From the Hawai'i Appleseed Center for Law and Economic Justice:

"On November 3, 2014, the U.S. Supreme Court denied plaintiffs' petition for certiorari in Korab v. Fink. Although the U.S. Supreme Court has declined to hear the case, the litigation on the matter is continuing. Because the State has yet to provide adequate assurances that cuts to critical health care benefits targeting COFA residents will not be implemented, we intend to continue our challenge on this life-or-death issue." Click here for more

From Civil Beat:

“Why should the court take this? The answer is very simple,” attorney Paul Alston told Civil Beat at the time. “People are going to die if they implement Basic Health Hawaii. This is not something that we can simply ignore.”

In 2010, the state designed BHH specifically for migrants from Micronesia. Basic Health Hawaii is a form of health coverage that limits the days of inpatient hospital care, outpatient visits and prescriptions. The plan also does not cover organ transplants or surgeries like heart surgery, and it covers dialysis only as an emergency service.

The plaintiffs in Korab v. McManaman argue that BHH is inadequate for the needs of Micronesians. Many suffer from cancer, diabetes and reproductive abnormalities that have been linked to the effects of U.S. nuclear testing in the Marshall Islands from 1946 to 1958.

On Monday, however, the high court rejected the plaintiffs’ appeal inKorab, leaving intact a 9th Circuit Court of Appeals decision in favor of the state. That decision found the state was not required to provide state-funded medical assistance benefits to noncitizens after the federal Medicaid program excluded them." Click here for more

From Governor Neil Abercrombie, Attorney General David A. Louie and DHS Director Patricia McManaman:

"According to Director McManaman, 'The state’s plan going forward includes a program that provides Medicaid-like coverage to our neediest aged, blind, and disabled noncitizens. Coverage for children and pregnant adults will remain unchanged. The plan also includes a transition period for other non-pregnant adult noncitizens to obtain health insurance through the Hawaii Health Connector, and a state-funded program to help these very low-income noncitizens pay their share of their health insurance premiums. This ensures that needy noncitizens who are ineligible for Medicaid still have access to quality, affordable health insurance.'"  Click here for more

Mahalo to our friends and allies at the National Asian Pacific American Women's Forum for their statement of solidarity in a press release and statement of support for the restoration of equal access to federal healthcare safety nets for COFA residents!

See the statement by clicking here: http://napawf.org/2014/04/ninth-circuit-decision-on-healthcare-shows-congress-must-act/ 
or download a copy of the statement. 

Mahalo to our friends and allies at the Asian & Pacific Islander American Health Forum for the following press release and statement of support for the restoration of equal access to federal healthcare safety nets for COFA residents, issued today:

Korab Decision Demonstrates "Dire Need" for Congress to Act

Case impacts access to care for COFA migrants in Hawaii  
April 16, 2014

WASHINGTON—Earlier this month, the U.S. Court of Appeals for the Ninth Circuit in Korab v. Fink ruled that Hawaii is not required to provide full Medicaid coverage to Compacts of Free Association (COFA) migrants from the Republic of Palau, the Republic of the Marshall Islands and the Federated States of Micronesia.  

The case arose after Hawaii shifted COFA migrants who were previously eligible for full-scope Medicaid in the state to the Basic Health Hawaii (BHH) program, which provides more limited coverage. Plaintiffs in the class action needed benefits such as dialysis and cancer treatment that were not covered by the BHH program.  They argued that Hawaii’s refusal to provide full Medicaid coverage violated the Equal Protection Clause of the Constitution.   

The Court rejected the argument and held that Hawaii was not required to “fill in the gaps” left by Congress as Congress has the power to regulate immigration and the conditions upon which aliens remain in the country. For many years, COFA migrants were eligible for Medicaid. In 1996, that changed when federal law rendered them ineligible. As a result, states with large COFA migrant populations have come under increasing pressure to tackle this humanitarian issue. Without federal dollars, states have shouldered the responsibility of providing care. 

“The Ninth Circuit decision showcases the dire need for immediate restoration of COFA eligibility for federally supported health programs,” said Kathy Ko Chin, APIAHF president and CEO. “The federal government is obligated to provide for the health of COFA migrants under long-standing treaties. This is demanded by America’s duty and commitment to the pacific territories. It is because Congress has not lived up to this commitment that COFA migrants are experiencing a crisis in access to needed care and states are left to cover the costs.” 

