The latest version of the U.S. Senate immigration reform bill restores Medicaid eligibility to migrants from three Pacific island nations in Micronesia.
The Senate Judiciary Committee voted Tuesday to reinstate eligibility by adopting an amendment from U.S. Sen. Mazie Hirono. The Democrat from Hawaii says the move will save the state millions of dollars each year.
Citizens of the Republic of Palau, the Republic of the Marshall Islands and the Federated States of Micronesia have the right to live and work in the U.S. under international treaties.
In exchange, the U.S. military controls extensive strategic land and water in the Pacific Ocean between Hawaii and China. That includes Kwajalein Atoll, the site of missile testing and space activities.
But the international agreements have caused tension between the U.S. federal government and state and territorial governments over who should pay for providing services to migrants.
In 1996, Congress revoked migrants’ eligibility for Medicaid, the federal health program for low-income people. The move shifted the financial burden for health care to states and territories.
Residents of Guam, Hawaii and the Northern Mariana Islands have felt the greatest fiscal impact. Between 2004 and 2010, all three reported spending more than $1 billion to provide services for the migrants, mainly for education and health care. That doesn’t take into account the contributions migrants have made through taxes and labor.
The federal government spent more than $200 million during the same time period to compensate the local governments. But state and territorial leaders have said the money is far from enough.
In Hawaii, public outcry against the rising health care costs caused the state Legislature to significantly cut health care benefits for the community three years ago. A federal judge struck down the move as discriminatory.
Advocates for providing health care to migrants have said the U.S. has a moral imperative to do so because of the negative health effects of U.S. nuclear testing in the Pacific. Critics have countered that the cost is too high.
More than 50,000 people — almost a fourth of the population of all three nations — have already moved to the U.S. They have settled in various states including California, Oregon and Arkansas.