An attorney representing the state’s Micronesian migrants says he will fight a decision by a 9th U.S. Circuit Court of Appeals panel allowing the state to reduce Medicaid health care benefits for 13,700 people under the Compact of Free Association.

"The battle is far from over," said Honolulu attorney Paul Alston, who served as co-counsel representing the migrants. "We’re going to take this to the end. We will not give up."

Alston plans to ask the panel to rehear the case. If that doesn’t work, the group will request the entire 9th Circuit to hear the case "because we think the panel got it wrong." If necessary, he will take it to the U.S. Supreme Court for review, he said.

Migrants are currently able to get the same benefits as the rest of those on Medicaid, the government health insurance program for low-income people. The decision, handed down on Tuesday, means the state could reduce benefits for migrants to four prescriptions a month and 12 doctor visits a year, Alston said.

"If you need dialysis or chemotherapy or if you need some other lifesaving treatment, either you don’t get it or you die or you go to the (emergency rooms)," he said. "It will cost hospitals a huge amount of money. You’re going to force them into very costly ER treatment and some you’re just going to kill. How crazy and how immoral is that?"

The Department of Human Services, which runs the Medicaid program, and Gov. Neil Abercrombie’s office didn’t comment beyond an earlier joint statement that said the state is reviewing the court’s decision to determine how best to proceed.

Congress, as part of comprehensive welfare reform in 1996, cut health care funding for migrants covered under the Compact of Free Association, which allows Palau, Marshall Islands and Federated States of Micronesia citizens to live and work in the United States in exchange for U.S. control of extensive strategic land and water in the Pacific Ocean.

Hawaii opted to include COFA residents in its health insurance plans for many years. Gov. Linda Lingle’s administration attempted to reduce coverage in 2009 and 2010 because of fiscal challenges, but was stopped both times by U.S. District Judge J. Michael Seabright, who handed down a preliminary injunction prohibiting the state from denying migrants full Medicaid benefits.

Alston said the injunction prevented a public health disaster.

"We got these people in our state who are allowed by federal law to be here from birth to death and the (health care) program that the state is offering as a substitute is garbage," he said. "All of this was done by the Lingle administration in a callous disregard for the health needs of this population. One would hope the Abercrombie administration would take a more economically rational and compassionate view as to how we treat these people who live among us."