COFA migrants have a special status under U.S. law and are allowed to freely travel, reside and work in the U.S. as tax-paying residents. There are over 56,000 COFA migrants residing in the country. Many of them experience heath disparities and inequities as a result of conditions in their home countries and U.S. military activities in these jurisdictions. Despite working and paying taxes in the country, they are excluded from federally supported health programs. 

Rep. Hanabusa and Sen. Hirono have both introduced bills and amendments to restore access to critical health programs in the past. 


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From Joakim "Jojo" Peter with the Compact of Free Association Community Advocacy Network (COFACAN).  For more information or to join the COFACAN e-mail list, contact Jojo at joakim@hawaii.edu or contact us here at HealthyPacific.org.

Dear citizens of Oceania and beyond:

Brothers and sisters, we call upon your support and the wisdom of our ancestors as we navigate through difficult waters.  On April 1, 2014, the Ninth Circuit Court handed down its ruling on the Korab v. Fink case.  This case involves the issue of whether the state can enroll citizen residents from the Compact of Free Association nations (COFA) in the medically insufficient Basic Health Hawai'i healthcare safety net.  The Ninth Circuit ruled 2-1 in favor of the state, removing a preliminary injunction that stopped the implementation of Basic Health Hawai'i.  The ruling therefore allows the state to limit COFA citizens to Basic Health Hawai'i if it so chooses.

The Attorney General has promised that the state will not deny citizens from the Federated States of Micronesia, Republic of the Marshall Islands and the Republic of Palau equal access to healthcare in Hawai'i until the Korab vs. Fink case is finally resolved.  However, BHH remains on the books.  It is unclear what will happen when the case is ultimately decided, or when a new governor is elected.  We stand together in hope and prayer that the State of Hawai‘i will continue to support our COFA citizens’ healthcare as it has from the beginning.   We continue to advocate for the State of Hawaiʻi to remove Basic Health Hawai'i from Hawaiʻi Administrative Rules and repeal Haw. Admin. Rules Chapter 17-1722.3.

We will continue to work with all who support us to take a unified stand to hold the federal government accountable in addressing the healthcare needs of COFA taxpayers and residents of the United States.  To the people of the COFA nations and our supporters, we humbly ask for your support to stand with us in our effort to persuade the state leaders to not forsake us.  Let us trust that they will not forsake us.  We are working closely with the leadership of the State of Hawai‘i, the U.S. Congress and with our partners throughout the nation to support a federal solution to repair the injustice of the Welfare Reform Act of 1996. We believe that the State and U.S. government must act consistently with the spirit of our long relationship between the COFA nations and the United States.  Historical background, summaries and factsheets on the history of this issue and the Korab vs. Fink court case can be found at our website www.healthypacific.org.

These are our goals moving forward:

1.     Request a full panel ("en banc") review from the Ninth Circuit Court of Appeals.

2.     Maintain current levels of Med-QUEST eligibility for our COFA citizens.

3.     Repeal HAR Chapter 17-1722.3 (Basic Health Hawai'i) from the Hawai'i Administrative Rules (HAR).

4.     Work in partnership with the State of Hawai'i and our national supporters towards a federal solution to restore Medicaid benefits for COFA citizens.

Here are some important actions that we must accomplish together:

1.     Let COFA citizens know that they are still currently covered under MED-QUEST until the state of Hawai'i decides their next steps. 

2.     Ask your organization to write a public statement in support of the COFA community.  Your letter can request the state of Hawai'i to repeal HAR Chapter 17-1722.3.

3.     Participate in meetings and activities to get informed and involved.

4.     Visit the www.healthypacific.org website for the latest news and info, and help spread the word about action alerts and other important announcements (use the hashtag #samecanoe on social media). 

We have heard reports that COFA citizens on Med-QUEST may be receiving notices regarding changes to their health coverage.  These notices may be related to a new mandatory re-enrollment period that affects every Med-QUEST recipient.  This new enrollment period is in effect from April to October.  The letters for this re-enrollment should not be confused with the Basic Health Hawai'i Plan.  Please contact your local community health center, case worker or DHS office if you need help filling out this form, and know that you have the right to an interpreter or translator by law.  Ask if you don't understand!

Basic Health Hawai'i is not yet in effect; however, if anyone receives any official documents regarding this plan we urge these citizens to e-mail us at restoringjusticehi@gmail.com so that we can investigate and follow up on these reports.  Please continue to check the website www.healthypacific.org for updates and answers to questions that have been submitted.  This canoe is ours to paddle, together.  As islanders, we appreciate and welcome the generous support of our hosts and partners in Hawai'i who would join us in this struggle to maintain our common humanity.

