of Palau, Federated States of Micronesia and Marshall Islands, have the right to live and work in the USA in return for USA military interests in their islands, yet face a range of exclusions from public services including Medicaid.  The Micronesian population is growing significantly in Oregon, working at the Port of Portland, farm-working in Marion County, and manufacturing in Washington and Clackamas County industries.  Many have migrated to Oregon as a result of the health fallout from USA nuclear testing and negative impacts of climate change on their economy and environment (Islanders Find Refuge, But No Paradise, Portland Tribune).

In 1996, Congress eliminated Micronesian “COFA” citizens from Medicaid and other federal benefits (e.g. SNAP, Section 8, student loans) as part of welfare reform.  At the same time, Congress continues to renew the COFA to preserve long-term military bases and strategic position in the South Pacific.  Despite years of seeking to restore Medicaid, progress has been slow.  Thanks to CANN, COFACAN and APIAHF, a new national coalition is emerging that may have the capacity to win federal restoration.  (APANO COFA Factsheet)

In Oregon, thanks to our elected leadership, COFA children and other immigrant children who face Medicaid exclusions (ie legal permanent residents who face the 5 year bar) are included in Oregon’s State Children’s Health Insurance Program.  Our work is focusing on the estimated 1,000 to 1,500 COFA adults who are Medicaid eligible, yet barred, to create a short-term, immediate fix to provide modest health coverage.  The COFA Premium Assistance workgroup is the result of HB 2522, legislation that CANN, APANO and others helped pass in the 2015 legislature.  We expect to propose a viable program to be funded by the 2016 legislature to help cover premiums and cost sharing.  (Why One Minority Group May Finally Get Health Coverage in Oregon, Portland Business Journal)

We invite APANO and our supporters to learn more by checking out the links to further readings and resources.  We are working hard to build a stronger coalition, prioritize this issue with our elected state and national leadership, and create a long-term policy solution.  Contact: Kristina Narayan, APANO Policy Associate for more information kristina@apano.org, 971-340-4861.

Further Readings & Resources:

Oregon House Health Hearing on HB 2522 Feb 2015- Testimony from CANN, APANO, National Association of Atomic Veterans, Oregon Law Center.

HB 2522A (2015, Oregon) – Legislation and collection of amendments and testimony.

Micronesians Continue To Seek Justice On 60th Anniversary of Bravo Nuclear Test (2014, Buzzfeed)

COMPACTS OF FREE ASSOCIATION: Guidelines Needed to Support Reliable Estimates of Cost Impacts of Growing Migration (2013, US Government Accountability Office)

HCR21 (2015, Oregon) – Legislative Resolution expressing support for COFA.