A federal judge ordered the state yesterday to restore lifesaving health benefits to low-income legal migrants from Micronesia, the Marshall Islands and Palau, a ruling that will cost taxpayers millions.

U.S. District Judge J. Michael Seabright issued a preliminary injunction requiring that more than 7,500 Pacific islanders receive health coverage equal to plans provided to Medicaid recipients.

The cash-strapped state had tried to save about $8 million annually by offering fewer benefits under a free plan called Basic Health Hawaii that went into effect July 1, but Seabright’s ruling ends that effort.

Micronesia, the Marshall Islands and Palau are beneficiaries of the Compact of Free Association, a 1986 pact with the United States granting it the right to use defense sites in exchange for financial assistance and migration rights after it used the Pacific islands for nuclear weapons testing from 1946 to 1958.

"Plaintiffs will suffer irreparable harm without a preliminary injunction because they would be left without adequate medical coverage, which will force them to pay for treatment on their own or completely forgo the treatment," Seabright wrote in his order.

The lawsuit claiming Basic Health Hawaii unlawfully discriminates against the migrants would likely be successful, Seabright wrote.

Migrants’ health coverage was limited to 10 days of inpatient hospital care each year, 12 annual outpatient visits and a maximum of four medication prescriptions per month under Basic Health Hawaii.

Those constraints fell short of the care needed by many cancer and kidney disease patients, Seabright wrote. Chemotherapy and radiation therapy treatments are unavailable in the Pacific nations, and dialysis machines are rare.

Migrants’ attorney Paul Alston said the state of Hawaii needed to treat legal residents from Pacific islands the same as U.S. citizens.

"The state must continue to provide an equal package of benefits, without regard to alienage," Alston said.

Lawyers for the state attorney general’s office said they might appeal, but that decision will depend on whether new Democratic Gov. Neil Abercrombie’s administration wants to continue the legal fight.

Deputy Attorney General Lee-Ann Brewer said the government argued that migrants’ benefits could be reduced because they were not eligible for federal Medicaid services, regardless of their nationality or origin.

Hawaii’s government spends more than $120 million a year on services for the migrants, and the federal government provides only $11 million to help cover the costs, according to the state Department of Human Services.

Seabright said the state is paying most of the cost of a federal obligation.

"Everyone here would rather see this cost spread around the entire nation than just the state of Hawaii," Seabright said in court.

Benefits must begin to be restored by tomorrow, and all migrants enrolled in Basic Health Hawaii will be reverted to their previous health care plans by Feb. 1, according to Seabright’s order.