In the wake of the Ninth Circuit opinion in Korab v. Fink,  which overruled a district court's preliminary injunction against the bare-bones and facially discriminatory healthcare plan known as Basic Health Hawaiʻi, the Hawaiʻi state Attorney General has now issued a press release indicating that the state will "make sure that COFA residents continue to have uninterrupted access to their health benefits while this lawsuit is pending."

See the Attorney Generalʻs press release here, or download a .pdf version by clicking here.

While this news comes as temporary relief for many COFA citizens who suffer from chronic illnesses requiring a much greater degree of healthcare than that afforded by Basic Health Hawaiʻi, others have noted that underlying concerns continue to remain unaddressed.

"Basic Health Hawaiʻi is still on the books," said Joakim "Jojo" Peter, a community leader and organizer who has sought to restore federal funding for COFA citizensʻ healthcare through Medicaid.  "While this governor has pledged his support and commitment to treating COFA citizens as equal human beings in terms of our healthcare safety net, it is an election year, and it could be less than a year before we have a new governor that has a different idea of how to treat our U.S. resident taxpayers, workers, students and family members, who just happen to be from the former U.S. trust territories now known as the COFA nations."

Despite petitions and other requests from community groups and supporters last year, Governor Abercrombie refused to drop the stateʻs appeal of the injunction against Basic Health Hawaiʻi, citing philosophical concerns with the district court's ruling, while at the same time assuring the COFA community that their sick and indigent family members would not be discriminated against under his administration.  Insofar as the governor has received some legal vindication of his philosophical concerns, community activists and leaders would prefer greater assurances than the promises made in the Attorney General's press release. 

"The governor got what he said he wanted," said Innocenta Sound-Kikku, community organizer and social worker at Kōkua Kalihi Valley.  "He said he wanted to appeal based on legal principles, and that he did not view our people's right to healthcare as any less than that of any other human being.  Now that he has a published Ninth Circuit opinion opening the door for states to discriminate against immigrants in access to healthcare, it is time for him to stand by his word and take Basic Health Hawaiʻi off the books." 

"We are continuing our years of work to uphold the federal government's ongoing responsibility to COFA citizens, and we will soon issue a statement of unity that any COFA community group may sign on to," said Peter.  "In the meantime, we respectfully request that the state and any others who are interested in our quest for justice to continue supporting ourselves and our families, as we seek a federal solution to provide for the healthcare needs of COFA citizens who reside in the U.S." 

PLEASE SEE BELOW FOR AN IMPORTANT ANNOUNCEMENT FROM JOAKIM PETER OF COFACAN.  More information will be forthcoming shortly.  

FOR DETAILS ON THIS FRIDAY'S MEETING, please contact us or e-mail restoringjusticehi@gmail.com. 

ALERT: Basic Health Hawai'i Preliminary Injunction Lifted

Earlier today, the Ninth Circuit Court of Appeals handed down its decision on the Basic Health Hawaiʻi case (Korab vs. Fink) after hearing the case over eighteen months ago. In its ruling, the court states that Hawaiʻi is not constitutionally obligated to provide medical care under its state run Medicaid programs for COFA citizens living in Hawaiʻi. This means that the state of Hawaiʻi is not necessarily in violation of the Equal Protection Clause of the U.S. Constitution by imposing Basic Health Hawaiʻi (BHH) on COFA citizens.  It also means that the preliminary injunction that was imposed on BHH is now lifted.  It is unclear now whether and/or when the state will reinstate BHH and endanger the health, well-being and lives of our families and community members as it has tried to do for almost 5 years.
 
We want to call on our partners and fellow community advocates who have been working hard on this issue to come together in a series of community conversations and dialogue so that we can come up with a plan of action to move forward on this issue. Our Micronesian communities need fair access to healthcare. This is an opportunity to make our unified voice heard and restore justice to our Micronesian citizens, not just in Hawaiʻi, but potentially throughout the United States. Now is the time for us to demonstrate the power we have in our community and in our strength and resilience as Pacific Islanders. Please come. Please forward this announcement and tell others.

Our first meeting will be held this Friday evening at 6 PM at Kuhio Park Terrace.  Details will be distributed shortly.  Please mark your calendars and stay tuned for more information.  

Oral arguments for Korab v. McManaman (appealing the district court's injunction against health care discrimination) have been rescheduled to June 18, 2012 in Pasadena, California.

For more information on actions surrounding this event, please e-mail restoringjusticehi@gmail.com