About 7,500 Micronesians and other Pacific islanders will lose their Medicaid health coverage on Feb. 28, but they will automatically be enrolled in an Obamacare replacement plan March 1, health officials said.
"Our goal was that nobody who needed medical coverage would even have a one-day gap in their coverage," said Jeff Kissel, executive director of the Hawaii Health Connector, which serves as the state’s official marketplace for insurance mandated by the Affordable Care Act.
The 7,500 migrants are the more able-bodied of some 13,700 citizens of Palau, the Marshall Islands and Federated States of Micronesia residing in Hawaii. Only people who are 65 and older, blind, disabled or pregnant can still be covered by Medicaid or Medicare as of March 1, Kissel said.
The others will automatically be switched over to Obamacare’s "Silver Plan," which provides coverage similar to Medicaid but requires a co-payment. In Hawaii, Kaiser Permanente and Hawaii Medical Service Association are the only two providers under the Health Connector.
Still, Kissel is urging the migrants to go through the enrollment process because they have 60 days to decide which insurer they want. If they miss the chance, they will have to wait a year to enroll in a different plan, he said.
Also, Kissel added, health officials want to find those who don’t have any kind of health care coverage and sign them up as new clients by Feb. 15.
Micronesians are allowed to live and work in the U.S. under the Compact of Free Association. The COFA contract was initiated in exchange for U.S. military rights, and to compensate islanders for the negative health and social impacts of nuclear testing after World War II.
Acknowledging the confusion and rush to sign everyone up, Kissel said there have been so many recent rulings on immigration and health care on the federal and state levels that it is "impossible to give a lot of people on the ground the whole picture in such a short amount of time. … This is not an easy adjustment to make."
And for migrants who are "not used to dealing with institutions, I’m very sympathetic," he added.
Yumina Defang, who moved with her family from Chuuk, Micronesia, in 2008, was at a Health Connector workshop Tuesday at St. Elizabeth’s Episcopal Church, one of many workshops offering language assistance available until Feb. 15.
"We heard they were going to cut off the medical insurance, and that made us so worried," she said. "I have five boys. I cannot afford to pay for them. It’s hard."
Even though she has a job, she and her husband have diabetes and heart problems that need daily treatment.
Defang said she didn’t understand the letter she received from Medicaid about switching to Obamacare, but after her friend "rushed to come here" to sign up, she did, too. Though she learned English in high school, "most of the Chuukese don’t know English," she said, nodding at a dozen other migrants in the room.
Joakim "JoJo" Peter, a Micronesian and head of the COFA Community Action Network, was there to sign people up and help translate. He said there has been a lot of confusion in getting the message out to migrants with so many "ins and outs" in health care policy.
"This is something new — to move 7,500 people from Medicaid to Obamacare," Peter said. "Of course, it takes a lot of momentum to get people to sign up, especially if the notification is written in English. It’s hard to understand."
Most of the people are asking him what the process entails, with questions like, "Am I going to be able to see my same doctor?" he said. Most of the migrants go to low-income clinics at Kokua Kalihi Valley and the Kalihi Palama Health Center, which might have different providers from what the Health Connector allows, Peter said.
Kissel said patients could continue seeing the same doctors if the doctors accept HMSA.
Peter has also helped organize hundreds of migrants in protest marches from St. Elizabeth’s in Palama to the Federal Building.
The marches, dubbed the Monthly Marches for Medical Mercy, started in April to protest a 9th Circuit Court of Appeals ruling to cut health care benefits to COFA members. The marches were led by St. Elizabeth’s pastor, David Gierlach, whose congregation is 25 percent Micronesian — about 50 members.
The marches have been suspended for the time being amid efforts to get state funds for the co-payments and deductibles, Gierlach said.
"I’m very hopeful the state Legislature will do the right thing," Gierlach said, citing parishioners who need kidney transplants. "I hope they recognize that these folks really need the help."
The schedule for Health Connector workshops can be found at www.hawaiihealthconnector.com or by calling 877-628-5076.